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Pediatrics
Quiz #3 Neurology Section
79
Other
Graduate
07/28/2009

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Term
meningomyelocele
Definition
Spinal cord that lies uncovered by skin or bone on the infant's back. Results in total paralysis and loss of sensation in the legs and incontinence of bowel and bladder
Term
meningocele
Definition
The spinal canal and cystic meninges are exposed on the back but the underlying spinal cord is anatomically and functionally intact
Term
spina bifida occulta
Definition
The skin of the back is apparently intact, but defects of the underlying bone or spinal canal are present.
Term
spina bifida
Definition
Defective closure of the caudal neural tube at the end of week 4 of gestation results in anomalies of the lumbar and sacral vertebrae or spinal cord
Term
Macrocephaly
Definition
A head circumference above the 97th percentile
Term
macrocrania
Definition
increased skull thickness
Term
hydrocephalus
Definition
enlargement of the ventricles
Term
megalencephaly
Definition
enlargement of the brain
Term
craniosynostosis
Definition
premature closure of one or more skull sutures
Term
Microcephaly vera
Definition
An autosomal recessive disorder that produces severe hypoplasia of the frontal regions of the brain and skull
Term
Holoprosencephaly
Definition
Failure of the primary cerebral vesicle to divide and expand laterally and often is associated with midline facial defects (hypotelorism, cleft lip, and cleft palate).
Term
The most common form of familial mental retardation?
Definition
fragile X syndrome
Term
Name this disorder: Caused by the loss of the maternal allele (of the long arm of chromosome 15) and is manifested by severe mental retardation, intractable seizures, tremulousness, a characteristic facies, and a happy external demeanor?
Definition
Angelman syndrome
Term
Name this Disorder: Caused by the loss of the paternal allele (of the long arm of chromosome 15) and is manifested by severe hypotonia and feeding difficulties in the neonatal period, cryptorchidism, small hands and feet, mild mental retardation, and almond-shaped eyes.
Definition
Prader-Willi syndrome
Term
The difference in phenotype, depending on loss of the maternal or paternal allele is called _____?
Definition
Imprinting
Term
phakomatosis
Definition
means "mother spots" or "birthmarks" and refers to tuberous sclerosis and neurofibromatosis
Term
Neurofibromatosis type 1 (NF1) is also known as ______?
Definition
von Recklinghausen disease
Term
café au lait spots, axillary freckling, cutaneous neurofibromas, and iris hamartomas (Lisch nodules) are the cardinal features of ________?
Definition
neurofibromatosis
Term
An autosomal dominant disorder, characterized by hamartomas in many organs, especially the brain, eye, skin, kidneys, and heart?
Definition
TUBEROUS SCLEROSIS
Term
Name this disorder: The classic clinical features are facial angiofibromas (formerly referred to as adenoma sebaceum), mental retardation, and severe epilepsy?
Definition
TUBEROUS SCLEROSIS
Term
Name this disorder: characterized by angiomas of the leptomeninges overlying the cerebral cortex in association with an ipsilateral facial port-wine nevus that, at the least, covers part of the forehead and upper eyelid?
Definition
Sturge-Weber syndrome
Term
Meningomyelocele in the fetus is suggested by an elevated?
Definition
alpha-fetoprotein
Term
spina bifida malformation can be prevented in many cases by _____ administration to the pregnant mother?
Definition
Folate
Term
Hydranencephaly
Definition
A condition in which the brain presumably develops normally, but then is destroyed by an intrauterine, probably vascular, insult.
Term
Schizencephaly
Definition
characterized by symmetric bilateral clefts within the cerebral hemispheres that extend from the cortical surface to the ventricular cavity
Term
Lissencephaly
Definition
Indicates smooth brain with absence of sulcation
Term
macrogyria
Definition
the gyri are few in number and too broad
Term
polymicrogyria
Definition
the gyri are too many and too small
Term
Name this malformation: diagnosed on the basis of the classic triad: complete or partial agenesis of the vermis, cystic dilation of the fourth ventricle, and enlarged posterior fossa?
Definition
Dandy-Walker malformation
Term
Degenerative diseases that affect gray matter are called _____?
Definition
Neuronal Degenerative Disorders; Examples: Mucopolysaccharidoses = types I H (Hurler syndrome), II (Hunter syndrome), III (Sanfilippo syndrome), Niemann-Pick disease, Tay-Sachs disease, Rett syndrome, & Mitochondrial diseases
Term
Degenerative diseases that affect the white matter are called _______?
