Pediatric Neurology
What to master
Know seizure classification and the difference between febrile seizures (simple vs complex) and epilepsy. Understand status epilepticus management-benzodiazepine first, then second-line agents. Master headache red flags: morning vomiting, focal signs, papilledema, and worsening with Valsalva. Know developmental neuroanatomy relevant to motor milestones and primitive reflex disappearance. Understand cerebral palsy (static, non-progressive) versus neurodegenerative disease (progressive loss). Know meningitis and encephalitis presentations and the role of lumbar puncture after excluding raised intracranial pressure.
Concepts that recur
Simple febrile seizure: 6 months–5 years, generalized, under 15 minutes, once in 24 hours-no routine workup or long-term treatment. Complex febrile seizure: focal, prolonged, or recurrent within 24 hours. Neonatal seizures are often subtle-lip smacking, cycling, apnea. Hydrocephalus presents with increasing head circumference, sunset eyes, and irritability. Migraine in children may be bilateral and shorter than in adults. Know Guillain-Barré syndrome (ascending weakness, areflexia, albuminocytologic dissociation).
Traps
Examiners test lumbar puncture timing in suspected raised intracranial pressure-obtain imaging first if focal signs or altered consciousness. Another trap is febrile seizure workup-routine EEG and imaging are not indicated for simple febrile seizures. Beware headache attributed to stress when red flags are present.
Rule of thumb
Status epilepticus: benzodiazepine first, then a second-line antiepileptic; always check glucose. For any child with a first seizure, ask about fever, trauma, toxins, and metabolic disease.