1. 6 hours / Neonate Born to a mother from rural background No homoeopathic orientation Call received at 1 am in the night for stabilizing a neonate having respiratory distress and convulsions immediately after birth following difficult labor. CASE 1 Paedatric Emergency

2. A/F: BIRTH TRAUMA + BIRTH ASPHYXIA PRESENTATION NO AURA ICTAL PHASE-BITING LIPS TWITCHING FACE  DISTORTION FACE HEAD ROLLING TO SIDES TONIC CLONIC MOVEMENTS OF EXTREMITIES CLENCHED FIST POST ICTAL – PROSTRATION PUPILS DILATED CASE 1 Paedatric Emergency

3. General condition: PoorPeripheral cyanosis Heart rate: 160 / minute Heart sounds Normal Respiratory Rate: 60/ minute Conducted sounds and crepitation CASE 1 Paedatric Emergency Examination: CNS: Generalized tonic - colonic movements of upper and lower extremities, facial distortion and frothing at mouth Hyper tonic spasm Plantars extensor Investigation : Serum Glucose : NormalSerum Calcium : Normal

4. STRUCTURE FORMFUNCTION TIME

5. CASE 1 Paedatric Emergency Brain Oedma and Hypoxia Cerebral irritation A/F: Birth Trauma and asphyxia Convulsions Status epilepticus Facial distortion 6 hours

6. TOTALITY A/F: Cerebral Concussion Facial distortion Pupils dilated Head turning sides Prostration CASE 1 Paedatric Emergency Pace of disease : Rapid Pathology : Acute Oedma of brain Vitality: Compromised Characteristic: Present Correspondence: Adequate 200 C frequently 1 hrly---4 hrly CICUTA SUSCEPTIBILITY ASSESSMENT

7. Ancillary measures Continuous Oxygen Radiant warmer Intermittent Naso – Oral Suction Naso gastric Intubations Intra Venous fluids CASE 1 Paedatric Emergency

8. FOLLOW UP CHILD RELAXED 1 st hr.Convulsions better in Freq. 2 nd hr.Convulsions better 50% 5 th hr.Convulsions better 75% Only facial twitching Child appeared PEACEFUL 8 th hr.Convulsions – NIL 24 th hr. CHILD ACTIVE CASE 1 Paedatric Emergency

9. Conclusion Long term evaluation and management of this child would only require constitutional treatment. The possible long-term brain damage was contained and cured within 24 hours, quite a feat considering that this child may not have survived at all!