Definition
Leukodystrophies; Ex: Metachromatic leukodystrophy, Krabbe disease, & Adrenoleukodystrophy
Term
Gray matter degeneration (neuronal degeneration) is characterized early by ____ & _____?
Definition
dementia and seizures
Term
Name this Disease: Sphingomyelin accumulating in foam cells of the reticuloendothelial system of the liver, spleen, lungs, and bone marrow. It also distends neurons of the brain.
Definition
Niemann-Pick disease (Gray Matter Degenerative Diseases)
Term
Name this disease: occurs commonly in Jewish children of eastern European background. Accumulation of GM2 ganglioside in cerebral gray matter and cerebellum. Infants are normal until 6 months of age, when they develop listlessness, irritability, hyperacusis, intellectual retardation, and a retinal cherry-red spot.
Definition
Tay-Sachs disease
Term
Name this Disease: common neurodegenerative disorder affecting only females with onset at about 1 year of age. It is characterized by the loss of purposeful hand movements and communication skills; social withdrawal; gait apraxia; stereotypic repetitive hand movements that resemble washing, wringing, or clapping of the hands; and acquired microcephaly.
Definition
Rett syndrome
Term
Name this Disease: Infants appear normal until late in the first year of life, when they exhibit psychomotor retardation, choreoathetosis, spasticity, and severe self-mutilation.
Definition
Lesch-Nyhan syndrome (causes excess uric acid)
Term
Name this disease: A treatable, degenerative condition that exhibits signs of cerebellar and basal ganglia dysfunction. It is an autosomal recessive inborn error of copper metabolism
Definition
Wilson disease
Term
Name this disease: degenerative inherited CNS disease primarily involving the periaqueductal region of the brainstem, caudate, and putamen. Symptoms usually begin before 2 years of age and consist of hypotonia, feeding difficulties, respiratory irregularity, weakness of extraocular movements, and ataxia.
Definition
Subacute necrotizing encephalomyelopathy, or Leigh disease
Term
a state of unresponsive unconsciousness is called _____?
Definition
Coma
Term
arousal is mediated by the ____?
Definition
RAS (reticular activating system)
Term
In ________ respiration, a period of hyperventilation with a crescendo-decrescendo pattern alternates with a shorter period of apnea
Definition
Cheyne-Stokes respiration
Term
A diverse group of clinical entities associated with abnormal excessive, exaggerated, chaotic, or explosive movements of voluntary muscles?
Definition
dyskinesias
Term
a hyperkinetic, rapid, unsustained, irregular, purposeless, nonpatterned movement?
Definition
Chorea
Term
a hyperkinetic, slow, coarse, writhing movement that is more pronounced in distal muscles?
Definition
Athetosis
Term
a hyperkinetic, brief flexion contraction of a muscle group, resulting in a sudden jerk?
Definition
Myoclonus
Term
a hyperkinetic, rhythmic, oscillatory movement caused by simultaneous contractions of antagonistic muscles?
Definition
Tremor
Term
rapid, purposeless, involuntary, stereotyped movements and typically involve the face, eyes, shoulder, and arm?
Definition
Tics
Term
An acute postinfectious demyelinating disorder of the spinal cord, treated with high-dose steroids?
Definition
Transverse myelitis
Term
Name this disease: Infants who are affected at birth or who become weak within the first several months of life usually progress to flaccid quadriplegia with bulbar palsy, respiratory failure, and death within the first year of life (Hint: think SMA)
Definition
Werdnig-Hoffmann disease; A mild form of the illness = Kugelberg-Welander syndrome
Term
Name this disease: an acute enteroviral illness with prodromal vomiting and diarrhea associated with an aseptic meningitis picture during which the patient experiences the evolution of an asymmetric flaccid weakness as groups of anterior horn cells become infected?
Definition
Poliomyelitis
Term
A postinfectious autoimmune peripheral neuropathy that often occurs after a respiratory or gastrointestinal infection?
Definition
Guillain-Barré syndrome
Term
Infection with Campylobacter jejuni is associated with a severe form of this illness?
Definition
Guillain-Barré syndrome
Term
Name this disease: A genetic polyneuropathy characterized by weakness and wasting of distal limb muscles. Complaints begin in the preschool years with pes cavus deformity of feet and weakness of the ankles with frequent tripping?
