Index

IAP Textbook of Pediatric Neurology Anoop Verma, PAM Kunju, Sujata Kanhere, Nitin Maheshwari

1:Neurologic Assessment
- INTRODUCTION
- HISTORY
- THE NEUROLOGICAL EXAMINATION
- GENERAL EXAMINATION
- HIGHER CORTICAL FUNCTION TESTS
  - Steps
  - Cranial Nerves
- EXAMINING THE MOTOR SYSTEM
- REFLEXES
- COORDINATION AND ABNORMAL MOVEMENT
  - Sensory Examination
  - How to Formulate the Diagnosis
    - Steps in Diagnosis
2:The Child with Developmental Delay
- INTRODUCTION
- GLOBAL DEVELOPMENTAL DELAY
- EXAMINATION
- DEVELOPMENTAL ASSESSMENT IN OFFICE PRACTICE
- DEVELOPMENTAL OBSERVATION CARD
- HEMISYNDROMES
- FORMULATING THE DIAGNOSIS
- CAUSES OF DEVELOPMENTAL DELAY
  - Prenatal/Perinatal
  - Postnatal
- INVESTIGATIONS
  - Biochemical Tests
  - Neuroimaging
- TREATMENT
- PROGNOSIS
- CERTAIN ANATOMICAL PATTERNS
- SOME DEVELOPMENTAL DISORDERS
3:Congenital Malformations of the Brain
- INTRODUCTION
- INCIDENCE
- ETIOLOGY
- CLASSIFICATION
- TREATMENT OF CONGENITAL BRAIN MALFORMATIONS
  - Prevention
4:Approach to Intracranial Infections in Children
- INTRODUCTION
- CLINICAL PRESENTATION
- INVESTIGATIONS
  - Cerebrospinal Fluid (Table 2)
- SPECIFIC FINDINGS IN MAGNETIC RESONANCE IMAGING
  - Electroencephalogram
  - Polymerase Chain Reaction
5:Clinical Features and Management of CNS Infection in the Child
- INTRODUCTION
  - Infections of Meninges
  - Parenchymal Infections
    - Encephalitis and Brain Abscess
- BACTERIAL MENINGITIS
  - Clinical Presentation
    - Immunologic Defects
    - Persistent Cerebrospinal Fluid Communications (Recurrent Meningitis)
- VIRAL MENINGITIS
- TUBERCULOUS MENINGITIS
- FUNGAL MENINGITIS
- ENCEPHALITIS
- BRAIN ABSCESS
- INVESTIGATIONS
- IMAGING STUDIES
- TREATMENT
- MANAGEMENT OF COMPLICATIONS
  - Repeated Episodes of Meningitis
- PROPHYLAXIS
  - Vaccines
- OTHER MENINGOENCEPHALITIDE
  - Viral Meningoencephalitis
6:Brain Abscess
- INTRODUCTION
- DIAGNOSIS
  - Focal Signs
- LABORATORY STUDIES
- CURRENT RECOMMENDATIONS
- PROGNOSIS
7:Approach to Childhood Neurotuberculosis
- EPIDEMIOLOGY
- PATHOGENESIS OF CNS TUBERCULOSIS
- CLASSIFICATION OF CNS TUBERCULOSIS
- CLINICAL FEATURES OF TUBERCULAR MENINGITIS
- CENTRAL NERVOUS SYSTEM TUBERCULOSIS IN HIV INFECTED PERSONS
8:Approach to Cerebral Malaria
- CEREBRAL MALARIA
- DEFINITION
- PATHOPHYSIOLOGY
- CLINICAL FEATURES
- DIAGNOSIS OF CEREBRAL MALARIA
- INVESTIGATIONS
- MANAGEMENT
- PREVENT RECRUDESCENCE AND TRANSMISSION
- PROGNOSIS
9:Approach to a Child with Neurocysticercosis
- WHEN TO SUSPECT NEUROCYSTICERCOSIS?
- WHAT ARE THE DIFFERENT TYPES OF NEUROCYSTICERCOSIS?
- WHAT ARE THE DIFFERENT STAGES OF THE CYSTICERCUS CYST?
- HOW TO CONFIRM THE DIAGNOSIS OF NEUROCYSTICERCOSIS?
- HOW TO DIFFERENTIATE BETWEEN TUBERCULOMA AND NEUROCYSTICERCOSIS?
- HOW TO TREAT NEUROCYSTICERCOSIS?
