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What are some key words for tension headaches?
band-like w/no visual/ GI/or neuro sx
worst HA of my life = ?
SAH
AM headache = ?
brain tumor
Headache affected by position changes = ?
Pseudotumor cerebri
What imaging should we get for ped w/tension HA?
none
What imaging should we get for ped w/migraines?
1. CT scan. Then tx medically. 2. MRI if tx not effective (controversial)
What is a good first-line agent for HA\\\'s?
NSAIDS
What are the two most common forms of recurrent HA\\\'s?
1. Tension 2. Migraines
What are some typical findings of migraines?
1. Unilateral 2. Throbbing 3. GI sx 4. Dizziness/vertigo 5. Photophobia/visual auras 6. Paroxysmal/recurrent
T/F Daily NSAID prophy for HA\\\'s is a good idea.
False (can cause rebound HA\\\'s)
Midrin is effective for both chronic HA types and is approved for use in what age of peds?
>8 y/o
What antimetic is most commonly used for chronic HA\\\'s due to low risk of dystonic reactions?
Promethazine
\\\"Triptans are considered \\\"\\\"safe\\\"\\\" down to what age?\\\"
12 y/o
What Ergotamine regimen is often used for severe inpt HA abortion therapy?
DHE & Reglan
What 3 meds are used for HA prophy?
1. Propanolol 2. TCA 3. Valproic Acid**
Propanolol should be avoided in what types of pts?
Asthmatics and diabetics
What are the types of generalized seizures?
1. T-C 2. Absence
What are the types of partial seizures?
1. Simple 2. Complex
What types of seizures have post-ictal phase?
1. T-C 2. Complex
What types of seizures begin diffusely?
Generalized seizures (T-C/ absence/ Febrile)
What types of seizures begin focally?
Partial (Simple/Complex)
How do we tx T-C seizures in a pt < 1 y/o?
Phenobarb
How do we tx T-C seizures in pts > 1 y/o?
Valproic acid or carbamazepine
What type of partial seizure has altered consciousness?
Complex**
What metabolic things can cause seizures?
1. Hyperk+ 2. Hypoglycemia 3. Hyper/Hypo calcemia**
Crying as soon as pt wakes up indicates what type of seizure?
Pseudoseizure
What is the age range for absence seizures?
5-15 y/o
What EEG finding is KEY for absence seizures?
3 Hz spike and dome/wave**
\\\"What type of seizure is associated w/a \\\"\\\"Jacksonian March\\\"\\\" (a generalizing progression)?\\\"
Simple**
What type of seizure has increased risk of recurrence?
Partial**
What are the doses for Phenytoin and Phenobarbitol?
1. Phenytoin 10-20mg/kg IV over 5-20 min 2. Phenobarbitol 5-20mg/kg IV**
What is the imaging modality of choice for detecting brain lesions in a subacute setting?
MRI
When should we perform a CT __before__ an LP in a febrile pt w/seizures?
1. Focal neuro signs 2. Papilledema
Does a neg EEG rule out seizures?
No
Does an EEG need to be repeated if positive for seizures?
no
What causes febrile seizures?
Rate change of temp** (not max temp)
What are the types of febrile seizures?
1. Simple (>90%) 2. Complex (<10%)
Febrile seizures are related to what two vaccinations?
1. DTaP 2. MMR
What are the features of simple FEBRILE seizures?
1. Generalized T-C 2. <15 min 3. Only occurs 1/24 hrs
What are the features of complex FEBRILE seizures?
1. Focal features 2. >15 min 3. Occurs 2+/24 hrs
What is the most common age range for febrile seizures?
12-18 mos**
When should we give benzo for febrile seizures?
5 min**
We should always r/o out ..................... in a pt w/febrile seizures.
Meningitis**
When should we do LP to r/o meningitis in a ped?
If unsure of r/o or if ped < 12 mos**
What type of febrile seizures is more likely to have recurrent seizures?
Complex**
What are the RF\\\'s for febrile seizures indicating recurring seizures in the future?
1. Recurrent 2. Complex 3. <12 mos
What things affect the anterior horn cells?
1. Spinal motor atrophy (Werdnig-Hoffman syndrome) 2. Polio**
What causes of weakness/hypotonia affect the peripheral nerves?
1. Guillian-Barre Syndrome 2. Charcot-Marie-Tooth Dz 3. Tick paralysis**
What things cause hypotonia/weakness by affecting the neuromuscular junction?
1. Myasthenia Gravis 2. Botulism
What causes death in polio?
Diaphragmatic paralysis**
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