Sepsis is a life-threatening condition that can develop from an infection. It occurs when the body's response to an infection damages its own tissues. The document discusses sepsis in children, including definitions, epidemiology, pathophysiology, clinical features, investigations, treatment guidelines, and future directions. Mortality from sepsis is high in developing countries, around 50% compared to 2-10% in industrialized nations. Young infants, especially those born premature or with low birth weight, are most at risk. Timely treatment of infection source and administration of antibiotics and fluids can help reduce mortality from this condition.
- Neonatal seizures, febrile seizures, CNS infections, and strokes are common neurological conditions seen in pediatrics.
- Common etiologies of neonatal seizures include hypoxic-ischemic encephalopathy, congenital CNS anomalies, intracranial hemorrhage, and electrolyte or metabolic abnormalities.
- Evaluation involves history, physical exam, lab studies, and neuroimaging like EEG, ultrasound, CT, or MRI depending on the situation.
- Treatment involves anticonvulsants tailored to the specific condition, with phenobarbital, phenytoin, and lorazepam as first line options for status epilepticus.
1) Paraplegia is defined as impairment of motor function in the lower extremities, which can be caused by lesions in the cerebral cortex, spinal cord, nerves supplying the lower limbs, or muscles directly.
2) Complete paralysis of both lower limbs is known as paraplegia, while partial paralysis is called paraparesis. Lesions that transect motor tracts cause spastic paraplegia or quadriplegia with heightened reflexes.
3) Determining the level and type of spinal cord lesion is important for diagnosis and involves assessing sensory loss, motor weakness, reflex changes, and associated symptoms.
semiological classification of seizure, localisation and lateralisation Vinayak Rodge
This document discusses seizure semiology and classification. It begins with an overview of seizure types including motor, aura, dialeptic, autonomic, and special seizures. Motor seizures are further divided into simple and complex seizures. Aura symptoms are described and their localizing value discussed. Dialeptic seizures include absence and complex partial seizures. Autonomic seizures must have objective evidence of autonomic changes. Special seizures include atonic, astatic, negative myoclonic, akinetic, aphasic, and hypomotor seizures. Lateralizing signs and their localizing value are then reviewed. Finally, generalized and focal epilepsies are contrasted, and features of frontal lobe seizures are outlined.
Febrile seizures are the most common type of seizure seen in children under 5 years old. While they can be alarming for parents, the majority are benign and have an excellent prognosis. Febrile seizures are classified as simple or complex based on features like duration, recurrence, and onset. Investigations are usually not needed but may include lumbar puncture in young infants to rule out infection. Treatment focuses on controlling fever and preventing prolonged seizures. Parents should be reassured that febrile seizures rarely cause neurological issues and most children outgrow them. Recurrence risks are highest for those under 18 months, with family history or complex initial seizures. Prophylaxis may be used to prevent recurrence but does not impact later epilepsy risk.
Sjögren's syndrome is an autoimmune disease that causes inflammation of the exocrine glands, most commonly the salivary and lacrimal glands, leading to dry eyes and dry mouth. It exists as either a primary form that occurs alone or a secondary form associated with other connective tissue diseases like rheumatoid arthritis. Diagnosis involves evaluating symptoms of dry eyes and dry mouth along with tests like salivary gland biopsy, salivary flow tests, and lab tests for autoantibodies. Treatment focuses on managing symptoms while complications can involve other organ systems.
This document discusses various conditions that can mimic epilepsy in children. It notes that epilepsy is sometimes underdiagnosed or overdiagnosed due to unusual symptom presentations or epilepsy mimics. Several common epilepsy mimics are described in detail for different age groups, including breath holding spells in infants, tics and parasomnias in children, and syncope in adolescents. Tables compare features of epilepsy mimics to epileptic seizures during sleep and wakefulness. In conclusion, the document emphasizes taking an age- and state-based approach to differentiating epilepsy from conditions it may imitate.
Sepsis is a life-threatening condition that can develop from an infection. It occurs when the body's response to an infection damages its own tissues. The document discusses sepsis in children, including definitions, epidemiology, pathophysiology, clinical features, investigations, treatment guidelines, and future directions. Mortality from sepsis is high in developing countries, around 50% compared to 2-10% in industrialized nations. Young infants, especially those born premature or with low birth weight, are most at risk. Timely treatment of infection source and administration of antibiotics and fluids can help reduce mortality from this condition.
