By Tommy Stödberg MD, Claes G. Frostell MD, PhD, Björn A. Larsson MD, PhD (auth.), Thomas Sejersen, Ching H. Wang (eds.)
This booklet presents techniques for overview and remedy within the zone of acute pediatric neurology; those are provided didactically with widespread use of illustrations and algorithms. Chapters within the first a part of the ebook speak about featuring signs of acute neurological stipulations. the second one a part of the e-book covers significant parts of acute pediatric neurology and every of those chapters has 3 key parts: description of featuring indicators; advised checks; and suggested interventions.
Acute Pediatric Neurology offers an obtainable, clinically targeted consultant to aid physicians within the emergency ward or extensive care unit in judgements on analysis and healing interventions in all significant acute pediatric neurological diseases.
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Extra info for Acute Pediatric Neurology
The second is to maintain the vital signs by ensuring the airway, breathing, and circulation, the ABCs. The third is to immediately treat the seizure, especially if prolonged, and the fourth is to identify and treat the precipitating cause, if possible. The last is to determine the AED needed to prevent subsequent seizure activity. Especially in regard to recognizing a seizure, it is important to know that the clinical manifestations of a seizure may vary. The classification of seizures and the epilepsy syndromes guides management.
Cause of coma. Electrographic, but clinically silent, seizures are common in critically ill and often heavily sedated patients in intensive care, independent of etiology . Therefore continuous EEG (cEEG) monitoring, if available, is preferred at least initially to ensure good sensitivity. Most would agree that electrographic nonconvulsive seizures should be ambitiously treated in the critically ill child, but details are under debate and more research needed. In addition to detecting epileptic seizure activity, EEG visualizes cortical electric activity and thus reflects the level of unconsciousness (or anesthesia).
Convulsive SE (CSE) is relatively easy to identify because of the overt convulsions, whereas nonconvulsive seizures or nonconvulsive SE (NCSE) may have no outward convulsive movements, and EEG is needed to identify the electrographic seizure activity. In a study of NCSE, subtle motor activity and ocular movement abnormalities were present in 75 and 50 %, respectively, in patients with NCSE . Nonconvulsive seizures or SE must also be considered in a patient with known epilepsy who presents with altered awareness.