Developmental medicine and child neurology
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Traumatic and non-traumatic coma is a common problem in paediatric practice with high mortality and morbidity. Early recognition of the potential for catastrophic deterioration in a variety of settings is essential and several coma scales have been developed for recording depth of consciousness that are widely used in clinical practice in adults and children. Prediction of outcome is probably less important, as this may be able to be modified by appropriate emergency treatment, and other clinical and neurophysiological criteria allow a greater degree of precision. ⋯ This is particularly important when the patient is being assessed by personnel dealing with adults as well as children, discussed on the telephone, handed over at shift change, or transferred between units or hospitals. The British Paediatric Neurology Association has recommended one of the modified child's Glasgow coma scales (CGCS) for use in the UK. This review looks at the recent history of the development of coma scales and the rationale for recommending the CGCS.
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Dev Med Child Neurol · Apr 2008
Comparative StudyThe Infant Motor Profile: a standardized and qualitative method to assess motor behaviour in infancy.
A reliable and valid instrument to assess neuromotor condition in infancy is a prerequisite for early detection of developmental motor disorders. We developed a video-based assessment of motor behaviour, the Infant Motor Profile (IMP), to evaluate motor abilities, movement variability, ability to select motor strategies, movement symmetry, and fluency. The IMP consists of 80 items and is applicable in children from 3 to 18 months. ⋯ Concurrent validity of IMP and AIMS was good (Spearman's rho=0.8, p<0.005). The IMP was able to differentiate between infants with normal neurological condition, simple minor neurological dysfunction (MND), complex MND, and abnormal neurological condition (p<0.005). This means that the IMP may be a promising tool to evaluate neurological integrity during infancy, a suggestion that needs confirmation by means of assessment of larger groups of infants with heterogeneous neurological conditions.
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Dev Med Child Neurol · Apr 2008
Analysis of the International Classification of Headache Disorders for diagnosis of migraine and tension-type headache in children.
In 2004, the revised International Classification of Headache Disorders (ICHD-II) was published. This study evaluates: (1) the results obtained from applying ICHD-II to children with primary headaches to distinguish between migraine without aura (MO) and tension-type headache (TTH); and (2) the results obtained from introducing modifications of the classification criteria for MO as suggested by various authors. There were 200 participants (93 males, 107 females; age range 3-17 y, mean 9 y 8 mo [SD 2 y 7 mo]). ⋯ Reduction of duration to 1 hour for MO produced a statistically non-significant increase in the number of children with MO. Behaviour during attacks was found to be simple to apply in evaluating intensity and therefore was introduced as a new criterion. Severe intensity was related to MO, whereas moderate or low-intensity was related to TTH.