Definition
HMSN, commonly called Charcot-Marie-Tooth disease
Term
Name this disease: May begin in the teenage years with the onset of ptosis, diplopia, ophthalmoplegia, and weakness of extremities, neck, face, and jaw. Fluctuating and generally minimal symptoms are present on awakening in the morning and gradually worsen as the day progresses or with exercise?
Definition
Myasthenia Gravis
Term
Name this disease: At about 2 to 3 years of age, boys develop an awkward gait and an inability to run properly. Examination shows firm calf hypertrophy and mild to moderate proximal leg weakness exhibited by a hyperlordotic, waddling gait and inability to arise from the ground easily?
Definition
Duchenne Dystrophy; A milder form of the disease is called Becker muscular dystrophy (starts later and progresses more slowly)
Term
Gower sign:
Definition
A child arises from a lying position on the floor by using his arms to "climb up" his legs and body
Term
A disorder of muscle relaxation. Patients grasp onto an object and have difficulty releasing their grasp, "peeling" their fingers away slowly
Definition
Myotonic Dystrophy
Term
Name this disease: The clinical features include progressive proximal muscle weakness coupled with dermatologic features, including erythematous rash around the eyes (heliotrope) and plaques on the knuckles (Gottron rash) and on the extensor surfaces of the knees, elbows, and toes.
Definition
Dermatomyositis
Term
The most useful neurodiagnostic test in distinguishing seizure from nonepileptic paroxysmal disorders?
Definition
EEG
Term
recurrent, unprovoked seizures is called _____?
Definition
Epilepsy
Term
Usually begins between ages 5 and 10 years. They are usually focal motor seizures involving the face and arm and tend to occur only during sleep or on awakening in more than half of patients. Symptoms commonly include abnormal movement or sensation around the face and mouth with drooling and a rhythmic guttural sound.
Definition
Benign focal epilepsy, also known as rolandic epilepsy
Term
Are brief contractions of the neck, trunk, and arm muscles, followed by a phase of sustained muscle contraction lasting 2 to 10 seconds. Spasms occur most frequently when the child is awakening from or going to sleep?
Definition
Infantile spasms (West syndrome)
Term
defined as ongoing seizure activity for greater than 20 minutes or repetitive seizures without return of consciousness for greater than 30 minutes?
Definition
Status epilepticus
Term
present at birth, ______ assess the functional integrity of the brainstem and basal ganglia?
Definition
primitive reflexes
Term
defined as a liveliness with which an arm or leg springs back to its original position after passive stretching and release?
Definition
Recoil
Term
Lack of coordination of movement is:
Definition
Ataxia
Term
A 24 month old infant has a (+) Babinski response on her left foot. What does this indicate?
Definition
The Babinski response is a sign of corticospinal tract dysfunction. The plantar response is consistently flexor (toes down) after 18 months of age. This reflex is unreliable in the neonates (<18mo old) except when asymmetric because the "normal" response at this age varies.
Term
To identify by touch an object placed in the hand is called?
Definition
stereognosis
Term
To identify by touch a number written in the hand is called?
Definition
graphesthesia
Term
When do most of the CNS reflexes of infancy appear and disappear?
Definition
Most appear at birth & disappear at 4-6 months.
Term
When do the parachute and landau reflexes appear and disappear?
Definition
Both appear at 6-8 months. Parachute never disappears. Landau disappears at 15-24 months.
Term
Which reflex is this: Tactile stimulus about the mouth results in the infant's mouth pursuing the stimulus?
Definition
Rooting reflex
Term
Which reflex is this: Sudden head extension causes extension followed by flexion of the arms and legs?
Definition
Moro reflex
Term
Which reflex is this: with the infant sitting, tilting to either side results in extension of the ipsilateral arm in a protective fashion?
Definition
Parachute
Term
Which reflex is this: with the infant supine, turnign of the head results in ipsilateral extension of the arm and leg in a "fencing" posture?
Definition
Tonic neck
Term
Overshooting or undershooting of a target is termed?
Definition
Dysmetria
Term
_____ respirations are irregularly irregular and indicate dysfunction of the low-brainstem medulla?
Definition
Gasping
Term
The normal volume of CSF is approx _____ in neonates & _____ in adults?
Definition
50ml in neonates & 150ml in adults
Term
Tx of hydrocephalus:
Definition
Acetazolamide and/or placing a shunt
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