10:Approach to Fungal Infection of Central Nervous System
- INTRODUCTION
- ETIOLOGY
- EPIDEMIOLOGY AND RISK FACTORS
- PATHOGENESIS
- CLINICAL SYNDROMES
- DIAGNOSIS
- DEFINITIVE TESTS
- TREATMENT
  - Drugs
  - Specific Treatment
11:Approach to a Child with Reduced Sensorium
- HOW TO ASSESS AND STABILIZE?
- REVIEWING THE HISTORY
- PERFORMING FOCUSED CLINICAL EXAMINATION
- CONDUCTING RELEVANT DIAGNOSTIC TESTS
- PREFERRED TERMINOLOGY
12:Anatomy and Localization of Neurological Disorders
- INTRODUCTION
- ANATOMY
  - Meninges and Intervening Spaces
- BRAIN
- LIMBIC SYSTEM
- SUBCORTICAL STRUCTURES
- SPINAL CORD
- LOCALIZATION OF NEUROLOGICAL LESION
13:Approach to Acute Stroke Syndromes
- INTRODUCTION
- DEFINITION
- ARTERIAL ISCHEMIC STROKES
- VENOUS SINUS THROMBOSIS
- HEMORRHAGIC STROKES
14:Febrile Seizures
- INTRODUCTION
- DEFINITION
- CLASSIFICATION OF FEBRILE SEIZURES
- ETIOLOGY: GENETIC BASIS AND RISK FACTORS
  - Risk Factors for First Febrile Seizure
- APPROACH TO A CHILD WITH FEBRILE SEIZURES
- PROGNOSIS
  - Risk Factors for Epilepsy in Children with Febrile Seizures
- CONCLUSION
15:Approach to a Child with Epilepsy
- INTRODUCTION
- DEFINITION
16:Approach to Benign Epilepsy Syndromes
- INTRODUCTION
- BENIGN CHILDHOOD EPILEPSY WITH CENTROTEMPORAL SPIKES
- BENIGN OCCIPITAL EPILEPSY WITH PANAYIOTOPOULOS SYNDROME
- IDIOPATHIC CHILDHOOD OCCIPITAL EPILEPSY (GASTAUT)
- BENIGN PARTIAL EPILEPSY OF INFANCY
- BENIGN PARTIAL EPILEPSY WITH AFFECTIVE SYMPTOMS
- SUMMARY
17:Approach to Intractable Epilepsy in Children
- DEFINITION
- FACTORS DETERMINING INTRACTABLE EPILEPSY
- MECHANISM OF DRUG RESISTANCE
- MANAGEMENT OF REFRACTORY EPILEPSY
- ANTIEPILEPTIC DRUGS
- KETOGENIC DIET
- EPILEPSY SURGERY
- CONCLUSION
18:Seizure Mimics in Infancy and Childhood
- NONEPILEPTIC ATTACK DISORDERS OF CHILDHOOD
- NEONATAL SEIZURE MIMICS
  - Jitteriness
  - Benign Neonatal Sleep Myoclonus
- INFANTILE MIMICS
  - Breath-holding Spells or Reflex Anoxic Seizure
- PAROXYSMAL TORTICOLLIS
  - Etiology
  - Clinical Features
  - Management
- BENIGN PAROXYSMAL VERTIGO
  - Etiology
  - Clinical Features
  - Management
- MYOCLONUS OF INFANCY
  - Clinical Features
  - Diagnosis
  - Management and Prognosis
- HYPEREKPLEXIA
  - Clinical Diagnosis
  - Diagnosis
  - Genetic Testing
  - Management
  - Prognosis
- SHUDDERING ATTACKS
  - Clinical History
  - Diagnosis
  - Treatment
  - Prognosis
- ALTERNATING HEMIPLEGIA OF CHILDHOOD
  - Clinical Features
  - Etiology
  - Diagnosis
  - Management
  - Prognosis
- CYCLIC VOMITING SYNDROME
  - Pathophysiology
  - Clinical Features
  - Supportive Criteria
  - Precipitating Events
  - Laboratory Studies
  - Treatment
- MIGRAINE
  - Migraine Variants
  - Causes
  - Laboratory Studies
  - Indication of Neuroimaging in Children with Headache
  - Treatment
    - Medical Care
    - Prophylaxis
  - Treatment of Status Migrainosus
    - Emergency Department Treatment
    - Inpatient Treatment
- PSYCHOGENIC NONEPILEPTIC SEIZURE
  - Causes
  - Clinical Presentation
  - Diagnosis
    - Video Electroencephalography Monitoring
  - Management
  - Prognosis
- SYNCOPE
- COMMON CONDITIONS OF SYNCOPE
  - Evaluation
  - Investigations
  - Treatment
- TICS
  - DSM 4 Diagnostic Criteria for Tourette's Disorder
  - Management
    - Behavioral Treatment
    - Pharmacologic Intervention
- OPSOCLONUS
  - Opsoclonus Myoclonus Syndrome
  - Signs and Symptoms
  - Diagnosis
  - Treatment
- SPASMUS NUTANS
- GASTROESOPHAGEAL REFLUX
- JACTATIO CAPITIS
- MASTURBATION
19:Approach to Neonatal Seizures
- INTRODUCTION
- EPIDEMIOLOGY/INCIDENCE
- DEFINITION
- PATHOPHYSIOLOGY
- CLASSIFICATION OF NEONATAL SEIZURES
- RELATION OF SEIZURE TO ELECTROENCEPHALOGRAPH
  - Does Absence of EEG Seizure Activity Indicate that a Clinical Seizure is Nonepileptic?