- Neonatal seizures, febrile seizures, CNS infections, and strokes are common neurological conditions seen in pediatrics.
- Common etiologies of neonatal seizures include hypoxic-ischemic encephalopathy, congenital CNS anomalies, intracranial hemorrhage, and electrolyte or metabolic abnormalities.
- Evaluation involves history, physical exam, lab studies, and neuroimaging like EEG, ultrasound, CT, or MRI depending on the situation.
- Treatment involves anticonvulsants tailored to the specific condition, with phenobarbital, phenytoin, and lorazepam as first line options for status epilepticus.
1) Paraplegia is defined as impairment of motor function in the lower extremities, which can be caused by lesions in the cerebral cortex, spinal cord, nerves supplying the lower limbs, or muscles directly.
2) Complete paralysis of both lower limbs is known as paraplegia, while partial paralysis is called paraparesis. Lesions that transect motor tracts cause spastic paraplegia or quadriplegia with heightened reflexes.
3) Determining the level and type of spinal cord lesion is important for diagnosis and involves assessing sensory loss, motor weakness, reflex changes, and associated symptoms.
semiological classification of seizure, localisation and lateralisation Vinayak Rodge
This document discusses seizure semiology and classification. It begins with an overview of seizure types including motor, aura, dialeptic, autonomic, and special seizures. Motor seizures are further divided into simple and complex seizures. Aura symptoms are described and their localizing value discussed. Dialeptic seizures include absence and complex partial seizures. Autonomic seizures must have objective evidence of autonomic changes. Special seizures include atonic, astatic, negative myoclonic, akinetic, aphasic, and hypomotor seizures. Lateralizing signs and their localizing value are then reviewed. Finally, generalized and focal epilepsies are contrasted, and features of frontal lobe seizures are outlined.
Febrile seizures are the most common type of seizure seen in children under 5 years old. While they can be alarming for parents, the majority are benign and have an excellent prognosis. Febrile seizures are classified as simple or complex based on features like duration, recurrence, and onset. Investigations are usually not needed but may include lumbar puncture in young infants to rule out infection. Treatment focuses on controlling fever and preventing prolonged seizures. Parents should be reassured that febrile seizures rarely cause neurological issues and most children outgrow them. Recurrence risks are highest for those under 18 months, with family history or complex initial seizures. Prophylaxis may be used to prevent recurrence but does not impact later epilepsy risk.
Sjögren's syndrome is an autoimmune disease that causes inflammation of the exocrine glands, most commonly the salivary and lacrimal glands, leading to dry eyes and dry mouth. It exists as either a primary form that occurs alone or a secondary form associated with other connective tissue diseases like rheumatoid arthritis. Diagnosis involves evaluating symptoms of dry eyes and dry mouth along with tests like salivary gland biopsy, salivary flow tests, and lab tests for autoantibodies. Treatment focuses on managing symptoms while complications can involve other organ systems.
This document discusses various conditions that can mimic epilepsy in children. It notes that epilepsy is sometimes underdiagnosed or overdiagnosed due to unusual symptom presentations or epilepsy mimics. Several common epilepsy mimics are described in detail for different age groups, including breath holding spells in infants, tics and parasomnias in children, and syncope in adolescents. Tables compare features of epilepsy mimics to epileptic seizures during sleep and wakefulness. In conclusion, the document emphasizes taking an age- and state-based approach to differentiating epilepsy from conditions it may imitate.
This document discusses the Babinski sign and plantar reflex. It begins by defining the plantar reflex as the response to stimulation of the sole of the foot. It then describes Babinski's original 1896 observation of the pathological plantar reflex known as the Babinski sign, in which dorsiflexion of the toes occurs. The rest of the document covers the physiology and assessment of the plantar reflex and Babinski sign, variations, mimickers, and upper limb equivalents. It emphasizes that a positive Babinski sign indicates pyramidal tract dysfunction and underlying neurological disease.
This document discusses approaches to macrocephaly and microcephaly. Macrocephaly is defined as a head circumference over 2 standard deviations above the mean, while microcephaly is under 3 standard deviations below the mean. Causes of macrocephaly include genetic factors, hydrocephalus, tumors, and metabolic disorders. Hydrocephalus results from abnormal CSF accumulation and can be obstructive or communicating. Microcephaly can be primary/genetic due to syndromes or secondary from infections, drugs, or hypoxia that impact brain development prenatally or in the first two years. Evaluation and treatment depends on the underlying cause.
