Cerebral palsy
RF	·       Prematurity ·       Low birth weight
Clx	·       Delayed motor milestones ·       Abnormal tone, hyperreflexia ·       Comorbid seizures, intellectual disability
Dx	·       MRI of the brain ·       ± Electroencephalography ·       ± Genetic/metabolic testing
Tx	·       Physical, occupational, speech therapies ·       Nutritional support ·       Antispastic medications

Febrile SZ 👶🏼
S/S	·       Bilateral Tonic-Clonic generalized ·       ⏰: <15 m + Return to baseline quickly ·       Do not Rx within 24 h
Dx	Age: 3m – 6ys No previous AFEBRlLE seizure No meningitis or encephalitis No acute metabolic cause
Tx	·       Abortive therapy (≥5 minutes) → Rectal Diazepam ·       Reassurance + Discharge pt (do not admit) + No need for F/U ·       Hospitalize only for 24h if did not return to baseline
Prog	ⓝ development/intelligence -30% risk of recurrence <5% risk of epilepsy

Acute causes of hemiplegia in 👶🏼
Cause	?
SZ	·       Hx of generalized limb jerking or LOC ·       Postictal confusion or Todd temporarily paralysis
Intracranial hemorrhage	·       Hx of trauma &/or bleeding disorder ·       Signs of ⤴️ICP (vomiting, bradycardia) ·       + imaging
Ischemic stroke	·       Hx of prothrombotic disorder (eg, antithrombin Ill deficiency) or cardiac disease (eg, patent ·       foramen ovale) ·       FND (eg, hemiplegia, aphasia, ataxia)
Hemiplegic migraine	·       Onset in adolescence & often positive FHx ·       Hx of headache & visual aura ·       Sx self-resolve

Bacterial Meningitis in 👶🏼 (age >1 month)
Clx	·       Fever ·       ⤴️ ICP (Headache, vomiting, AMS) ·       Meningeal irritation (nuchal rigidity)
Dx	·       CBC + Blood cultures ·       LP for CSF analysis
Tx	·       IV vancomycin & ceftriaxone OR cefotaxime ·       Dexamethasone for Haemophi/us influenzae type b meningitis
Comp	·       Intellectual/behavioral disabilities ·       Hearing loss ·       Cerebral palsy ·       Epilepsy

Sturge-Weber Syndrome
Path	Mutation in GNAQ gene
S/S	·       Port wine stain (trigeminal N /CN VI/V2) ·       Leptomeningeal capillary-venous malformation ·       SZ ± hemiparesis ·       Intellectual disability ·       Visual field defects ·       Glaucoma
Dx	MRI with contrast
Tx	·       Laser therapy ·       Antiepileptic drugs ·       Intraocular pressure reduction

Tuberous Sclerosis
?	·       Neurocutaneous autosomal dominant  ·       hamartin and tuberin form a complex that down regulates mTOR signaling ·       when this pathway is 🆎 → hamartomas everywhere
S/S	·        infantile spasms in infants and have hypsarrhythmias on EEG ·       SZ ·       Arrhythmia 2ndary to cardiac rhabdomyomas
Dx	Genetic testing
Tx	Corticotropin for infantile spasms