Seminars in pediatric neurology
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Semin Pediatr Neurol · Mar 2000
ReviewImproving shoulder and elbow function in children with Erb's palsy.
Many children who sustain birth injuries to the brachial plexus suffer significant functional limitations due to various sequelae affecting the shoulder and elbow or forearm. The maintenance of full passive mobility during the period of neurological recovery is essential for normal joint development. ⋯ Reconstruction of forearm rotation contractures significantly improves the appearance and use of the extremity for many basic activities. Each child must be carefully evaluated, therapy maximized, and the surgical approach individualized to obtain the best result.
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Focal upper extremity neuropathies are common in neonates. The brachial plexus is the most common site involved. Brachial plexus injuries may involve different structures, thus producing different clinical presentations: complete brachial plexus palsy, Duchenne-Erb palsy, upper-middle trunk brachial plexus palsy, Klumpke palsy, fascicular brachial plexus palsy, and bilateral brachial plexus palsy. ⋯ The differential diagnosis of brachial plexus palsy includes pseudoparesis, amyoplasia congenita, congenita varicella syndrome, and neurological lesions at other neuroanatomical levels. The cause and the degree of injury dictate the prognosis. The prognosis of obstetric brachial plexus injury is usually good.
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Semin Pediatr Neurol · Dec 1999
ReviewNeuroimaging of postnatal pediatric central nervous system infections.
Pediatric neuroimaging plays an important role in the timely diagnosis of postnatal central nervous system (CNS) infections, and in some patients the imaging findings are sufficiently specific to suggest a cause. The sequela of CNS infection, including hydrocephalus, subdural collections, ischemia/infarction, cerebral abscess, demyelination, and vascular thrombosis, can be accurately depicted and serially followed with current imaging techniques. The purpose of this review is to describe the spectrum of pediatric postnatal CNS infections, emphasizing key pathological and neuroimaging features, and to outline the strengths, weaknesses, and applications of current neuroimaging technology. The prenatal and perinatal infections falling under the designation of TORCH (toxoplasmosis, other [e.g., syphilis, HIV], rubella, cytomegalovirus, and herpes simplex II) are not covered.
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Despite several decades of improved therapy and prevention of infectious diseases, infectious pathogens remain major causes of morbidity and mortality in humans worldwide. Among the most complex and daunting problems facing medical science is the evolution of antibiotic resistance among many common and once easily-treated infectious agents. This review summarizes the status of newer antimicrobial agents that have utility against pathogens infecting the central nervous system.
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Functional magnetic resonance imaging (fMRI) allows for the noninvasive mapping of the anatomical location of disparate functional brain activities. The means for carrying out fMRI involves the use of existing MR technology coupled with a special software image acquisition program or the use of a specially designed head coil. Thus far in pediatric neurology, fMRI has assisted in the presurgical localization of critical functions and the investigation of various developmental activities. The technique of fMRI, its applications in pediatric neuroscience, and future potential are outlined in this article.