Week 2: Neurological Disorders in the Pediatric Patient

Vocabulary-style flashcards covering key terms and definitions from the pediatric neurology notes (meningitis, seizures, Reye syndrome, brain injury, diagnostics, vaccines, and treatments).

Meningitis

Inflammation of the meninges that can be viral (aseptic) or bacterial (septic); rapid initiation of care improves prognosis; viral is usually less severe and managed with supportive care, while bacterial requires antibiotics and contact precautions.

Viral (aseptic) meningitis

Meningitis caused by viruses (e.g., CMV, HSV, enteroviruses, HIV, arboviruses); management is supportive; CSF is typically clear with normal/slightly elevated WBC, normal glucose, and normal to mildly elevated protein; Gram stain is negative.

Bacterial (septic) meningitis

Meningitis caused by bacteria (e.g., Neisseria meningitidis, Hib, E. coli); contagious; prognosis depends on speed of treatment; CSF is typically cloudy with elevated WBC and protein, decreased glucose, and positive Gram stain.

Meningococcal disease

Meningitis caused by Neisseria meningitidis; can progress to meningococcemia with petechial/purpuric rash; requires immediate medical attention.

Reye syndrome

Life-threatening syndrome of liver dysfunction and cerebral edema, often following viral illness when aspirin is used; peak incidence with influenza; treated with supportive care, Vitamin K, and mannitol; prognosis improves with early recognition.

Seizure

Transient, abnormal electrical activity in the brain resulting in altered behavior or consciousness.

Seizure precautions

Safety measures during a seizure: protect from injury, maintain airway, place in side-lying, do not restrain, remove restrictive items, time the seizure, do not place anything in the mouth, prepare for oxygen, and stay with the child.

Generalized tonic-clonic seizure

Seizure involving both hemispheres with a tonic phase (stiffness) and clonic phase (jerking), possible loss of consciousness and incontinence.

Absence seizure

Brief loss of consciousness (about 5–10 seconds) with a blank stare and automatisms; no prolonged postictal state; can immediately resume activity.

Myoclonic seizure

Brief, sudden muscle contractions that may be symmetric or asymmetric; usually no prolonged postictal state and may involve face or trunk.

Atonic (akinetic) seizure

Sudden loss of muscle tone lasting seconds, often leading to a drop attack and subsequent confusion.

Infantile spasms

Peak incidence at 3–7 months; sudden, brief muscle contractions; may include flexed head or extended arms; treatment can include ACTH; may involve LOC.

Febrile seizure

Seizure associated with fever (38.9–40°C); typically 15–20 seconds; management includes acetaminophen or ibuprofen, tepid baths, and light clothing.

Electroencephalogram (EEG)

Test that records brain electrical activity to identify seizure origin; can be performed during sleep or with stimulation; a normal EEG does not rule out seizures; caffeine should be avoided before testing.

Ketogenic diet

High-fat, very low-carbohydrate, low-protein diet used to reduce seizures in some children (often under 8) by inducing ketosis.

Vagal nerve stimulator (VNS)

Implantable device that stimulates the vagus nerve to reduce seizure frequency; used as adjunct therapy.

Intracranial pressure (ICP)

Pressure inside the skull; elevated with brain injury; management includes avoiding factors that raise pressure, maintaining head midline, and minimizing stimulation.

Mannitol

Osmotic diuretic used to reduce cerebral edema and lower ICP; monitor for changes in mental status indicating electrolyte imbalance.

Basilar skull fracture

Fracture at the base of the skull; signs include CSF leakage from nose/ears, raccoon eyes, Battle sign; often requires antibiotics.

Concussion

Mild traumatic brain injury; graded I–III; symptoms include headache, nausea, amnesia; initial management focuses on ABCs; risk of second-impact syndrome; symptoms may appear later.

Skull fracture types

Linear, depressed, comminuted, basilar, open, and growing fractures.

Concussion signs and symptoms

Headache, nausea, vomiting, photophobia, dizziness, fatigue, mood changes, irritability, sleep disturbance; may have a dazed appearance.

Petechiae and purpura (meningococcemia)

Rashes (petechiae/purpura) associated with meningococcal disease; indicate urgent assessment and treatment.

Pneumococcal conjugate vaccine (PCV)

Vaccine that reduces risk of bacterial meningitis caused by Streptococcus pneumoniae.

Haemophilus influenzae type B vaccine (Hib)

Vaccine that reduces risk of Hib meningitis.

Lumbar puncture (LP)

Diagnostic procedure to obtain cerebrospinal fluid for analysis; not performed if increased ICP due to risk of brain herniation.

CSF findings – bacterial meningitis

Cloudy CSF with elevated WBC and protein, decreased glucose; Gram stain typically positive.

CSF findings – viral meningitis

Clear CSF with normal glucose, normal to slightly elevated protein, and slightly elevated WBC; Gram stain negative.