Peds neuro

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Amygdarya

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I know this may be a little esoteric, but does anyone have any suggestions regarding good resources for pediatric neurology rotation? Any books? Articles? Web sites? What topics should I focus on (aside from, say, seizure disorders, development and developmental issues, genetic - aka metabolic and mitochondrial - diseases, childhood brain tumors)? Anything to pay particular attention to in a pediatric neuro patient? Any specific approaches/modifications for peds neuro exam?

Thank you!

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My neuro rotation was peds neuro and all I did was Blueprints Neuro + UWorld neuro + UptoDate whatever diagnoses I was seeing in clinic. Peds neuro is a lot of seizures and pseudoseizures plus the things you listed, if you hit all those you should be pretty good for the majority of cases you see.

I saw a lot of neurofibromatosis and tuberous sclerosis patients, but my med school institution was kind of a hub for that so perhaps my experience was skewed. But those are two high yield diseases to know about. Also movement disorders, and neuromuscular disorders like dystrophies.
 
My neuro rotation was peds neuro and all I did was Blueprints Neuro + UWorld neuro + UptoDate whatever diagnoses I was seeing in clinic. Peds neuro is a lot of seizures and pseudoseizures plus the things you listed, if you hit all those you should be pretty good for the majority of cases you see.

I saw a lot of neurofibromatosis and tuberous sclerosis patients, but my med school institution was kind of a hub for that so perhaps my experience was skewed. But those are two high yield diseases to know about. Also movement disorders, and neuromuscular disorders like dystrophies.
Thanks Ismet! I will read up on the disorders you mentioned.
It seems like there are a lot of seizures +/- metabolic disorders +/- random post-infection neuro phenomena etc here. And so Blueprints and UptoDate it is :)

This is (the first half of) my core neuro rotation as well, and I haven't done peds yet, so the realization that things differ *a lot* in little humans depending on their age (especially neurodevelopmentally!) was quite refreshing today :D I also realized that I had no clue how to do any kind of exam, let alone neuro exam, on kids. I'm prerounding on a 12-month old with seizures for the first time tomorrow, and I'm trying to figure out what kind of exam I should do (BigRedBeta's link is just perfect!)/what kind of information I should look for. I'm fairly comfortable prerounding on adults now after 6 months of practice, but with kids, especially infants, I feel like I'm back to square one. Reading Bates pediatric exam for the first time ever.
 
Thanks Ismet! I will read up on the disorders you mentioned.
It seems like there are a lot of seizures +/- metabolic disorders +/- random post-infection neuro phenomena etc here. And so Blueprints and UptoDate it is :)

This is (the first half of) my core neuro rotation as well, and I haven't done peds yet, so the realization that things differ *a lot* in little humans depending on their age (especially neurodevelopmentally!) was quite refreshing today :D I also realized that I had no clue how to do any kind of exam, let alone neuro exam, on kids. I'm prerounding on a 12-month old with seizures for the first time tomorrow, and I'm trying to figure out what kind of exam I should do (BigRedBeta's link is just perfect!)/what kind of information I should look for. I'm fairly comfortable prerounding on adults now after 6 months of practice, but with kids, especially infants, I feel like I'm back to square one. Reading Bates pediatric exam for the first time ever.

Haha yeah, kids aren't just little adults! The exam, especially the neuro exam, is a different animal in kids, usually requires some tricks and a lot of patience! Gets easier as the kid gets older, and then you can kind of make a game out of it. And for babies and little kids, always save the "scary" stuff for last, like eyes, ears, reflexes or else they're not going to cooperate again after they're upset. Get to know the baby reflexes, when you expect them to appear and disappear so that you know what's normal and abnormal. And developmental milestones are a major part of the exam even through toddlerhood, but these get more familiar as you see more kids.

For a 12 month old, they're likely to have "stranger danger" and may not be cool with you being all up in their face. Unless you're absolutely required to do so, don't wear your white coat. If parent can hold baby while you do the exam, and maybe talk to them for a little bit at a distance, that may help the kid warm up to you. I'll often approach an apprehensive 1 year old by handing them the bell of my stethoscope - they're usually curious enough to take it and hold it and once they see that it's not going to hurt them, they're usually okay with me guiding the bell to listen to their heart, lungs, and abdomen. Or you can demonstrate on mom/dad. If you can get a little toy, you can get their attention and test stuff like EOM and visual fields. I have a little rubber duck keychain that lights up and quacks that works perfectly for this ($3 at CVS!). Bates should have you covered for all the parts of the infant/pediatric exam. One component that I would forget about at first was checking the anterior fontanelle, then getting a sense of what's normal and what's sunken, full, and bulging. Hopefully you'll be seeing a lot of babies so you can get a lot of practice!
 
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Haha yeah, kids aren't just little adults! The exam, especially the neuro exam, is a different animal in kids, usually requires some tricks and a lot of patience! Gets easier as the kid gets older, and then you can kind of make a game out of it. And for babies and little kids, always save the "scary" stuff for last, like eyes, ears, reflexes or else they're not going to cooperate again after they're upset. Get to know the baby reflexes, when you expect them to appear and disappear so that you know what's normal and abnormal. And developmental milestones are a major part of the exam even through toddlerhood, but these get more familiar as you see more kids.

For a 12 month old, they're likely to have "stranger danger" and may not be cool with you being all up in their face. Unless you're absolutely required to do so, don't wear your white coat. If parent can hold baby while you do the exam, and maybe talk to them for a little bit at a distance, that may help the kid warm up to you. I'll often approach an apprehensive 1 year old by handing them the bell of my stethoscope - they're usually curious enough to take it and hold it and once they see that it's not going to hurt them, they're usually okay with me guiding the bell to listen to their heart, lungs, and abdomen. Or you can demonstrate on mom/dad. If you can get a little toy, you can get their attention and test stuff like EOM and visual fields. I have a little rubber duck keychain that lights up and quacks that works perfectly for this ($3 at CVS!). Bates should have you covered for all the parts of the infant/pediatric exam. One component that I would forget about at first was checking the anterior fontanelle, then getting a sense of what's normal and what's sunken, full, and bulging. Hopefully you'll be seeing a lot of babies so you can get a lot of practice!
This is very helpful (also for my upcoming peds rotation), thank you!
 
"Handbook of Pediatric Neurology" By Katherine B. Sims. This handbook was a blessing when I did Ped Neuro as a resident. You could probably see if your library has electronic access or get the kindle version if you don't want to buy the book. I will say that it does come in handy during that rotation.
 
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"Handbook of Pediatric Neurology" By Katherine B. Sims. This handbook was a blessing when I did Ped Neuro as a resident. You could probably see if your library has electronic access or get the kindle version if you don't want to buy the book. I will say that it does come in handy during that rotation.
Thank you, that book looks great! Just ordered a used copy on Amazon, which may not get to me by the end of the rotation but should be useful in the future since I'm seriously considering Psychiatry vs Neurology.
 
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