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Hypoxic-Ischemic Encephalopathy and Other Neonatal Encephalopathies
ABSTRACTPURPOSE OF REVIEWNeonatal encephalopathy is the most common condition in neonates encountered by child neurologists. The etiology is most often global hypoxia-ischemia due to failure of cerebral perfusion to the fetus caused by uterine, placental, or umbilical cord compromise prior to or during delivery. Other etiologies of neonatal encephalopathy include ischemic stroke and intracranial hemorrhage, infection, developmental anomalies, and inborn errors of metabolism.RECENT FINDINGSTherapeutic hypothermia is standard of care for the treatment of neonatal encephalopathy presumed to be caused by hypoxia-ischemia. The ...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2018 Category: Neurology Tags: Review Articles Source Type: research

Neurologic Complications in the Pediatric Intensive Care Unit
This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit.RECENT FINDINGSConvulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation. Seizures may add to neurologic morbidity, and continuous EEG monitoring is needed for up to 24 hours for detection. Hypothermia has not been shown to improve outcome after cardiac arrest in children, but targeted temperature management with controlled normotherm...
Source: CONTINUUM: Lifelong Learning in Neurology - February 1, 2018 Category: Neurology Tags: Review Articles Source Type: research

Normothermia and Stroke
Opinion statementIn the past two decades, there has been much focus on the adverse effect of fever on neurologic outcome, the benefits of hypothermia on functional outcomes, and the interplay of associated complications. Despite decades of experience regarding randomized, safety and feasibility, case-controlled, retrospective studies, there has yet to be a large, randomized, multicenter, clinical trial with the appropriate power to address the potential benefits of targeted temperature modulation compared to hypothermia alone. What remains unanswered is the appropriate timing of initiation, duration, rewarming speed, and d...
Source: Current Treatment Options in Neurology - February 26, 2017 Category: Neurology Source Type: research