By Peter L. Heilbroner MD PhD;Glenn Castaneda MD
Geared to basic care practitioners, this simple, useful advisor specializes in review and administration of common pediatric neurologic stipulations. insurance comprises regimen problems comparable to complications, ADHD and faculty difficulties, autism, seizures, developmental delays, behavioral difficulties, tics, adjustments in gait, and dizziness, in addition to neurologic stipulations encountered within the emergency room. The authors deal with daily questions resembling easy methods to distinguish severe from non-serious stipulations, even if to reserve an EEG or MRI, what to do while a baby doesn't reply to medicine, and the way to debate universal matters with mom and dad. each one bankruptcy comprises average case studies.
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Extra info for Pediatric Neurology: Essentials for General Practice
If the patient has a headache accompanied by a stiff neck, maneuvers to elicit Kernig sign and Brudzinski sign (see Chapter 1) should be performed. Percussion of the maxillary, and in older children and adolescents, frontal sinuses may elicit tenderness, suggesting sinusitis. In rare cases, a cranial bruit from an arteriovenous malformation is detected by auscultation over the mastoids or orbits. If the patient’s pain is primarily in the temporal area, he may be asked to open and close the mandible while the temporomandibular joint is palpated to feel for a jaw click (a sign of temporomandibular joint syndrome).
1). WHAT CAUSES HEADACHES? There are no sensory nerve endings in the brain. Therefore, brain tumors cause headaches only when they grow large enough to stretch the painsensitive cerebral blood vessels and meninges or when they obstruct the normal flow of cerebrospinal fluid and cause hydrocephalus. ” This practice is not based on a good understanding of the pathogenesis of headaches and, given the high cost of brain imaging studies as well as the possibility of unnecessary radiation exposure, should be discouraged.
In contrast, diseases of the lower motor neuron cause weakness, decreased muscle tone, and diminished reflexes. These signs are present immediately following an injury and persist indefinitely. , the spinal cord), the motor nerve root, the nerve, or the neuromuscular junction. Typical presentations would include the flaccid lower extremities of a child with a history of lumbar meningomyelocele (Fig. 8), the weakness and areflexia associated with Guillain-Barré syndrome (Fig. 9), and the flaccid arm of a baby born with a brachial plexus injury (Erb palsy; Fig.