- DIFFERENTIAL DIAGNOSIS
- ETIOLOGY OF NEONATAL SEIZURES
- IDIOPATHIC SYNDROMES OF CLINICAL SEIZURES IN THE NEWBORN
  - Epileptic Syndromes
  - Nonepileptic Syndromes
- APPROACH TO NEONATAL SEIZURES
  - Investigations
- MANAGEMENT OF NEONATAL SEIZURES (TABLE 2)
- PROGNOSIS (TABLE 3)
  - Risk of Recurrence
    - Risk of Subsequent Epilepsy: 10–30%
- PREVENTION OF NEONATAL SEIZURES
- LONG-TERM OUTCOME
20:Practical Approach in Management of Status Epilepticus
- INTRODUCTION
- DEFINITION
- OUTCOME OF STATUS EPILEPTICUS
- MORBIDITY AND MORTALITY ?
- CLASSIFICATION OF STATUS EPILEPTICUS
- ETIOLOGY
- CAUSES
- DRUGS WHICH CAN CAUSE SEIZURES
- HEMODYNAMICS
- PATHOPHYSIOLOGY
- MANAGEMENT GOALS
- SUPPORTIVE CARE
- ANTICONVULSANTS
- TREATMENT
  - Drug Therapy
- RAPID-ACTING ANTICONVULSANTS
  - Pharmacology
  - Midazolam
  - Lorazepam
  - Diazepam
  - Stage 1 (0 minute)
  - Stage 2 (5 minutes)
  - Stage 3 (10 minutes)
  - Stage 4 (45 minutes)
  - Stage 5 (60 minutes)
  - Other Options
- TREATMENT OF REFRACTORY STATUS EPILEPTICUS
- TREATMENT OF STATUS EPILEPTICUS: WHAT NOW?
- NONINTRAVENOUS STATUS EPILEPTICUS
- MANAGEMENT AFTER STOPPING OF CONVULSIONS
- COMPLICATIONS
- SUMMARY
21:Approach to Neurophysiology Investigations
- INTRODUCTION
- ELECTROENCEPHALOGRAPHY (EEG)
- ELECTRODES AND THEIR APPLICATION
- WEST SYNDROME (FIGS 10 AND 11)
  - Classical Hypsarrhythmia on EEG (Fig. 12)
    - Early Childhood
- LENNOX-GASTAUT SYNDROME
  - Electroencephalography (Fig. 14)
- MYOCLONIC ASTATIC
  - Electroencephalography
- CHILDHOOD ABSENCE
  - Electroencephalography (Figs 17 and 18)
- SYNDROMES IN ADOLESCENCE (FIGS 19 TO 22)
- ELECTROMYOGRAPHY AND NERVE CONDUCTION VELOCITY
  - Nerve Conduction Study/Needle EMG Test
- NERVE CONDUCTION STUDY
- ELECTRONYSTAGMOGRAPHY SUMMARY
- EVOKED POTENTIALS
  - Evoked Potential
    - General Techniques
    - Evoked Potential Modalities
- VISUAL EVOKED POTENTIALS
- BRAINSTEM AUDITORY EVOKED POTENTIAL
  - Interpretation
  - Disorders
22:Basics of MRI and CT
- INTRODUCTION
- COMPUTED TOMOGRAPHY
  - Spiral CT
  - Clinical Application of Spiral CT
- MAGNETIC RESONANCE IMAGING
- RECENT ADVANCES IN MRI
- CT AND MRI TECHNIQUES
- MRI TECHNIQUES
  - Normal axial CT and MRI Scan Anatomy
- SOME NEUROIMAGING FEATURES
  - Posterior Fossa Mass—Child
- SOME COMPARATIVE SCANS (Figs 10 to 15)
23:Guidelines for the Diagnosis and Management of Childhood Epilepsy
- INTRODUCTION
- OBJECTIVES
- RECOMMENDATIONS
- STATUS EPILEPTICUS
24:Approach to a Child with Cerebral Palsy
- INTRODUCTION
25:Approach to Autism Spectrum Disorders
- INTRODUCTION
- AUTISM FEATURES
- AUTISM
  - Definition
