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Different stroke(s)
A 13-year-old boy with mild learning difficulties presented to his district general hospital after an unwitnessed episode of collapse with vomiting but no loss of consciousness. He had 3 days of lethargy and intermittent occipital headaches waking him from sleep. Two days later, after another ‘funny turn’, he represented with right-side paraesthesia, weakness and word-finding difficulty. He had three previous ‘collapses’ over the last 6 months, including symptoms of transient dizziness, slurred speech, dribbling, difficulty swallowing and left-facial paraesthesia from which he had recovere...
Source: Archives of Disease in Childhood - Education and Practice - May 17, 2016 Category: Pediatrics Authors: Mundada, V., Krishnakumar, D., Chitre, M., Das, T. Tags: Oncology, Eye Diseases, Drugs: cardiovascular system, Echocardiography, Headache (including migraine), Infection (neurology), Neurooncology, Pain (neurology), Stroke, Hypertension, Ophthalmology, Valvar diseases, Radiology, Rheumatology, Dermatology, Clin Source Type: research

Annelizabeth ’s story: Care that feels like home, close to home
When you’re 5, it’s nice to have a place that feels like a second home. Where there are lots of hugs. And songs. And games. And you can curl up and watch “Frozen,” your favorite movie. For Annelizabeth Jean-Baptiste, a spunky Waltham kindergartener, that place is Boston Children’s Hospital at Waltham. Annelizabeth, or Annie (but never Anna, she says), first came to Boston Children’s at Waltham two weeks after she was born. Her mother Elcie wasn’t expecting that her fourth child would need special care. “It was a difficult pregnancy. I was very excited and relieved when she was born.” But that sense of rel...
Source: Thrive, Children's Hospital Boston - August 29, 2016 Category: Pediatrics Authors: Lisa Fratt Tags: Our Patients’ Stories Boston Children's at Waltham Dr. Rachael Grace sickle cell disease Source Type: news

Idaho mom goes the distance to help teen with scoliosis
“You want a hospital with the best technology and the best nurses and doctors in the country. You expect that, and you expect it to be clean. Boston Children’s has all of that,” says Lisa Findlay, a mom from Hayden, Idaho. “What made the difference was how much everyone loves these kids. Everyone who walked into Aaron’s room, from the surgeons to nurses’ aides to janitors and child life specialists, was on a mission to help Aaron.” From the time he was born, Aaron encountered one medical challenge after another. He was born with hypoplastic left heart syndrome (HLHS), a serious congenital heart defect. By...
Source: Thrive, Children's Hospital Boston - April 2, 2015 Category: Pediatrics Authors: Lisa Fratt Tags: Orthopedics Our patients’ stories Source Type: news

What Causes Facial Nerve Palsy?
Discussion Facial nerve palsy has been known for centuries, but in 1821 unilateral facial nerve paralysis was described by Sir Charles Bell. Bell’s palsy (BP) is a unilateral, acute facial paralysis that is clinically diagnosed after other etiologies have been excluded by appropriate history, physical examination and/or laboratory testing or imaging. Symptoms include abnormal movement of facial nerve. It can be associated with changes in facial sensation, hearing, taste or excessive tearing. The right and left sides are equally affected but bilateral BP is rare (0.3%). Paralysis can be complete or incomplete at prese...
Source: PediatricEducation.org - June 3, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

What Causes Muscle Weakness?
Discussion Muscle tone is the slight tension that is felt in a muscle when it is voluntarily relaxed. It can be assessed by asking the patient to relax and then taking the muscles through a range of motion such as moving the wrists, forearm and upper arm. Muscle strength is the muscle’s force against active resistance. Impaired strength is called weakness or paresis. There are 5 levels of muscle strength. 0 = No muscle contraction detected 1 = Barely detected flicker of contraction 2 = Active movement with gravity eliminated 3 = Active movement against gravity 4 = Active movement against gravity and some resistance ...
Source: PediatricEducation.org - December 9, 2013 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Experience Journal: Growing up with cerebral palsy
Cerebral palsy (CP) is the most common physical disability of childhood. The term CP is an umbrella term for a group of disorders that affect body movement and posture as a result of damage to a baby’s developing brain. There are many causes for CP, but all occur either during pregnancy, birth or shortly after birth. Common causes include differences in brain development, infection or stroke. Oxygen deprivation is accountable for only a small percentage of cases of CP; often, the cause is unknown. Although CP is a lifelong condition that can’t be reversed, children with the diagnosis can lead rich, fulfilling lives wit...
Source: Thrive, Children's Hospital Boston - March 18, 2016 Category: Pediatrics Authors: Erin Horan Tags: Experience Journal Cerebral Palsy Program 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

