Acute Pediatric Neurology PDF
Preview Acute Pediatric Neurology
Acute Pediatric NNNNNNeeeeeeuuuuuurrrrrroooooollllllooooooggggggyyyyyy Thomas Sejersen Ching H. Wang Editors 123 Acute Pediatric Neurology Thomas Sejersen (cid:129) Ching H. Wang Editors Acute Pediatric Neurology Editors Thomas Sejersen Ching H. Wang Department of Pediatric Neurology Department of Pediatric Neurology Astrid Lindgrens Barnsjukhus Driscoll Children’s Hospital Karolinska University Hospital Corpus Christi Stockholm TX Sweden USA Pediatric Neurology unit Department of Women’s and Children’s Health Karolinska Institutet Stockholm Sweden ISBN 978-0-85729-490-6 ISBN 978-0-85729-491-3 (eBook) DOI 10.1007/978-0-85729-491-3 Springer London Heidelberg New York Dordrecht © Springer-Verlag London 2014 This work is subject to copyright. 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Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) We would like to dedicate this book to all our patients and their families. They gave us the opportunities to acquire our knowledge and experience that cumulated to the production of this book. Pref ace A substantial proportion of admissions to pediatric emergency departments, urgent care clinics, hospital wards, and pediatric intensive care units have pediatric neuro- logical causes (20–30 %), or are accompanied by neurological issues. This illus- trates that neurological diseases account for a large volume of pediatric emergencies, and many severe and critical pediatric cases. There is thus a great need for care providers to have access to updated literature aiding in diagnosis and management of emergencies related to pediatric neurology. However, we could not fi nd such a book in the present day publications. Although there are very good books in acute pediatrics, they do not cover the topics of acute pediatric neurology in suffi cient details. Considering the importance of pediatric neurology both in volume and in severity of pediatric emergencies, it was therefore a surprise for us to fi nd the lack of an updated book dedicated to this fi eld. This issue became more pressing to both of us when we encountered frequent requests for neurological consultations from general pediatricians and pediatric intensivists. These health providers frequently expressed an urgent need for a reference book that covers comprehensive topics of pediatric neurological issues that can be used as a rapid guide for the care of chil- dren in acute settings. Having previously had a very pleasant and productive collaboration in develop- ing care guidelines for neuromuscular diseases, we (Thomas Sejersen and Ching Wang) decided to team up again to edit this book on acute pediatric neurology. It is our hope that we can to some extent fi ll this gap with the present multi-authored book. This book is intended to be a practical guide, covering major pediatric neuro- logical diseases of relevance in the acute settings. The fi rst part of the book, Chaps. 1, 2, 3, 4, 5, 6, 7, covers major acute neurological symptoms, and differential diag- noses to consider. These should help clinicians to recognize various neurological conditions presented, perform essential neurological examination, and formulate some differential diagnoses in preparation for further diagnostic workup. The sec- ond part of the book, Chaps. 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, is intended to give practical advice on managements including diagnostic assessments and therapeutic interventions on the common and important acute pediatric neurological vii viii Preface conditions. Although each chapter will have much of its own individual character- istic, they will all have three key elements: (1) description of presenting symptoms, (2) recommended assessments, and (3) recommended interventions. Most chapters have at least one European and one North American author. With this we hope to cover some of the differences that may exist in diagnosis and management in Europe and North America. We hope that this book will reach a wide readership including pediatricians, pediatric neurologists, neurologists, pediatric intensivists, and neona- tologists. Should this book be well received, we hope that possible mistakes will be corrected in a second edition to follow. This will also allow us to keep updating and adding valuable new information on managements in acute pediatric neurology. We want to use this opportunity to thank all the authors who contributed to the chapters in this book. They generously shared their precious experience in their fi eld of expertise and worked with us patiently through the several revisions of the manuscripts. We also want to thank the developmental editors Barbara Lopez-Lucio and Joanna Bolesworth who helped compiling the chapters and keeping track on the production timelines, and the entire production team from Springer who produced this book in a pleasant and readable format. Lastly, we want to thank Drs. Darryl De Vivo and Lieven Lagae for their mentoring and encouragement and critical reading of the chapters. Stockholm, Sweden Thomas Sejersen TX, USA Ching H. Wang Foreword I In times of nonstop and everywhere availability of web-“knowledge”, it seems strange to advocate a classic textbook on pediatric neurology and especially on acute problems in clinical pediatric neurology. Most of our fellows (those who actu- ally see the patients in the emergency ward) know very well where to fi nd the ade- quate dosage for treating an ongoing seizure, but sometimes lack the background scientifi c knowledge about long-lasting seizures and status epilepticus. Our classi- cal teaching is very good in describing the most common neurological diseases, but not too much emphasis is put on the acute aspects of these diseases. In this respect, it is indeed time for a good and reliable textbook on acute aspects in pediatric neu- rology. Looking at my (full) bookcase, I fi nd only one book on “neurologic emer- gencies in infancy and childhood” (eds. J.M. Pellock, E.C.Myer), published back in 1993! It is one of the few textbooks I have actually read from page 1 to page 408 (I admit) and I still consult it in late night situations when I get nervous about an acute neurological problem in a child on the ward. But now, I get even more nervous real- izing that I continue to turn to a 20-year-old textbook… The book you are holding in your hands, A cute Pediatric Neurology , therefore certainly fi lls a gap and a need. The book deals with almost all acute neurological problems in childhood and is written by experts in the fi eld. What I like best in most chapters is the theoretical and pathophysiological background of these acute neuro- logical situations. This is what we need to fully understand our treatment para- digms. It remains the only way to prevent the art of medicine of becoming a web-based cookbook business. In addition, lots of fl owcharts and tables give advice on what diagnostic tests to run and which treatments are the most adequate. The editors and authors have to be congratulated with this textbook! I am sure it will be used in many teaching opportunities and in everyday clinical situations, but my advice is to simply start reading it now! It will give you a good and reassuring feel- ing, either because you will continue to fool yourself with “I already know this” or because (as in my case), you will silently admit a lot of things have changed in the last 20 years and you badly needed this magnifi cent update. Leuven, Belgium Lieven Lagae ix
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