Seminars in pediatric neurology
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Status epilepticus (SE) is a common pediatric neurologic emergency that refers to a prolonged seizure or recurrent seizures without a return to baseline mental status between seizures. Appropriate treatment strategies are necessary to prevent prolonged SE and its associated morbidity and mortality. This review discusses the importance of a rapid and organized management approach, reviews data related to commonly utilized medications including benzodiazepines, phenytoin, phenobarbital, valproate sodium, and levetiracetam, and then provides a sample SE management algorithm.
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Semin Pediatr Neurol · Sep 2010
ReviewStatus epilepticus treatment and outcome in children: what might the future hold?
Status epilepticus is a life-threatening emergency that requires urgent treatment. Over the past decade, numerous advances have been made in the management of status epilepticus. ⋯ Neuroscientific advances are revealing mechanisms of status epilepticus that could translate into targets for treating acute status epilepticus and even reducing epileptogenesis. This article discusses future trends in the diagnosis, neurobiology, and treatment of status epilepticus.
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Migraine and epilepsy, more alike than different, are two of the most common conditions faced in pediatric neurology. This review covers the epidemiology of both disorders, similarities and differences which aid in their mutual diagnoses, and predisposing conditions for the combination of both. Treatments for both migraine and epilepsy can be very useful, although rarely completely successful for migraines. Although the abortive agents used are vastly different, the preventative treatments share mostly similarities, and are commonly anticonvulsant drugs.
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Semin Pediatr Neurol · Dec 2009
The discovery of hypothermic neural rescue therapy for perinatal hypoxic-ischemic encephalopathy.
The development of the concepts of delayed post-ischaemic neuronal death and neural rescue brought about a search for clinical treatments to reduce brain damage after birth asphyxia. Cooling had long been an unproven empyrical therapy, and a 20 year programme of careful laboratory and clinical research has proved that hypothermia reduces neurological damage in infants suffering perinatal asphyxial encephalopathy.
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Spasticity and other forms of muscle overactivity caused by cerebral palsy may impair function or ease of care or may cause discomfort or poor body image. The treatment program for a child with spasticity may include allied health therapy, exercise, casting, constraint-induced therapy, oral medications, chemodenervation, intrathecal baclofen, selective dorsal rhizotomy, and orthopedic surgery. Techniques may be combined for greater efficacy and better tailoring to the needs of the child. This article provides an overview of each approach, with a review of significant research findings in support of each.