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8: Neurological Disorders
Terms in this set (55)
abnormally small head
• Developmental delay
• Intellectual disability
• Problems with movement and balance
• Feeding/swallowing disorders
• Hearing/vision loss
Microcephaly Causes and Risk Factors
• Severe malnutrition
• Interruption of brain blood supply
• Pregnancy infections: rubella, toxoplasmosis, Zika, etc.
Most occur in the first 72 hours after birth
Grades I and II are most common, and often there are no further complications. Grades III and IV are the most serious and may result in long-term brain injury to the infant. After a grade III or IV IVH, blood clots may form and block CSF causing hydrocephalus
Intraventricular Hemorrhage Grade I
bleeding occurs just in the germinal matrix
Intraventricular Hemorrhage Grade II
bleeding also occurs inside the ventricles, but they're not enlarged
Intraventricular Hemorrhage Grade III
ventricles are enlarged by the accumulated blood
Intraventricular Hemorrhage Grade IV
bleeding extends into the brain tissue around the ventricles
4 ventricles with narrow passages. CSF flows & exits cisterns at base of brain. CSF covers surface of brain & SC & reabsorbs into blood
if flow or absorption blocked, increase pressure against brain tissue
closed spaces that serve as reservoirs
brain tissue buoyant, cushion, shock absorber; deliver nutrients & remove waste; compensate for changes in intracranial blood volume
• An unusually large head
• A bulging or tense fontanel
• Poor feeding
• Eyes fixed downward (sunsetting of
• Deficits in muscle tone and strength
• Poor responsiveness to touch
• Poor growth
• Blurred or double vision, eyes fixed
• Abnormal enlargement of the head
• Sleepiness or lethargy
• Nausea or vomiting
• Unstable balance
• Poor coordination
• Poor appetite
• Urinary incontinence
• Behavioral and cognitive changes
• Change in personality
• Decline in school performance
• Delays with previously acquired skills
drains excess CSF & relieves cranial pressure
Death of the white matter of the brain due to softening of the brain tissue
-fetuses and newborns; premature at greatest risk
-caused by a lack of oxygen or blood flow to the area around ventricles of brain & results in death or loss of brain tissue.
-May accompany a hemorrhage in the periventricular- intraventricular area and can lead to cerebral palsy
-diagnosed by ultrasound of the head
Periventricular Leukomalacia risk for
motor disorders, delayed mental development,
coordination problems, and vision and hearing impairments
Hypoxic Ischemic Encephalopathy
reduction in the supply of oxygen to the brain and other organs with low blood flow to vital organs
-Occurs in the perinatal period, just before or after delivery
-caused by asphyxia
lack of oxygen
Lack of blood supply
refers to any condition that results from reduced blood and oxygen supply to the brain
suffocation; leading cause of infant fatalities in the US
can be subtle and may go unnoticed, or may be mistaken for daydreaming. 3 types. aware and may get upset or embarrassed
Seizure activity starts
1 area of brain & may spread to other regions
awareness retained (formerly known as simple partial seizures) Often proceeded by certain experiences, known as an aura. These may include visual, olfactory, or motor phenomena.
Focal dyscognitive seizures
awareness altered (formerly known as complex partial seizures). The person may appear confused or dazed, and may not be able to respond to questions or directions
Focal seizures evolving to a bilateral convulsive seizure
(formerly known as secondarily generalized tonic clonic seizures) Jerking activity may start in a specific muscle group and spread to surrounding muscle groups. Unusual activities may occur that are not under conscious control, such as lip smacking or other repetitive movements.
Result of abnormal activity in both hemispheres of the brain simultaneously. They all involve a loss of consciousness, and typically happen without warning. There are six main types. unaware & upset or tired afterward
produce a sustained contraction of the muscles of the limbs followed by their extension, along with arching of the back. The individual often stops breathing during the seizure
shaking of the limbs
a tonic component followed by a clonic component.
spasms of muscle groups
loss of muscle activity
often subtle, with a minor activity, such as eye blinking or a turn of the neck
Perinatal arterial ischemic stroke is the most common form of stroke in children. (AKA fetal stroke, prenatal stroke, and in utero stroke)
Risk peaks during the perinatal period
infancy to 19: 1/20,000
40% no symptoms & results noticed later
60% have specific symptoms (e.g. recurrent focal for 1st 3 days)
Pediatric Stroke may cause:
• cerebral palsy, usually with hemiplegia or hemiparesis
• speech and language difficulties
• sensory processing disorders
• visual and hearing loss
• cognitive impairment
• behavioral or emotional challenges, including ADD/ADHD
• Feeding/swallowing disorders
A group of diseases that cause progressive weakness and loss of muscle mass.
