Pediatric neurology
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Pediatric neurology · Feb 2014
Comparative Study Observational StudyManagement of pediatric migraine in a tertiary care versus community based emergency department: an observational pilot study.
Because of a lack of guidelines for the management of pediatric migraine in the emergency department setting, marked variations in treatment protocols exist between institutions. We aimed to characterize differences in management strategies for pediatric migraine treatment between a community-based and a tertiary care emergency department. ⋯ Low rates of intravenous combination therapy, antidopaminergic agent, and serotonin agonist use were noted across both hospital settings. Community-based physicians used opiates and obtained neuro-imaging more than those in the academic setting. Standardization of care in the emergency setting coupled with reliable acute care plans that are based on evidenced-based guidelines can allow for better control of episodic migraine and reduce emergency department visits.
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Pediatric neurology · Feb 2014
Electrophysiological characteristics of the pediatric femoral nerve and their use in clinical diagnosis.
To explore the electrophysiological characteristics of the pediatric femoral nerve at different ages. ⋯ The development of pediatric femoral nerve mainly began after 1 years old and continued to 14 years old. The proximal latency and compound muscle action potential amplitude of the pediatric femoral nerve have clinical value. Detection of the femoral nerve is important in the diagnosis of lower limb monoplegia, especially for acute flaccid paralysis associated with nonpolio enterovirus infection.
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Pediatric neurology · Feb 2014
Outcomes of greater occipital nerve injections in pediatric patients with chronic primary headache disorders.
Chronic migraine is common in pediatrics and generally disabling. In adults, infiltration of the area around the greater occipital nerve can provide short- to medium-term benefit in some patients. This study reports the efficacy of greater occipital nerve infiltrations in pediatric patients with chronic primary headache disorders. ⋯ Greater occipital nerve injections benefitted 53% of pediatric patients with chronic primary headache disorders. Efficacy appeared greater in chronic migraine than NDPH. Given the benign side effect profile, a greater occipital nerve infiltration seems appropriate before more aggressive approaches.
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Pediatric neurology · Jan 2014
Review Case ReportsLambert-Eaton syndrome, an unrecognized treatable pediatric neuromuscular disorder: three patients and literature review.
Lambert-Eaton myasthenic syndrome, a presynaptic neuromuscular junction autoimmune disorder, rarely occurs in children. Patients typically present with proximal lower extremity weakness with areflexia. ⋯ Lambert-Eaton myasthenic syndrome is a diagnosis that must be considered in children presenting with unidentified proximal muscle weakness. In most children, Lambert-Eaton myasthenic syndrome is a primary autoimmune disorder that is treatable. Nevertheless, a search for malignancy is recommended.
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Pediatric neurology · Jan 2014
Cerebrospinal fluid TNF-α, IL-6, and IL-8 in children with bacterial meningitis.
We evaluated the levels of cerebrospinal fluid concentrations of tumor necrosis factor-α, interleukin-6, and interleukin-8 in bacterial meningitis in children. ⋯ The increased concentration of cerebrospinal fluid tumor necrosis factor-α, interleukin-6, and interleukin-8 in children with meningitis suggests a role in the pathogenesis of bacterial meningitis and these levels might prove to be useful in children whose diagnosis is in question.