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Striking a balance: Charlie ’s recovery from neonatal stroke
“Hey, Charlie,” says Dr. Michael Rivkin as he gently dangles a small rubber ducky in front of the little boy. “Would you like this?” A wide smile breaks out across the toddler’s face. Why yes, he certainly would like that duck. He reaches and grasps at it, closing his tiny fingers around the toy. For Charlie Strzempek, it’s nothing more than a playful act. But for his parents, Kathleen and Tom, it’s a major accomplishment. Dr. Rivkin isn’t simply offering his patient a toy. He’s testing his ability to grab and hold an object in his right hand — the side of his body affected by a neonatal stroke. A shin...
Source: Thrive, Children's Hospital Boston - December 27, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories Dr. Michael Rivkin Julie Croteau occupational therapy stroke Stroke and Cerebrovascular Center Source Type: news

Bouncing back: Nolan ’s life after stroke
Although he’s only a little over a year old, Nolan Morel is a bona fide charmer. Clad in a red shirt and navy blue suspenders, he flashes a happy grin at his mother, Rosalia; his physician, Dr. Laura Lehman; and the others in the room. “Look at those dimples!” someone coos, and he giggles in response. “I can’t believe how social he’s being,” laughs Rosalia. “He wasn’t always like this.” In fact, Nolan’s first several days of life were anything but lighthearted. Just a few hours after his birth at a hospital north of Boston, he stopped breathing and had to be manually resuscitated and given oxygen. Whe...
Source: Thrive, Children's Hospital Boston - December 7, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories child life Dr. Laura Lehman feeding therapy occupational therapy physical therapy stroke Stroke and Cerebrovascular Center Source Type: news

What Are the Classifications of Perinatal Stroke?
Discussion Perinatal stroke occurs in about 1:1000 live births and is a “focal vascular injury from the fetal period to 28 days postnatal age.” Perinatal stroke is the most common cause of hemiparetic cerebral palsy and causes other significant morbidity including cognitive deficits, learning disabilities, motor problems, sensory problems including visual and hearing disorders, epilepsy, and behavioral and psychological problems. Family members are also affected because of the potential anxiety and guilt feelings that having a child with a stroke presents, along with the care that may be needed over the child&#...
Source: PediatricEducation.org - May 1, 2023 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Full circle: From moyamoya patient to intern
It’s the last day of Justin Doo’s research internship in the Department of Neurology at Boston Children’s Hospital and he’s eager to join the team for a celebratory scoop of ice cream at JP Licks. Before he leaves, he meets with his supervisor, Dr. Laura Lehman — but they both know this isn’t a final goodbye. The 18-year-old will see Dr. Lehman again within the year, because he isn’t just her intern. He’s also her patient. Unlike most summer interns, Justin has already spent plenty of time at Boston Children’s — more than a decade, in fact. When he was 7 years old, his parents brought him to the hospita...
Source: Thrive, Children's Hospital Boston - August 29, 2017 Category: Pediatrics Authors: Jessica Cerretani Tags: Diseases & Conditions Our Patients’ Stories Dr. Darren Orbach Dr. Edward Smith Dr. Laura Lehman Dr. Michael Scott moyamoya Moyamoya Disease Program Pial Synangiosis Source Type: news

What Causes Ataxia?
Discussion Coordination and balance problems are caused by various problems affecting the central and peripheral nervous system. Normal development of a child or weakness of a child are commonly mistaken for true ataxia. Ataxia specifically refers to “…impairment of the coordination of movement without loss of muscle strength.” If it is purely due to abnormalities of the cerebellum then there should be no changes in mental status, sensation or weakness. Sometimes it is difficult to determine if there are abnormalities in other areas. For example, Guillian-Barre often presents with difficulty or clumsy wal...
Source: PediatricEducation.org - March 31, 2014 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Genetics are Associated with Multiple Sclerosis?
Discussion Multiple sclerosis (MS) is “a chronic degenerative, often episodic disease of the central nervous system marked by patchy destruction of the myelin that surrounds and insulates nerve fibers, usually appearing in young adulthood and manifested by one or more mild to severe neural and muscular impairments, as spastic weakness in one or more limbs, local sensory losses, bladder dysfunction, or visual disturbances.” It is a chronic disease and therefore symptoms must occur more than once. The first episode is called an acute demyelinating attack. Fifteen to forty-five percent of children with their first...
Source: PediatricEducation.org - April 4, 2016 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Causes Hyperammonemia?
Discussion Reye’s syndrome (RS)is named for Dr. Douglas Reye who along with Drs. G. Morgan and J. Baral described encephalopathy and fatty accumulation and degeneration in children in a 1963 Lancet article. RS usually affects children but can occur at all ages. All organs can be affected but the liver and brain are primarily affected causing liver failure and encephalopathy as toxic metabolites (especially ammonia) accumulate, and intracranial hypertension and cerebral edema occurs. As the ammonia levels begin to rise (> 100 mg/dL) patients lose their appetite, have nausea and emesis and mental status changes whic...
Source: PediatricEducation.org - February 20, 2017 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Polyuria, Polydipsia and Possible Diabetes Insipidus?
Discussion The body is smart. It has mechanisms for maintaining balances within the body in a closely controlled manner but allows for a variety of states. This is very true for fluid balance in the body which is highly controlled between almost all of the major body organ systems. When fluid is low, the sensor sends signals for us to drink, and conserves fluid until we can. When the fluid is high, the kidneys excrete the excess and sends signals not to drink. Usually it works very well. While there are many pathological states that can cause polyuria and/or polydipsia, the most common reason is excessive fluid intake beca...
Source: PediatricEducation.org - March 7, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

Is This Primary Exertional Headache?
Discussion Commonly occurring primary headaches include tension, cluster and migraine headaches. “Other primary headaches” are often situational. Patients can have more than 1 type of these “other” headaches along with more common headaches. Other primary headaches as a group tend to be self-limited with long remission periods. Some other primary headaches include: Thunderclap headache Explosive sudden onset with maximum intensity in less 1 minute and resolution within 5 minutes usually 43/100,000 persons in adults Primary or secondary Secondary causes include intracranial hemorrhage, stroke, thro...
Source: PediatricEducation.org - November 21, 2022 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news