Neonatal sepsis is a clinical syndrome of bloodstream infection in infants under 4 weeks of age, characterized by systemic signs of infection. It can be early onset (under 72 hours) or late onset (over 72 hours) sepsis. Common causes are bacteria like E. coli, S. aureus, and K. pneumoniae transmitted from the mother or hospital environment. Risk factors include prematurity, prolonged rupture of membranes, maternal infection, and low birth weight. Symptoms vary but can include lethargy, poor feeding, respiratory distress, and abnormal vital signs. Diagnosis involves blood, CSF, and urine cultures with supportive tests like complete blood count. Treatment involves identifying the source, administering parenteral antibiotics, and
This document summarizes the cranial nerves IX through XII that innervate the head and neck region. It describes the motor, sensory and autonomic functions of the glossopharyngeal (CN IX), vagus (CN X), accessory (CN XI) and hypoglossal (CN XII) nerves. It also discusses lesions of these nerves and their resulting clinical presentations. Pseudobulbar and true bulbar palsy are defined based on whether the lesion is upstream or within the motor nuclei of these cranial nerves. Common causes of each condition are provided.
The document discusses several clinical reflex tests used in neurological examinations. It provides details on how to perform Babinski's sign, Hoffman's sign, Wartenberg's sign, and the abdominal reflex. Babinski's sign assesses pyramidal tract function in the lower extremities. A positive result indicates dysfunction. Hoffman's sign similarly evaluates the upper extremities. Wartenberg's sign reveals flexor hypertonia in the arms. The abdominal reflex is a spinal reflex that can be absent in upper motor neuron conditions. Performing these reflexes properly provides clinical information on a patient's neurological status.
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
This document provides an overview of acute gastroenteritis. It defines acute diarrhea and lists common causes in both adults and children, including viral, bacterial, and parasitic infections as well as some non-infectious conditions. The document outlines the clinical approach to a patient with acute diarrhea including taking a thorough history and physical exam. It notes key indications for testing stool or blood. The management section discusses rehydration therapy including oral rehydration solutions, diet, use of anti-diarrheal medications, antimicrobial therapy, and probiotics.
A patient with streptococcal pharyngitis develops tender red bumps along her entire tibia. This is most likely erythema nodosum, which presents as pretibial tender erythematous nodules and can be associated with streptococcal infections.
A 3-day-old infant presents with a rash containing eosinophils. This is likely to be erythema toxicum neonatorum, a benign and self-resolving rash of newborns.
A 4-year-old boy develops abdominal pain, vomiting, knee pain and a petechial rash on his legs. He is diagnosed with Henoch-Schönlein purpura,
A floppy infant refers to reduced muscle tone and loose joints. The main features of a floppy infant are hypotonia, abnormal postures, and delayed motor milestones. A thorough physical exam assesses tone in the limbs, neck, and trunk through various tests like leg traction and arm recoil. The cause may be central nervous system related like cerebral palsy or metabolic conditions. Alternatively, it could indicate a peripheral neuropathy, myopathy, or neuromuscular junction pathology. Further workup may include blood tests, electrophysiology, muscle biopsy, and genetic testing to determine the specific condition. Timely diagnosis and management including rehabilitation can help improve outcomes.
This document contains a template for documenting personal and medical history for a newborn baby. It includes sections for personal details, presenting complaints, obstetric history organized by trimester of pregnancy, natal history, postnatal history, immunization history, family history, socioeconomic history, physical exam findings organized by system, assessment of gestational age, anthropometry measurements, and neurological exam including reflexes. The physical exam section provides details to assess for any dysmorphisms or abnormalities.
This document provides an overview of stroke syndromes caused by occlusion of arteries in the brain. It describes the classification of strokes as affecting either the anterior or posterior circulation. For anterior circulation strokes, it details the territories supplied and clinical syndromes caused by occlusion of the middle cerebral artery, anterior cerebral artery, and anterior choroidal artery. For posterior circulation strokes, it outlines the arteries involved and syndromes related to vertebral, basilar, and posterior cerebral artery occlusions such as lateral medullary syndrome and lateral pontine syndromes. Diagrams are included to illustrate the vascular anatomy and clinical findings.
