Alterations of Neurologic Function in Children

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Alterations of Neurologic Function in Children

• Chapter 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