Abnormal genes (mutations) interfere with the production of proteins needed to form healthy muscle.
Muscular Dystrophy signs and symptoms
Main sign: progressive muscle weakness. Begin at different ages and in different muscle groups, depending on the type. Difficulties with breathing, swallowing, and speaking are common
-Non-progressive, permanent disorders of movement and postural development in children. 33% have significant cognitive impairment
-damage to brain in utero, at birth, or shortly after birth. May be caused by anoxia, hemorrhage, infections, or toxins
-most common type (affects 80%).
-Muscles are very tight (hypertonic). Scissor gait.
-Dysphagia and dysarthria
-Lesion in motor cortex or pyramidal tract
Dyskinetic (Athetoid) CP
-problems controlling movement. The movements are uncontrollable and can be slow and writhing or rapid and jerky.
-Sometimes the face and tongue are affected and the person has a hard time sucking, swallowing, and talking.
-Hypotonia/hypertonia is variable from day to day.
-lesion in basal ganglia or extrapyramidal tract
problems with balance and coordination, and fine motor. lesion in cerebellum
most common mixed form is spastic-dyskinetic
DIPG and focal glioma
DIPG diffuse intrinsic pontine glioma
fast-growing and spreads all through the brainstem. It is hard to treat and has a poor prognosis. Children under 3 years may have a better prognosis
slow-growing and is in one area of the brain stem. It is easier to treat than DIPG and has a better prognosis
types of brain tumors
-original symptoms of these tumors may not include dysphagia or speech problems, but surgical resection often damages cranial nerves and the brain stem. Any function controlled by the brainstem or cranial nerves may be affected
most common malignant brain tumor of childhood, and it accounts for about 20 percent of all childhood brain tumors
make up 19% of brain tumors
10% of childhood tumors
-Becomes apparent around 3-6 months of age
• Progressive cognitive and motor degeneration
• Includes seizures, hearing loss, paralysis
• Feeding and swallowing disorders become increasingly severe
• Death usually occurs in early childhood.
• Ashkenazi Jews (1/27 carrier), French Canadians, Louisiana Cajuns
• Ashkenazi Jews: 1/30 is a carrier (recessive)
• Disorder of the autonomic nervous system, affecting development and survival of sensory, sympathetic and some parasympathetic neurons
• Insensitivity to pain/heat/taste, inability to produce tears, poor growth, scoliosis, labile blood pressure, speech-language disorders, swallowing disorders, GI dysmotility
• Doesn't affect intelligence
Traumatic Brain Injury
Nondegenerative acquired brain injury resulting from a bump, blow, or jolt to the head or a penetrating head injury that disrupts normal brain function. Focal: Gunshot wound Diffuse: Shaken baby
Symptoms can vary depending on site of lesion, extent of damage to the brain, and the child's age or stage of development. In children is a chronic disease process rather than a one-time event, because symptoms may change and unfold over time
loss of consciousness for less than 30 minutes, an initial Glasgow Coma Scale (GCS) or Pediatric GCS of 13-15 after 30 minutes of injury onset, and PTA for not greater than 24 hours.
uncomplicated: no overt neuroimaging findings.
complicated: intracranial abnormalities (e.g., bruising or blood) on CT or MRI.
loss of consciousness and/or PTA for 1-24 hours and a GCS of 9-12
loss of consciousness for more than 24 hours and PTA for more than 7 days with a GCS of 3-8
THIS SET IS OFTEN IN FOLDERS WITH...
Pediatric Dyphagia Anatomy
9: Congenital Abnormalities
7: GI & Nutrition
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