This document provides an overview of evaluating patients presenting with dizziness or vertigo. It discusses classifying vertigo based on duration, whether it is central or peripheral in origin, and non-vestibular causes. A thorough history and physical exam including neurologic and vestibular testing is outlined. Key diagnostic tests like Dix-Hallpike, caloric testing, and VEMP are described. Common causes of vertigo like BPPV, vestibular neuronitis, and Meniere's disease are highlighted based on presenting symptoms, exam findings, and test results.
(1) Spinal muscular atrophy (SMA) is a genetic disease caused by a mutation or deletion of the SMN1 gene on chromosome 5, resulting in degeneration of spinal cord motor neurons and progressive muscle weakness. (2) SMA Type 1, also called infantile SMA or Werdnig-Hoffman disease, has an onset
Hydrancephaly is a rare condition where the brain's cerebral hemispheres are absent and the cranial vault is filled with fluid. It results from occlusion of the bilateral internal carotid or middle cerebral arteries, leading to liquefaction of brain tissue in the affected arterial territories while sparing structures supplied by the posterior circulation. Diagnostically, hydrancephaly is characterized by the absence of the cortical mantle with normal brain parenchyma replaced by liquefied tissue lined by leptomeninges, while the cerebellum and brain stem are usually intact. The prognosis is poor, with most infants dying within the first year of life.
A 58-year-old female presented with sudden onset blurred vision and right-sided weakness and was found to have an acute left thalamic infarction; imaging showed no vascular abnormalities but she had an incidental finding of a possible atrial septal defect; she was treated with tPA and made a full recovery with no residual deficits.
The document discusses two cases of bedwetting or nocturnal enuresis in children. It then provides background information on nocturnal enuresis, including definitions, prevalence, risk factors, types, pathophysiology and diagnostic criteria. Nocturnal enuresis is defined as involuntary voiding during sleep after a child reaches 5 years of age. It affects 15-20% of children at age 5 and 5-10% at age 10. Boys are more commonly affected than girls. Family history is positive in about 50% of cases. The causes of nocturnal enuresis include delayed maturation of the brain mechanisms that inhibit bladder contractions during sleep, small bladder capacity, nocturnal excess urine production,
1. The document discusses various causes of myelopathy including infectious, autoimmune, demyelinating, paraneoplastic, metabolic, toxic, and vascular etiologies.
2. Clinical features, imaging, cerebrospinal fluid analysis and differential diagnosis for different types of myelopathies are provided with key distinguishing factors between compressive vs non-compressive, inflammatory vs non-inflammatory myelopathies.
3. Specific conditions like acute transverse myelitis, neuromyelitis optica, HIV myelopathy, syphilitic myelopathy, and acute disseminated encephalomyelitis are summarized in detail.
This document provides an overview of the examination of the nervous system. It discusses the central nervous system including the brain and spinal cord, as well as the peripheral nervous system with the somatic and autonomic divisions. The brain is examined in detail including the forebrain, midbrain, hindbrain, and structures like the thalamus and hypothalamus. Broadmann's areas and the functions of different lobes of the cerebrum are outlined. The effects of lesions in various areas are also summarized.
The document provides information on pediatric stroke. It defines stroke and describes the different types that can occur in children, including arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke. Risk factors and potential causes are discussed for each type. Clinical features may include seizures, weakness on one side of the body, difficulty speaking or swallowing. Diagnosis involves neuroimaging like CT or MRI along with other lab tests. Treatment focuses on neuroprotection, recanalization of blocked vessels, and anticoagulation or antiplatelet therapies to prevent further clotting.
AFP is a clinical syndrome characterized by rapid onset of weakness or paralysis in one or more limbs. Common causes of AFP include Guillain-Barré syndrome, poliomyelitis, transverse myelitis, and traumatic neuritis. For polio eradication efforts, all AFP cases must be reported and investigated within 48 hours by collecting two stool specimens at least 24 hours apart and analyzing them for the presence of wild poliovirus. Isolating wild poliovirus from stool specimens would classify the case as confirmed polio.
