Pediatric emergency medicine trisk 2500 2500
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development or migration, usually genetic, chromosomal, or environmental) and
secondary microcephaly (caused by a late insult to a normally developed brain,
including hypoxia, ischemia, infection, trauma, or metabolic disorders) ( Table
96.2 ). Patients present at a mean age of 7 to 8 months with neurodevelopmental
delays (65%) and acute seizure disorder (43%). Seizures may be recurrent and
difficult to control. History and physical examination are able to determine
causality in only one-third of cases. History of prematurity, perinatal history of
maternal infection, congenital infection, drug and alcohol abuse, environmental
exposures, family history of metabolic or genetic diseases, and birth data relating
to possible anoxic injury may be of help. A thorough neurologic examination is
warranted. Management of microcephaly usually requires a multidisciplinary
approach. Control of acute seizures and referral to pediatric neurologist is
recommended. Specific testing, for example, MRI, audiology, metabolic and
genetic testing (karyotype, chromosomal microarray, chromosomal breakage
analysis, and sequencing) can then be done.