- PERVASIVE DEVELOPMENTAL DISORDER (DSM IV)
- CRITERIA FOR AUTISTIC DISORDER (DSM IV)
  - Triad of Autism
  - A Total of Six or More Manifestations from One to Three
- COMMUNICATION DEFICITS IN AUTISM
- AUTISM: PLAY
- COGNITIVE DYSFUNCTION IN AUTISM
- SENSORIMOTOR SYMPTOMS IN AUTISM
- INSTRUMENTS FOR DIAGNOSIS OF ASD
- EARLY RECOGNITION
- MANAGEMENT
- AUTISM: DIFFERENTIAL DIAGNOSES
- CHILDHOOD DISINTEGRATIVE DISORDER (HELLER DEMENTIA)
  - Rett Syndrome
26:Approach to Neurodegenerative Disorders in Children
- NEURODEGENERATIVE DISORDERS
- WHEN TO SUSPECT THAT THERE IS NEURODEGENERATION?
  - Approach
- WHAT TO LOOK FOR IN THE EXAMINATION?
27:Movement Disorders
- INTRODUCTION
  - Differences from Epilepsy1
- APPROACH TO DIAGNOSIS
- ODD MOVEMENT DISORDERS6
- MANAGEMENT
  - Summary of Drugs used in Movement Disorders
28:Approach to a Child with Opsoclonus-Myoclonus Syndrome
- INTRODUCTION
- HISTORICAL NOTE
- INCIDENCE AND ASSOCIATIONS
- CLINICAL FEATURES
- INVESTIGATIONS
- PATHOGENESIS
- MANAGEMENT
- OUTCOME
- PRACTICE POINTS
29:Ataxia in Children
- INTRODUCTION
- ETIOLOGY
- CERTAIN TYPES OF CEREBELLAR ATAXIA
- A SPECIAL SYNDROME: JOUBERT SYNDROME
- INVESTIGATION
- TREATMENT
30:Approach to Neuromuscular Diseases in Children
- APPROACH TO DIAGNOSIS
- FLOPPY INFANT
- INVESTIGATIONS
- POINTS TO LOOK FOR IN PHYSICAL EXAMINATION
- INVESTIGATIONS
31:Approach to a Floppy Baby
- INTRODUCTION
- CLINICAL PRESENTATION AND APPEARANCE
- DIAGNOSTIC APPROACH
- INVESTIGATIONS
- THERAPEUTIC APPROACH
32:Approach to a Child with Myopathy or Myositis
- INTRODUCTION
- CONGENITAL MYOPATHIES
- MUSCULAR DYSTROPHIES
  - Duchenne Muscular Dystrophy (DMD)
  - Myotonic Muscular Dystrophy
- INFLAMMATORY MYOPATHIES
  - Inflammatory Myopathy Associated with Infection
    - Influenza Myositis
  - Dermatomyositis
    - Clinical Presentation
- METABOLIC MYOPATHIES
- CHANNELOPATHIES
  - Classification
  - Clinical Presentation
33:Pediatric Headache
- MANAGEMENT PROTOCOL
- COMPREHENSIVE HEADACHE EXAMINATION
- EXAMINATION
- INVESTIGATION
- IMAGING
- TREATMENT
- AMERICAN ACADEMY OF NEUROLOGY: GUIDELINES
- AMERICAN ACADEMY OF NEUROLOGY: PROPHYLAXIS
- DRUGS
34:Approach to a Child with Neurocutaneous Syndrome
- INTRODUCTION
- NEUROFIBROMATOSIS TYPE 1
- NEUROFIBROMATOSIS TYPE 2
- TUBEROUS SCLEROSIS COMPLEX
- ATAXIA TELANGIECTASIA
- VON HIPPEL-LINDAU SYNDROME
35:Approach to Nutritional Disorders of Nervous System
- INTRODUCTION
- PROTEIN-CALORIE MALNUTRITION
- COBALAMIN (VITAMIN B12)
- FOLATE DEFICIENCY
  - Laboratory Findings
  - Treatment
- THIAMINE
  - Clinical Manifestations
  - Treatment
- NIACIN
  - Clinical Manifestations
  - Treatment
