[Neuropediatric emergencies--epileptic seizures and acute hemiplegia].
Status epilepticus and stroke are life-threatening neurological emergencies and immediate recognition and medical management are imperativ. There is a serious risk of neurological sequelae. To limit secondary brain damage a prolonged seizure has to be treated without delay. After a short history and clinical evaluation (principles of resuscitation) a benzodiazepine (usually diazepam or lorazepam) has to be administered and in case of persistence of seizure-activity phenytoin or phenobarbital. Blood- and urine-sample must be collected in the acute phase to perform further metabolic or toxic examinations. A paralysis with acute onset is suspicious for ischaemic or haemorrhagic stroke. A precise neurological examination is mandatory for accurate neuroradiological work-up and to initiate appropriate investigations for risk factors. These patients require an immediate interdisciplinary treatment in a tertiary care centre with neuropaediatry, neuroradiology and neurosurgery.
Strozzi
S
S
Neuropadätrie, Medizinische Universitats-Kinderklinik, Inselspital, Bern. susi.strozzi@insel.ch
Steinlin
M
M
D000208:Acute Disease; D000927:Anticonvulsants / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D003937:Diagnosis, Differential; D004630:Emergencies; D004635:Emergency Medicine / Q000379:methods; D004638:Emergency Treatment / Q000379:methods; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D005858:Germany; D006429:Hemiplegia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009462:Neurology / Q000379:methods; D010372:Pediatrics / Q000379:methods; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors
D000927:Anticonvulsants