Rotation in pediatric neuro

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st2205

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Considering doing a peds rotation after doing an adult one. Just wanted to inquire in what the bread and butter of peds may be and what kind of things would generally be expected to get out of a few weeks in the field.

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You'll see seizures, seizures, and more seizures. If you're "lucky" you might see a sad case of Rett's syndrome or another neurodegenerative condition but 99% of the work they do is seizure-related. I think the peds neuro rotation is best on the inpatient side -- you'll get more variety and get to experience how they work-up new patients as opposed to clinic where it will be increasing keppra doses by 20% all day long.
 
If you're at a busy place you'll likely see seizures and headaches as the most common. However many pediatric neurologists subspecialize so depending on who you're working with you'll see the bread and butter of their niche.

Inpatient consults are good (especially in the NICU), but the bulk of pediatric neurology practice is outpatient, so that's where you'll get the best feel of the field.
 
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I seem to recall a lot of parents trolling for a PANDAS diagnosis so they wouldn't have to face the fact that their kid is nuts. At CHB I also recall a bunch of "abdominal migraine" consults.

Seizures. Neurologic regression. Mito disease.
 
Outpatient was a huge proportion of seziure and headaches (usually migraine). Expect certain specialty clinics too (for example neurofibromatosis).

I echo the above for inpatient, which seemed to be new seizures, possible seizures, breakthrough seizures, more exotic heritable conditions and their workup, strokes, neuro-oncology, and a certain number of kids with special needs whose parents just need a break for a weekend and bring their kids in for "neurologic worsening" or "seizures" on Friday afternoon.

While this may be quite commentator-specific, I found that my pediatric neurology rotations tended to me among the most depressing rotations that I completed in all of residency, fellowship, and even the final two years of medical school combined.

The people who do this branch of medicine for a living deserve major props in my book.
 
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