Neonatal Neurology and Developmental Care Flashcards

Which medication is first-line for treating morphine-refractory seizures in neonates after phenobarbital failure?

Answer: Levetiracetam or phenytoin/fosphenytoin

Levetiracetam or phenytoin/fosphenytoin are commonly used second-line agents when phenobarbital fails to control neonatal seizures.

When assessing pain in a non-verbal ventilated neonate, which validated tool is most appropriate?

Answer: Neonatal Infant Pain Scale (NIPS) or PIPP

NIPS (Neonatal Infant Pain Scale) or PIPP (Premature Infant Pain Profile) assess behavioral and physiologic pain indicators in non-verbal neonates.

Nonnutritive sucking (NNS) during tube feeding in premature infants is beneficial because it:

Answer: Promotes GI maturation, weight gain, and oral feeding transition

NNS stimulates GI hormones, promotes suck-swallow coordination, and is associated with faster transition to full oral feeding and improved weight gain.

Which reflex in a neonate is assessed by stroking the lateral aspect of the foot from heel to toe?

Answer: Babinski (plantar) reflex

The Babinski reflex is elicited by stroking the lateral sole; normal neonates show dorsiflexion of the big toe and fanning of the other toes.

Which condition is characterized by white matter injury in premature neonates occurring in a watershed distribution?

Answer: Periventricular leukomalacia (PVL)

PVL occurs in the arterial border zones around the lateral ventricles, making premature white matter vulnerable to ischemia-reperfusion and excitotoxic injury.

A neonate has an abnormal head ultrasound showing bilateral periventricular echogenicity. What follow-up imaging is recommended?

Answer: Serial head ultrasound and MRI at term-corrected age

Serial head ultrasound monitors lesion evolution, and MRI at term-corrected age provides definitive assessment of white matter injury extent and neurodevelopmental prognosis.