Shake It Up
You are seeing an elementary school aged child who has repeated episodes of lapses in awareness with abrupt onset. EEG demonstrates 3 Hz spike and wave patterns, which is consistent with this diagnosis.
What are absence seizures?
This 'band-like' headache is often related to emotional stress.
What is a tension headache?
This is the most common type of brain tumor in children.
What is an astrocytoma?
Autoimmune disorder in which myelin in central nervous system is destroyed.
What is Multiple Sclerosis?
What gets wetter as it dries?
What is a towel?
A 3 year old presents following a generalized 10 minute tonic clonic seizure, a fever of 104.9F, and a family history of “seizures as a child.”
What are febrile seizures?
According to UpToDate, there are many prophylactic medications that can be used to prevent migraines in children. Name two.
-Cyproheptadine
-Propranolol (first-line)
-Flunarizine (class-CCB)
-Amitriptyline
-Topiramate
-Valproate
-Nutraceuticals
This is a glial cell tumor, and in children it is most commonly located in the fourth ventricle where tumor expansion leads to obstruction of CSF and increased ICP.
What is an ependymoma?
This type of fracture is associated with bilateral orbital ecchymoses ("racoon eyes”) and otorrhea.
What is a basilar skull fracture?
The person who makes it, sells it.
The person who buys it, doesn’t use it.
The person who uses it, doesn’t know he is using it.
What is a coffin?
One seizure after another without a period of recovery.
What is status epilepticus?
According to the AAP, there are many 'red flag' signs for headaches. Name one of these red flags.
-Headaches that wake the patient from sleep
-Early-morning headaches
-Progressively worsening emesis
-Cough/valsalva worsens it
-Presence of an abnormal neurological exam (Includes thorough fundoscopic evaluation to evaluate for papilledema)
-New and/or different type of headache from patient’s known baseline headaches
What is a medulloblastoma?
This syndrome is characterized by normal development until age 6-18 months followed by regression of speech, loss of purposeful hand movements, development of stereotypical movements, and gait abnormalities.
What is Rett syndrome?
I have six faces and twenty-one eyes, yet I cannot see.
What is a die?
When it is a supratentorial tumor, this type of tumor classically presents with seizures, weakness, and sensory changes.
What is a pilocytic astrocytoma?
A triad is seen with increased ICP, and it includes these three things.
What are hypertension, bradycardia, and irregular respirations?
This arises in the sella turcica, and symptoms include visual field defects and hormonal deficiencies due to compression of surrounding structures.
What is a craniopharyngioma?
This diagnosis has a triad of fever, headaches, and focal neurological changes, such as seizures.
What is a brain abscess?
You use a knife to slice my head,
And weep beside me when I’m dead.
What is an onion?
In the early 1900's, Alfred Hauptmann first used this medication to sedate his patients so he could sleep at night. He incidentally discovered it's anti-epileptic properties.
What is phenobarbital?
According to UpToDate and Pediatrics in Review, this vitamin can be given as migraine prophylaxis for patients whose families would rather try supplements before conventional drugs, and has a side-effect of discoloring urine.
What is Vitamin B2, or riboflavin?
A cancer whose common symptoms include anorexia and abdominal pain and distention but elevated urinary catecholamines (HVA and VMA) are pathognomonic.
What is a neuroblastoma?
This syndrome is characterized by the sudden or gradual development of aphasia, or the inability to understand or express language, between the ages of 2 and 8. This syndrome is also characterized by an abnormal EEG, especially during sleep, with about 70% of children having seizures.
What is Landau-Kleffner syndrome?
Two sisters we are, one is dark and one is fair,
In twin towers dwelling we’re quite the pair,
One from land and one from sea,
Tell us truly, who are we?
What is salt and pepper?