A father ’s hope for his son’s life
Juan and Fredy in 2017. Juan was looking forward to having his son, Fredy, 14, finally come home to live with him. The teenager had been living under the care of his grandmother since he was a toddler. But on that long-awaited homecoming day, Juan was quickly jarred from feeling great joy to grave concern. “When I saw his face, one side looked very different from the other and his lip was swollen,” says Juan. “He admitted right away that his face had been hurting.” Juan remembered that the last time he’d seen his son — more than one year ago — Fredy’s face had looked slightly different then too. But whateve...
Source: Thrive, Children's Hospital Boston - April 12, 2017 Category: Pediatrics Authors: Kat J. McAlpine Tags: Diseases & Conditions Our Patients’ Stories Dr. Cameron Trenor Dr. Carolyn Rogers Dr. Darren Orbach Dr. Reza Rahbar Dr. Salim Afshar interventional radiology juvenile nasopharyngeal angiofibroma tumor Source Type: news

What Are Some Risk Factors for Cerebral Palsy?
Discussion The term, cerebral palsy, or CP has gone through many iterations with the first description in 1861 by W.J. Little who described it as “The condition of spastic rigidity of the limbs of newborn children.” The most recent definition is from Rosenbaun et al. in 2007 which states it is “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cog...
Source: PediatricEducation.org - March 9, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Are the Main Acyanotic Congenital Heart Diseases?
Discussion Congenital heart diseases (CHD) are malformations of the heart and great vessels. It occurs in about 5-8/1000 live births. Cyanotic congenital heart disease is often noted perinatally because of cyanosis, respiratory distress and/or poor feeding or other distress type problems. A review can be found here. Acyanotic congenital heart disease (ACHD) can present at birth but often is seen in older children or adults unless the lesions are severe, especially obstructive lesions. Severe lesions may also cause cyanosis and distress type problems in patients also. Shunting lesions cause problems by diverting blood flo...
Source: PediatricEducation.org - August 17, 2020 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

How Common are Aortic Aneurysms?
Discussion Aortic root dilatation or thoracic aortic aneurysm occurs in 6:100,000 individuals > 50 years of age. It is due to aging, hypertension, hypercholesterolemia, and smoking. Tertiary syphilis was a cause in the preantibiotic era. Pediatric aneurysms are very uncommon but the exact prevalence is different due to the various causes. Aneurysms are due to genetic disorders, congenital anomalies or post-surgical repair. In pediatric patients with sudden cardiac deaths, 5.4% are due to ruptured thoracic aortic aneurysms. Learning Point Some causes of pediatric aneurysms include: Familial thoracic aneurysm and dissect...
Source: PediatricEducation.org - February 22, 2021 Category: Pediatrics Authors: Pediatric Education Tags: Uncategorized Source Type: news

What Causes Sudden Vision Loss?
Discussion Vision loss, whether chronic or acute, is distressing at any time for patients and families. Prompt evaluation and treatment are important as maintenance of any acuity and light or movement is considered paramount. Most vision loss is due to chronic problems and aging issues but the differential diagnosis is broad. For any age, but especially children, uncorrected refractive errors can cause problems in not only in childhood but throughout someone’s lifetime. Visual impairment for distance vision is considered mild if worse than 6/12 in meters = 20/40 in feet or 0.3 LogMAR and for moderate impairment is 6/...
Source: PediatricEducation.org - September 5, 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