patofisiologi dan penatalaksanaan wus (pathophysiology and management of wake...vita kusuma
Vita Kusuma Rahmawati memberikan ringkasan tentang patofisiologi dan penatalaksanaan Wake Up Stroke (WUS). WUS didefinisikan sebagai stroke dengan gejala yang diketahui saat bangun tidur antara pukul 00.01-06.00 atau 06.00-12.00. Studi menunjukkan 40-50% stroke terjadi pagi hari dan WUS terjadi pada 8-18% kasus stroke. Hipotesis etiologi WUS meliputi variabilitas tekanan darah nokturnal dan
This document discusses the Babinski sign and plantar reflex. It begins by defining the plantar reflex as the response to stimulation of the sole of the foot. It then describes Babinski's original 1896 observation of the pathological plantar reflex known as the Babinski sign, in which dorsiflexion of the toes occurs. The rest of the document covers the physiology and assessment of the plantar reflex and Babinski sign, variations, mimickers, and upper limb equivalents. It emphasizes that a positive Babinski sign indicates pyramidal tract dysfunction and underlying neurological disease.
This document discusses approaches to macrocephaly and microcephaly. Macrocephaly is defined as a head circumference over 2 standard deviations above the mean, while microcephaly is under 3 standard deviations below the mean. Causes of macrocephaly include genetic factors, hydrocephalus, tumors, and metabolic disorders. Hydrocephalus results from abnormal CSF accumulation and can be obstructive or communicating. Microcephaly can be primary/genetic due to syndromes or secondary from infections, drugs, or hypoxia that impact brain development prenatally or in the first two years. Evaluation and treatment depends on the underlying cause.
Neonatal sepsis is a clinical syndrome of bloodstream infection in infants under 4 weeks of age, characterized by systemic signs of infection. It can be early onset (under 72 hours) or late onset (over 72 hours) sepsis. Common causes are bacteria like E. coli, S. aureus, and K. pneumoniae transmitted from the mother or hospital environment. Risk factors include prematurity, prolonged rupture of membranes, maternal infection, and low birth weight. Symptoms vary but can include lethargy, poor feeding, respiratory distress, and abnormal vital signs. Diagnosis involves blood, CSF, and urine cultures with supportive tests like complete blood count. Treatment involves identifying the source, administering parenteral antibiotics, and
This document summarizes the cranial nerves IX through XII that innervate the head and neck region. It describes the motor, sensory and autonomic functions of the glossopharyngeal (CN IX), vagus (CN X), accessory (CN XI) and hypoglossal (CN XII) nerves. It also discusses lesions of these nerves and their resulting clinical presentations. Pseudobulbar and true bulbar palsy are defined based on whether the lesion is upstream or within the motor nuclei of these cranial nerves. Common causes of each condition are provided.
The document discusses several clinical reflex tests used in neurological examinations. It provides details on how to perform Babinski's sign, Hoffman's sign, Wartenberg's sign, and the abdominal reflex. Babinski's sign assesses pyramidal tract function in the lower extremities. A positive result indicates dysfunction. Hoffman's sign similarly evaluates the upper extremities. Wartenberg's sign reveals flexor hypertonia in the arms. The abdominal reflex is a spinal reflex that can be absent in upper motor neuron conditions. Performing these reflexes properly provides clinical information on a patient's neurological status.
1. Acute flaccid paralysis (AFP) is defined as sudden onset of weakness or paralysis over 15 days in patients under 15 years old. It suggests involvement of the lower motor neuron complex.
2. Common causes of AFP include poliomyelitis, Guillain-Barré syndrome, transverse myelitis, botulism, and non-polio enteroviruses. Clinical features and investigations can help differentiate between these causes.
3. Treatment depends on the underlying etiology but may include supportive care, IV immunoglobulin, plasmapheresis, and corticosteroids. Prognosis ranges from full recovery to residual deficits or death, depending on the cause and extent of
This document provides an overview of acute gastroenteritis. It defines acute diarrhea and lists common causes in both adults and children, including viral, bacterial, and parasitic infections as well as some non-infectious conditions. The document outlines the clinical approach to a patient with acute diarrhea including taking a thorough history and physical exam. It notes key indications for testing stool or blood. The management section discusses rehydration therapy including oral rehydration solutions, diet, use of anti-diarrheal medications, antimicrobial therapy, and probiotics.
A patient with streptococcal pharyngitis develops tender red bumps along her entire tibia. This is most likely erythema nodosum, which presents as pretibial tender erythematous nodules and can be associated with streptococcal infections.
