Neurological Diseases in Pediatrics PDF
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University of Milano-Bicocca
Alessandro Cattoni
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Summary
This document is a presentation on the pathology of the central nervous system in pediatrics, covering epidemiology, clinical picture, diagnosis, and treatment strategies. It specifically tackles bacterial meningitis, its different forms, associated risk factors, and response to therapy for infants, toddlers, and children above 1 year of age. It includes a discussion on various forms of meningitis and their prevention.
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LA PATOLOGIA DEL SISTEMA NERVOSO CENTRALE IN PEDIATRIA Dr Alessandro Cattoni Epidemiology Bacterial meningitis is globally a rare disease (1000/mcl - Proteins in CSF > 1g/L (>100 mg/dl) - Batterioscopic positive In the presence of these signs, the initiation of i...
LA PATOLOGIA DEL SISTEMA NERVOSO CENTRALE IN PEDIATRIA Dr Alessandro Cattoni Epidemiology Bacterial meningitis is globally a rare disease (1000/mcl - Proteins in CSF > 1g/L (>100 mg/dl) - Batterioscopic positive In the presence of these signs, the initiation of intravenous (and steroidal) antibiotic therapy is mandatory. INTRO CLINICS DIAGNOSIS THERAPY Empiric antibiotic therapy 1ms of life: - USA 4% - Developing countries: 8% (range 0-15% depending on the case and bacterial strains). Risk factors related to increased mortality or neurological sequelae: - Streptococcus pneumoniae infection - Epileptic seizures after 72h from the beginning of antibiotic tp - Glicorrachia 15 min Non ricorrenti nelle successive Ricorrenti nelle successive 24 h 24 h Età dai 6m ai 6aa Età < 6 mesi o > 6 anni Sviluppo psicomotorio normale Pregressa patologia del SNC EEG normale EEG alterato Familiarità positiva per Familiarità positiva per epilessia convulsione febbrile Fattori di rischio per recidiva Convulsioni febbrili: diagnostica differenziale Indicazioni al ricovero Convulsioni febbrili: gestione Interventi assistenziali in corso di convulsione febbrile VANNO ATTUATI I SEGUENTI INTERVENTI Distendere il bambino su un piano Non trattenere il bambino durante le crisi Rimuovere eventuali oggetti che potrebbero provocare lesioni Non posizionare nessun presidio in bocca (abbassa lingua, etc..) Mantenere il collo in posizione neutra per mantenere pervie le vie aeree Allentare gli indumenti Somministrare antipiretico Bibliography S.L. Kaplan. Bacterial meningitis in children older than one month: clinical features and diagnosis, treatment and prognosis. UpTodate 2014. Bacterial meningitis and meningococcal septicaemia. NICE guidelines CG102, 2010 A. R. Tunkel, B. J. Hartman, S. L. Kaplan et al. Practice Guidelines for the Management of Bacterial Meningitis. Clinical Infectious Diseases 2004;39:1267–84 S. Esposito, M. Semino…N. Principi. “Should corticosteroids be used in bacterial meningitis in children?” European Journal of Paediatric Neurology. Volume 17, Issue 1, Pages 24-28, January 2013. Nigrovic LE, Kuppermann N, Malley R, Bacterial Meningitis Study Group of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics. Children with bacterial meningitis presenting to the emergency department during the pneumococcal conjugate vaccine era. Acad Emerg Med 2008; 15:522. Chandran A, Herbert H, Misurski D, Santosham M. Long-term sequelae of childhood bacterial meningitis: an underappreciated problem. Pediatr Infect Dis J 2011;30:3e6
