Pediatric Neurology
Core concepts
Know the approach to seizures - febrile, focal, generalized, and status epilepticus - and the indications for EEG and neuroimaging. Understand headache red flags, the differential for acute weakness (Guillain-Barré, transverse myelitis, stroke), and the recognition of meningitis and encephalitis. Master developmental milestones and the evaluation of global developmental delay, cerebral palsy, and neuromuscular disorders. Know the basics of raised intracranial pressure and the signs of a space-occupying lesion.
Traps
Questions test whether you can distinguish a simple febrile seizure (generalized, under 15 minutes, once in 24 hours) from a complex one, and whether you over-investigate. Another trap is missing headache red flags (morning vomiting, papilledema, focal signs, worsening with Valsalva). Do not forget that a child with acute flaccid weakness and areflexia suggests Guillain-Barré, not a central lesion.
Worked example
A 6-year-old with fever and a 5-minute generalized seizure has a simple febrile seizure; the correct management is reassurance and antipyretics, without routine EEG, neuroimaging, or antiepileptic therapy. The trap is ordering extensive workup for a benign, self-limited event.
Rule of thumb
In a child with a seizure, first stabilize airway, breathing, and circulation; then ask whether the event was provoked (fever, metabolic, toxic) before labeling it epilepsy.