Pediatric Neurology - Unit 2: Traumatic Brain Injury, Seizures, Meningitis/Encephalitis, Cerebral Palsy

Vocabulary flashcards covering key terms and definitions from pediatric neurology topics in the provided notes.

Seizure

A sudden abnormal discharge of neurons in the cerebral cortex that alters function or behavior.

Seizure Disorder

A condition of recurrent seizures; typically brief (often ≤1–2 minutes) and often provoked by external factors; less than one-third are true epilepsy.

Tonic-Clonic Seizure

Seizure with tonic stiffening followed by clonic jerking; may have an aura; onset can be at any age; usually lasts ≤1–2 minutes and may include incontinence.

Aura

A subjective warning sensation or perception that precedes some seizures.

Postictal Phase

The recovery period after a seizure, characterized by altered consciousness, drowsiness, confusion, or headache.

Febrile Seizure

Most common seizure type in young children, triggered by rapid fever rise; typically tonic-clonic and brief (<1–2 minutes); usually before age 3; evaluate to rule out infection.

Infantile Spasms

Tonic-like spasms occurring in infancy (3–12 months) indicating cerebral defect; associated with developmental delay and poor prognosis.

Absence Seizure

Brief lapses in awareness (often <10 seconds) with stares; no falls; may occur many times daily and often remits with adolescence.

Atonic Seizure

Drop attack with sudden loss of muscle tone leading to collapse; consciousness typically returns quickly; helmet safety advised.

Myoclonic Seizure

Sudden, brief, involuntary muscle jerks, usually affecting arms/legs; often on one side; typically without loss of consciousness.

Status Epilepticus

Continuous or repeatedly lasting seizures (often >30 minutes) or any seizure lasting >5 minutes; medical emergency requiring rapid intervention.

Seizure Precautions

Safety measures to prevent injury during seizures: side-lying, bed low, padded rails, ready O2 and suction, IV access, emergency meds.

Ketogenic Diet

High-fat, very-low-carbohydrate diet used to reduce seizures; ratio around 4:1 fat to protein/carbs; induces ketosis; requires medical supervision.

Vagus Nerve Stimulator (VNS)

Surgically implanted device delivering electrical impulses to the vagus nerve; magnet can transiently reduce seizure frequency; may affect swallowing or breathing during stimulation.

Corpus Callosotomy

Surgical disconnection of the corpus callosum to limit seizure spread, especially generalized and drop attacks; can be partial or complete with substantial effect.

Two-Stage Brain Mapping

Pre-surgical procedure with surface electrodes to map seizure activity; patient awake to identify functional areas; guides tissue removal.

Cannabidiol (CBD)

Non-psychoactive cannabis-derived product used for seizures; not THC; dosing standards lacking; possible interactions with antiseizure meds; long-term effects uncertain.

Baclofen

GABA-B receptor agonist used to treat spasticity; can be taken orally or delivered intrathecally via pump; no reversal agent; overdose signs include lethargy and respiratory depression.

Bacterial Meningitis

Inflammation of the meninges caused by bacteria; more virulent with higher mortality and risk of permanent sequelae; rapid onset.

Meningitis Pathophysiology

White blood cells accumulate in CSF causing obstruction and edema; often follows URI or otitis; may involve brain.

HIB (Haemophilus influenzae type B)

A leading cause of bacterial meningitis in children under 5 before vaccination; now greatly reduced due to vaccines; potential for deafness, brain damage.

Meningococcal Meningitis

Meningitis caused by Neisseria meningitidis; high mortality and risk of severe sequelae; vaccine recommended; common in adolescence.

Kernig’s Sign

Pain or resistance when extending the knee with the hip flexed; indicates meningitis.

Brudzinski’s Sign

Involuntary flexion of the hips and knees when the neck is passively flexed; indicates meningitis.

Spinal Tap (Lumbar Puncture)

Procedure to collect CSF for analysis; used to diagnose meningitis/encephalitis; assesses WBC, pathogens, and glucose/protein levels.

Nuchal Rigidity

Stiff neck; a common sign of meningitis.

Viral Meningitis

Meningitis caused by viruses (e.g., enteroviruses, measles/mumps), typically milder; usually self-limited in 7–10 days; antibiotics not required.

Encephalitis

Inflammation of brain tissue; may be caused by viruses or other agents; presents with altered mental status, fever, seizures, and focal deficits.

Cerebral Palsy (CP)

Non-progressive, permanent motor disability due to early brain injury affecting movement and posture.

CP Types

Spastic, Dyskinetic/Athetoid, Hypotonic, Ataxic, and Mixed forms.

Selective Dorsal Rhizotomy

Surgical procedure to reduce spasticity in CP by cutting select dorsal nerve rootlets.

Botox (Botulinum Toxin) for CP

Injections to reduce focal spasticity in CP by weakening overactive muscles.

GCS (Children’s)

Modified pediatric Glasgow Coma Scale used to assess consciousness in children.

COAT (Children’s Orientation and Amnesia Test)

Tool to assess orientation and memory after brain injury; repeated approximately every 8 hours.

Modified Coma Scale (MCCS)

Pediatric coma scale assessing eye opening, verbal, and motor responses.

Return to Play after Concussion

Return-to-play guidelines require medical clearance after asymptomatic rest and gradual resumption, with no symptoms for at least 24 hours of rest.

Post-Concussion Brain Rest

Limit cognitive/screen time and physical activity; gradually resume as symptoms resolve after injury.

Developmental Considerations after TBI

Possible delayed/cognitive development, memory and emotional changes, behavioral changes, and higher risk of later risk behaviors.

Concussion Safety (Helmets)

Prevention strategy emphasizing helmet use and protective equipment to reduce risk of head injury.

NPO (Nothing by Mouth)

NPO status means nothing by mouth until fully alert or cleared by physician.

Aseptic Nursing Care in Meningitis/Encephalitis

Isolation, seizure precautions, quiet/dark environment, careful medication administration, and monitoring for signs of increased ICP.

ICP Monitoring and S/s

Monitoring for signs of increased intracranial pressure (headache, vomiting, changes in LOC, pupil changes) in CNS infections and injury.