1 Alterations of Neurologic Function in Children Chapter 19

Mosby items and derived items © 2006 by Mosby, Inc. 2 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

Mosby items and derived items © 2006 by Mosby, Inc. 3 Structure and Function of the Nervous System in Children  Sulcus limitans  Basal plate  Alar plate  Sutures  Fontanelles  Myelin sheath

Mosby items and derived items © 2006 by Mosby, Inc. 4 Structure and Function of the Nervous System in Children

Mosby items and derived items © 2006 by Mosby, Inc. 5 Structure and Function of the Nervous System in Children

Mosby items and derived items © 2006 by Mosby, Inc. 6 Structural Malformations  Defects of neural tube closure Anencephaly Encephalocele Meningocele Myelomeningocele  Arnold-Chiari type II malformation  Tethered cord syndrome

Mosby items and derived items © 2006 by Mosby, Inc. 7 Structural Malformations

Mosby items and derived items © 2006 by Mosby, Inc. 8 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)

Mosby items and derived items © 2006 by Mosby, Inc. 9 Axial Skeleton Malformations

Mosby items and derived items © 2006 by Mosby, Inc. 10 Encephalopathies  Static encephalopathies Cerebral palsy  Static cerebral palsy  Dyskinetic cerebral palsy  Ataxic cerebral palsy

Mosby items and derived items © 2006 by Mosby, Inc. 11 Encephalopathies  Inherited metabolic disorders Defects in amino acid metabolism  Phenylketonuria (PKU) Hyperphenylalaninemia Defects in lipid metabolism  Lysosomal storage diseases  Tay-Sachs disease

Mosby items and derived items © 2006 by Mosby, Inc. 12 Seizure Disorders  Epilepsy Partial seizures Generalized seizures Unclassified epileptic seizures  Infantile spasms  Lennox-Gastaut syndrome  Juvenile myoclonic epilepsy Status epilepticus  Benign febrile seizures

Mosby items and derived items © 2006 by Mosby, Inc. 13 Acute Encephalopathies  Reye syndrome  Meningitis Bacterial meningitis Viral meningitis

Mosby items and derived items © 2006 by Mosby, Inc. 14 Children and HIV  HIV infections in children Perinatally through the placenta Exposure to infected maternal blood and vaginal secretions Postpartum ingestion of breast milk

Mosby items and derived items © 2006 by Mosby, Inc. 15 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

Mosby items and derived items © 2006 by Mosby, Inc. 16 Childhood Tumors  Brain tumors Medulloblastoma Ependymoma Astrocytoma Brainstem glioma Optic nerve glioma

Mosby items and derived items © 2006 by Mosby, Inc. 17 Childhood Brain Tumors

Mosby items and derived items © 2006 by Mosby, Inc. 18 Childhood Tumors  Embryonal tumors Neuroblastoma Retinoblastoma

Mosby items and derived items © 2006 by Mosby, Inc. 19 Childhood Tumors