Alterations of Neurologic Function in Children Chapter 19

Alterations of Neurologic Function in Children Chapter 19 1

Structure and Function of the Nervous System in Children o Develops from a dorsal thickening of the ectoderm (neural plate) n n n o Neural groove and folds Neural tube Neural crest Mesoderm n Blood vessels, microglial cells, dural and arachnoid layers of the meninges, the capsule of some peripheral nerve endings, and nerve coverings 2 Mosby items and derived items © 2006 by Mosby, Inc.

Structure and Function of the Nervous System in Children o o o Sulcus limitans Basal plate Alar plate Sutures Fontanelles Myelin sheath 3 Mosby items and derived items © 2006 by Mosby, Inc.

Structure and Function of the Nervous System in Children 4 Mosby items and derived items © 2006 by Mosby, Inc.

Structure and Function of the Nervous System in Children 5 Mosby items and derived items © 2006 by Mosby, Inc.

Structural Malformations o Defects of neural tube closure n n Anencephaly Encephalocele Meningocele Myelomeningocele o o Arnold-Chiari type II malformation Tethered cord syndrome 6 Mosby items and derived items © 2006 by Mosby, Inc.

Structural Malformations 7 Mosby items and derived items © 2006 by Mosby, Inc.

Axial Skeleton Malformations o Spinal bifida occulta n o Vertebral defect that allows the protrusion of the neural tube contents Cranial deformities n n Acrania Craniosynostosis Microcephaly Congenital hydrocephalus o Macewen sign (“cracked-pot” sign) 8 Mosby items and derived items © 2006 by Mosby, Inc.

Axial Skeleton Malformations 9 Mosby items and derived items © 2006 by Mosby, Inc.

Encephalopathies o Static encephalopathies n Cerebral palsy o o o Static cerebral palsy Dyskinetic cerebral palsy Ataxic cerebral palsy 10 Mosby items and derived items © 2006 by Mosby, Inc.

Encephalopathies o Inherited metabolic disorders n Defects in amino acid metabolism o Phenylketonuria (PKU) n n Hyperphenylalaninemia Defects in lipid metabolism o o Lysosomal storage diseases Tay-Sachs disease 11 Mosby items and derived items © 2006 by Mosby, Inc.

Seizure Disorders o Epilepsy n n n Partial seizures Generalized seizures Unclassified epileptic seizures o o o n o Infantile spasms Lennox-Gastaut syndrome Juvenile myoclonic epilepsy Status epilepticus Benign febrile seizures 12 Mosby items and derived items © 2006 by Mosby, Inc.

Acute Encephalopathies o o Reye syndrome Meningitis n n Bacterial meningitis Viral meningitis 13 Mosby items and derived items © 2006 by Mosby, Inc.

Children and HIV o HIV infections in children n Perinatally through the placenta Exposure to infected maternal blood and vaginal secretions Postpartum ingestion of breast milk 14 Mosby items and derived items © 2006 by Mosby, Inc.

Cerebrovascular Disease o Cerebrovascular disease in children differs in adults in three ways: n n n o o Absence of predisposing factors Differences in the clinical response Anatomic site of the pathologic condition Occlusive cerebrovascular disease Hemorrhagic cerebrovascular disease 15 Mosby items and derived items © 2006 by Mosby, Inc.

Childhood Tumors o Brain tumors n n n Medulloblastoma Ependymoma Astrocytoma Brainstem glioma Optic nerve glioma 16 Mosby items and derived items © 2006 by Mosby, Inc.

Childhood Brain Tumors 17 Mosby items and derived items © 2006 by Mosby, Inc.

Childhood Tumors o Embryonal tumors n n Neuroblastoma Retinoblastoma 18 Mosby items and derived items © 2006 by Mosby, Inc.

Childhood Tumors 19 Mosby items and derived items © 2006 by Mosby, Inc.