A 3-day-old infant presents with a rash containing eosinophils. This is likely to be erythema toxicum neonatorum, a benign and self-resolving rash of newborns.
A 4-year-old boy develops abdominal pain, vomiting, knee pain and a petechial rash on his legs. He is diagnosed with Henoch-Schönlein purpura,
A floppy infant refers to reduced muscle tone and loose joints. The main features of a floppy infant are hypotonia, abnormal postures, and delayed motor milestones. A thorough physical exam assesses tone in the limbs, neck, and trunk through various tests like leg traction and arm recoil. The cause may be central nervous system related like cerebral palsy or metabolic conditions. Alternatively, it could indicate a peripheral neuropathy, myopathy, or neuromuscular junction pathology. Further workup may include blood tests, electrophysiology, muscle biopsy, and genetic testing to determine the specific condition. Timely diagnosis and management including rehabilitation can help improve outcomes.
This document contains a template for documenting personal and medical history for a newborn baby. It includes sections for personal details, presenting complaints, obstetric history organized by trimester of pregnancy, natal history, postnatal history, immunization history, family history, socioeconomic history, physical exam findings organized by system, assessment of gestational age, anthropometry measurements, and neurological exam including reflexes. The physical exam section provides details to assess for any dysmorphisms or abnormalities.
This document provides an overview of stroke syndromes caused by occlusion of arteries in the brain. It describes the classification of strokes as affecting either the anterior or posterior circulation. For anterior circulation strokes, it details the territories supplied and clinical syndromes caused by occlusion of the middle cerebral artery, anterior cerebral artery, and anterior choroidal artery. For posterior circulation strokes, it outlines the arteries involved and syndromes related to vertebral, basilar, and posterior cerebral artery occlusions such as lateral medullary syndrome and lateral pontine syndromes. Diagrams are included to illustrate the vascular anatomy and clinical findings.
This document provides an overview of evaluating patients presenting with dizziness or vertigo. It discusses classifying vertigo based on duration, whether it is central or peripheral in origin, and non-vestibular causes. A thorough history and physical exam including neurologic and vestibular testing is outlined. Key diagnostic tests like Dix-Hallpike, caloric testing, and VEMP are described. Common causes of vertigo like BPPV, vestibular neuronitis, and Meniere's disease are highlighted based on presenting symptoms, exam findings, and test results.
(1) Spinal muscular atrophy (SMA) is a genetic disease caused by a mutation or deletion of the SMN1 gene on chromosome 5, resulting in degeneration of spinal cord motor neurons and progressive muscle weakness. (2) SMA Type 1, also called infantile SMA or Werdnig-Hoffman disease, has an onset
Hydrancephaly is a rare condition where the brain's cerebral hemispheres are absent and the cranial vault is filled with fluid. It results from occlusion of the bilateral internal carotid or middle cerebral arteries, leading to liquefaction of brain tissue in the affected arterial territories while sparing structures supplied by the posterior circulation. Diagnostically, hydrancephaly is characterized by the absence of the cortical mantle with normal brain parenchyma replaced by liquefied tissue lined by leptomeninges, while the cerebellum and brain stem are usually intact. The prognosis is poor, with most infants dying within the first year of life.
A 58-year-old female presented with sudden onset blurred vision and right-sided weakness and was found to have an acute left thalamic infarction; imaging showed no vascular abnormalities but she had an incidental finding of a possible atrial septal defect; she was treated with tPA and made a full recovery with no residual deficits.
The document discusses two cases of bedwetting or nocturnal enuresis in children. It then provides background information on nocturnal enuresis, including definitions, prevalence, risk factors, types, pathophysiology and diagnostic criteria. Nocturnal enuresis is defined as involuntary voiding during sleep after a child reaches 5 years of age. It affects 15-20% of children at age 5 and 5-10% at age 10. Boys are more commonly affected than girls. Family history is positive in about 50% of cases. The causes of nocturnal enuresis include delayed maturation of the brain mechanisms that inhibit bladder contractions during sleep, small bladder capacity, nocturnal excess urine production,
1. The document discusses various causes of myelopathy including infectious, autoimmune, demyelinating, paraneoplastic, metabolic, toxic, and vascular etiologies.
2. Clinical features, imaging, cerebrospinal fluid analysis and differential diagnosis for different types of myelopathies are provided with key distinguishing factors between compressive vs non-compressive, inflammatory vs non-inflammatory myelopathies.
