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Alterations of Neurologic Function in ChildrenChapter 19

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Structure and Function of the Nervous System in Children Develops from a dorsal thickening of the ectoderm

(neural plate) Neural groove and folds Neural tube Neural crest

Mesoderm Blood vessels, microglial cells, dural and arachnoid layers

of the meninges, the capsule of some peripheral nerve endings, and nerve coverings

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Structure and Function of the Nervous System in Children Sulcus limitans Basal plate Alar plate Sutures Fontanelles Myelin sheath

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Structure and Function of the Nervous System in Children

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Structure and Function of the Nervous System in Children

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Structural Malformations Defects of neural tube closure

Anencephaly Encephalocele Meningocele Myelomeningocele

Arnold-Chiari type II malformation Tethered cord syndrome

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Structural Malformations

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Axial Skeleton Malformations Spinal bifida occulta

Vertebral defect that allows the protrusion of the neural tube contents

Cranial deformities Acrania Craniosynostosis Microcephaly Congenital hydrocephalus

Macewen sign (“cracked-pot” sign)

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Axial Skeleton Malformations

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Encephalopathies Static encephalopathies

Cerebral palsy Static cerebral palsy Dyskinetic cerebral palsy Ataxic cerebral palsy

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Encephalopathies Inherited metabolic disorders

Defects in amino acid metabolism Phenylketonuria (PKU)

Hyperphenylalaninemia

Defects in lipid metabolism Lysosomal storage diseases Tay-Sachs disease

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Seizure Disorders Epilepsy

Partial seizures Generalized seizures Unclassified epileptic seizures

Infantile spasms Lennox-Gastaut syndrome Juvenile myoclonic epilepsy

Status epilepticus Benign febrile seizures

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Acute Encephalopathies Reye syndrome Meningitis

Bacterial meningitis Viral meningitis

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Children and HIV HIV infections in children

Perinatally through the placenta Exposure to infected maternal blood and vaginal

secretions Postpartum ingestion of breast milk

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Cerebrovascular Disease Cerebrovascular disease in children differs in

adults in three ways: Absence of predisposing factors Differences in the clinical response Anatomic site of the pathologic condition

Occlusive cerebrovascular disease Hemorrhagic cerebrovascular disease

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Childhood Tumors Brain tumors

Medulloblastoma Ependymoma Astrocytoma Brainstem glioma Optic nerve glioma

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Childhood Brain Tumors

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Childhood Tumors Embryonal tumors

Neuroblastoma Retinoblastoma

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Childhood Tumors