- PYRIDOXINE
  - Clinical Manifestations
- VITAMIN E
- VITAMIN A AND D
- COPPER DEFICIENCY
36:Approach to Rabies
- INTRODUCTION
- EPIDEMIOLOGY
  - Reservoir of Infection
  - Mode of Transmission
- ETIOPATHOLOGY
- CENTRAL NERVOUS SYSTEM INVOLVEMENT
- CLINICAL FEATURES
- DECISION TO TREAT
- APPROACH TO POST-EXPOSURE PROPHYLAXIS
  - Management of Animal Bite Wound (Figs 4A to D)
- RABIES IMMUNOGLOBULINS
- ANTIRABIES VACCINES
- VACCINES AND REGIMEN APPROVED FOR INTRADERMAL USE IN THE COUNTRY
  - Regimen
    - Updated Thai Red Cross Schedule (2-2-2-0-2)
    - Intradermal Injection Technique
- POST-EXPOSURE PROPHYLAXIS FOR PREVIOUSLY VACCINATED PERSONS
- PRE-EXPOSURE VACCINATION
- TREATMENT OF CLINICAL RABIES
37:Neurotoxic Snake Envenomation
- INTRODUCTION
- MECHANISM OF NEUROTOXICITY
- CLINICAL FEATURES
- SYSTEMIC ENVENOMATION
- MANAGEMENT
- FIRST AID
- INITIAL TREATMENT
- NEUROTOXICITY HAS SET IN—NOW WHAT?
  - Specific Treatment
  - Neutralization of Venom
- ANTI-SNAKE VENOM: WHEN TO GIVE?
- ANTI-SNAKE VENOM: HOW MUCH?
- ANTI-SNAKE VENOM ANAPHYLAXIS: WHAT TO DO?
  - Reversal of Neurotoxicity
  - Mechanical Ventilation: Anti-snake Venom Ineffective or not Available: What to do?
- ANCILLARY TREATMENT
38:Cerebrospinal Fluid
- WHAT DOES THE CEREBROSPINAL FLUID DO?
- SOME CEREBROSPINAL FLUID FACTS
- BLOOD-BRAIN BARRIER
  - Lumbar Puncture
    - Procedure
  - Contraindications for Performing Lumbar Puncture
- CISTERNAL PUNCTURE
  - Diagnosis made by Lumbar Puncture
- ANALYZING CEREBROSPINAL FLUID
- POINTS TO REMEMBER
39:Fundus Examination in Children
- INTRODUCTION
- PATHOLOGIES
- CAUSES OF CHERRY-RED SPOT
  - Central Retinal Artery Occlusion with Systemic Conditions
- RETINOPATHY OF PREMATURITY
- HEREDITARY VITREORETINOPATHIES
- FUNDUS PICTURE APPEARANCES OF SOME IMPORTANT OCULAR DISEASES (FIGS 1 TO 13)
Drugs Appendix
- ACETAZOLAMIDE
- ACYCLOVIR
- ADRENOCORTICOTROPIC HORMONE
- ARIPIPRAZOLE
- BACLOFEN
- BENZATROPINE (BENZTROPINE)
- BOTOX (BOTULINUM TOXIN TYPE A)
- CARBAMAZEPINE
- CARNITINE (LEVOCARNITINE)
- CLONAZEPAM
- CLONIDINE
- CLOZAPINE
- CO-CARELDOPA
- DANTROLENE
- DIAZEPAM
- ETHOSUXIMIDE
- FELBAMATE
- HALOPERIDOL
- IMMUNOGLOBULIN (INTRAVENOUS)
- LAMOTRIGINE
- LEVETIRACETAM
- MANNITOL
- METHYLPREDNISOLONE
- MIDAZOLAM
- OLANZAPINE
- OXCARBAZEPINE
- PENICILLAMINE
- PHENOBARBITONE (PHENOBARBITAL)
- PHENYTOIN
- PIMOZIDE
- PIRACETAM
- PRIMIDONE
- PROPRANOLOL
- PYRIDOXINE (VITAMIN B6)
- RISPERIDONE
- THIAMINE (VITAMIN B1)
- TOPIRAMATE
- TRICLOFOS SODIUM
- TRIENTINE DIHYFROCHLORIDE
- TRIHEXYPHENIDYL (BENZHEXOL)
- VALPROIC ACID (SODIUM VALPROATE)
- VIGABATRIN
- ZONISAMIDE

INDEX

TOC
Index

Chapter Notes