3. Specific conditions like acute transverse myelitis, neuromyelitis optica, HIV myelopathy, syphilitic myelopathy, and acute disseminated encephalomyelitis are summarized in detail.
This document provides an overview of the examination of the nervous system. It discusses the central nervous system including the brain and spinal cord, as well as the peripheral nervous system with the somatic and autonomic divisions. The brain is examined in detail including the forebrain, midbrain, hindbrain, and structures like the thalamus and hypothalamus. Broadmann's areas and the functions of different lobes of the cerebrum are outlined. The effects of lesions in various areas are also summarized.
The document provides information on pediatric stroke. It defines stroke and describes the different types that can occur in children, including arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke. Risk factors and potential causes are discussed for each type. Clinical features may include seizures, weakness on one side of the body, difficulty speaking or swallowing. Diagnosis involves neuroimaging like CT or MRI along with other lab tests. Treatment focuses on neuroprotection, recanalization of blocked vessels, and anticoagulation or antiplatelet therapies to prevent further clotting.
AFP is a clinical syndrome characterized by rapid onset of weakness or paralysis in one or more limbs. Common causes of AFP include Guillain-Barré syndrome, poliomyelitis, transverse myelitis, and traumatic neuritis. For polio eradication efforts, all AFP cases must be reported and investigated within 48 hours by collecting two stool specimens at least 24 hours apart and analyzing them for the presence of wild poliovirus. Isolating wild poliovirus from stool specimens would classify the case as confirmed polio.
patofisiologi dan penatalaksanaan wus (pathophysiology and management of wake...vita kusuma
Vita Kusuma Rahmawati memberikan ringkasan tentang patofisiologi dan penatalaksanaan Wake Up Stroke (WUS). WUS didefinisikan sebagai stroke dengan gejala yang diketahui saat bangun tidur antara pukul 00.01-06.00 atau 06.00-12.00. Studi menunjukkan 40-50% stroke terjadi pagi hari dan WUS terjadi pada 8-18% kasus stroke. Hipotesis etiologi WUS meliputi variabilitas tekanan darah nokturnal dan
Dokumen ini membahas manfaat puasa bagi otak, di antaranya puasa dapat meningkatkan aktivitas otak tertentu yang terkait dengan pengambilan keputusan dan memori jangka panjang, mengurangi risiko penyakit seperti diabetes dan kanker, serta memberikan rasa tenang dan meningkatkan kemampuan otak dalam membentuk jaringan saraf baru. Puasa juga dapat melatih otak untuk memberikan stimulus positif sehingga dapat mengubah struktur dan
Dysphagia Bedside Screening for Acute-Stroke Patients
The Gugging Swallowing Screen
Dysphagia Bedside Screening for Acute-Stroke Patients: The Gugging Swallowing Screen
Dachenhausen and Michael Brainin
Michaela Trapl, Paul Enderle, Monika Nowotny, Yvonne Teuschl, Karl Matz, Alexandra
2007;38:2948-2952; originally published online September 20, 2007;Stroke.
doi: 10.1161/STROKEAHA.107.483933
Impact of the Neutrophil Response to Granulocyte Colony-Stimulating Factor o...vita kusuma
This is a journal critical appraisal taken from Gautier et al. Journal of Neuroinflammation 2014, 11:96 http://www.jneuroinflammation.com/content/11/1/96
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
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Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
10. major motor milestones of childhood
• 2–4 months: rolling over.
• 5–7 months: sitting without support.
• 8–9 months: getting to sitting.
• 9–11 months: cruising.
• 12–16 months: walking.
• 14–18 months: running.
• 3–4 years: hop on one foot.
• 3–4 years: rides a tricycle.
• 6–7 years: rides a bicycle.
VIT 10
11. Babinski Sign
The main pathologic reflex sought in
children is the Babinski sign, the
response of the great toe elicited by
stroking the plantar surface of the
foot.
Because of the lack of myelination of
the corticospinal tracts for the lower
extremities, a Babinski or an up-
going toe (also called the extensor
plantar response) is the normal
finding during the first year of life.
VIT 11
13. Gait Examination
After cruising, the child begins
to take steps on his or her own
between 12 and 15 months of
age.
In this early, toddler gait, the
station is wide based and arms
are held in front in the high
guard position.
VIT 13