Assessment of acute motor deficit in the pediatric emergency room
Journal Title: Jornal de Pediatria - Year 2017, Vol 93, Issue 0
Abstract
Objectives This review article aimed to present a clinical approach, emphasizing the diagnostic investigation, to children and adolescents who present in the emergency room with acute-onset muscle weakness. Sources A systematic search was performed in PubMed database during April and May 2017, using the following search terms in various combinations: “acute,” “weakness,” “motor deficit,” “flaccid paralysis,” “child,” “pediatric,” and “emergency”. The articles chosen for this review were published over the past ten years, from 1997 through 2017. This study assessed the pediatric age range, from 0 to 18 years. Summary of the data Acute motor deficit is a fairly common presentation in the pediatric emergency room. Patients may be categorized as having localized or diffuse motor impairment, and a precise description of clinical features is essential in order to allow a complete differential diagnosis. The two most common causes of acute flaccid paralysis in the pediatric emergency room are Guillain–Barré syndrome and transverse myelitis; notwithstanding, other etiologies should be considered, such as acute disseminated encephalomyelitis, infectious myelitis, myasthenia gravis, stroke, alternating hemiplegia of childhood, periodic paralyses, brainstem encephalitis, and functional muscle weakness. Algorithms for acute localized or diffuse weakness investigation in the emergency setting are also presented. Conclusions The clinical skills to obtain a complete history and to perform a detailed physical examination are emphasized. An organized, logical, and stepwise diagnostic and therapeutic management is essential to eventually restore patient's well-being and full health.
Authors and Affiliations
Marcio Vasconcelos
Characterization of a group unrelated patients with arthrogryposis multiplex congenita
Objective Arthrogryposis multiplex congenita is a relatively rare neuromuscular syndrome, with a prevalence of 1:3000–5000 newborns. In this study, the authors describe the clinical features of a group of 50 unrelated Me...
Acute kidney injury in HIV-infected children: comparison of patients according to the use of highly active antiretroviral therapy
Objective To assess clinical and laboratory data, and acute kidney injury (AKI) in HIV-infected children using and not using highly active antiretroviral therapy (HAART) prior to admission. Methods A retrospective study...
Erratum on “Association of neopterin as a marker of immune system activation and juvenile rheumatoid arthritis activity”
In the affiliation of the authors of the original article “Association of neopterin as a marker of immune system activation and juvenile rheumatoid arthritis activity” (J Pediatr (Rio J). 2015;91(4):352-357), where it re...
Validation of the Inventaire du Milieu Familial Questionnaire (French version of the Infant/Toddler HOME) into the Brazilian Portuguese language
Objective To validate the Brazilian Portuguese version of the Family Environment Assessment questionnaire (Inventaire du Milieu Familial). Methods The validation process was carried out in two stages. First, translation...
Probiotics: an update
Objective Triggered by the growing knowledge on the link between the intestinal microbiome and human health, the interest in probiotics is ever increasing. The authors aimed to review the recent literature on probiotics,...