Acute Neurological Emergencies in Children

  • Indumathi Santhanam
  • Sangeetha Yoganathan


Rapid identification and appropriate treatment of raised ICP are essential to prevent secondary brain injury.


Status Epilepticus Glasgow Coma Scale Neuroleptic Malignant Syndrome Sodium Valproate Cerebral Venous Thrombosis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Acute Neurological Emergencies in Children

  1. 1.
    Laureys S, Owen AM, Schiff ND. Brain function in coma, vegetative state, and related disorders. Lancet Neurol. 2004;3:537–46.CrossRefPubMedGoogle Scholar
  2. 2.
    Dehaene S, Naccache L. Towards a cognitive neuroscience of consciousness: basic evidence and a workspace framework. Cognition. 2001;79:1–37.CrossRefPubMedGoogle Scholar
  3. 3.
    Zeman A. Consciousness. Brain. 2001;124:1263–89.CrossRefPubMedGoogle Scholar
  4. 4.
    Jose B, Gruener G, Brazis P. Examination of the patient who has a disorder of consciousness. In: De Myer’s. The neurological examination.6th ed. New York: Mac Graw Hill Companies; 2011. p. 523.Google Scholar
  5. 5.
    Larner AJ. False localising signs. J Neurol Neurosurg Psychiatry. 2003;74:415–8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Joseph JV. False localizing signs in neurology. Indian J Clin Pract. 2013;23:553–6.Google Scholar

Raised Intracranial Pressure: Causes and Management

  1. 7.
    Welch K. The intracranial pressure of infants. J Neurosurg. 1980;52:693–9.CrossRefPubMedGoogle Scholar
  2. 8.
    Mokri B. The Monro-Kellie hypothesis: applications in CSF volume depletion. Neurology. 2001;56:1746Y1748.Google Scholar
  3. 9.
    Ranjit S. Emergency and intensive care management of a comatose patient with intracranial hypertension, current concepts. Indian Pediatr. 2006;43:409–15.PubMedGoogle Scholar
  4. 10.
    Pickard JD, Czosnyka M. Management of raised intracranial pressure. J Neurol Neurosurg Psychiatry. 1993;56:845–58.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 11.
    Malayeri AA, Bavarian S, Mehdizadeh M. Sonographic evaluation of optic nerve diameter in children with raised intracranial pressure. J Ultrasound Med. 2005;24:143–7.PubMedGoogle Scholar
  6. 12.
    Melo JR, Di Rocco F, Blanot S, Cuttaree H, Sainte-Rose C, Oliveira-Filho J, Zerah M, Meyer PG. Trans-cranial Doppler can predict intracranial hypertension in children with severe traumatic brain injuries. Childs Nerv Syst. 2011;27:979Y984.CrossRefGoogle Scholar
  7. 13.
    Singhi SC, Tiwari L. Management of intracranial hypertension. Indian J Pediatr. 2009;76:519–29.CrossRefPubMedGoogle Scholar

Status Epilepticus

  1. 14.
    Guidelines for epidemiologic studies on epilepsy. Commission on epidemiology and prognosis, international league against epilepsy. Epilepsia. 1993;34:592–6.Google Scholar
  2. 15.
    Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia. 1999;40:120–2.CrossRefPubMedGoogle Scholar
  3. 16.
    Abend NS, Gutierrez-Colina AM, Dlugos DJ. Medical treatment of pediatric status epilepticus. Semin Pediatr Neurol. 2010;17:169–75.CrossRefPubMedGoogle Scholar
  4. 17.
    Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain. 2011;134:2802–18.CrossRefPubMedGoogle Scholar
  5. 18.
    Huff JS, Fountain NB. Pathophysiology and definitions of seizures and status epilepticus. Emerg Med Clin North Am. 2011;29:1–13.CrossRefPubMedGoogle Scholar
  6. 19.
    Riviello JJ Jr, Ashwal S, Hirtz D, Glauser T, Ballaban-Gil K, Kelley K, Morton LD, Phillips S, Sloan E, Shinnar S; American Academy of Neurology Subcommittee; Practice Committee of the Child Neurology Society. Practice parameter: diagnostic assessment of the child with status epilepticus (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2006;67:1542–50.Google Scholar
  7. 20.
    Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn2+ sensitivity of hippocampal dentate granule cell GABA-A receptors. J Neurosci. 1997;17:7532–40.PubMedPubMedCentralGoogle Scholar
  8. 21.
    Chamberlain JM, Okada P, Holsti M, Mahajan P, Brown KM, Vance C, Gonzalez V, Lichenstein R, Stanley R, Brousseau DC, Grubenhoff J, Zemek R, Johnson DW, Clemons TE, Baren J, Pediatric Emergency Care Applied Research Network (PECARN). Lorazepam vs diazepam for pediatric status epilepticus: a randomized clinical trial. JAMA. 2014;311:1652–60.CrossRefPubMedGoogle Scholar
  9. 22.
    Prasad M, Krishnan PR, Sequeira R, Al-Roomi K. Anticonvulsant therapy for status epilepticus. Cochrane Database Syst Rev. 2014;9:CD003723.PubMedGoogle Scholar
  10. 23.
    Yu KT, Mills S, Thompson N, et al. Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures. Epilepsia. 2003;44:724–6.CrossRefPubMedGoogle Scholar
  11. 24.
    Ozdemir D, Gulez P, Uran N, et al. Efficacy of continuous midazolam infusion and mortality in childhood refractory generalized convulsive status epilepticus. Seizure. 2005;14:129–32.CrossRefPubMedGoogle Scholar
  12. 25.
    Kahriman M, Minecan D, Kutluay E, Selwa L, Beydoun A. Efficacy of topiramate in children with refractory status epilepticus. Epilepsia. 2003;44:1353–6.CrossRefPubMedGoogle Scholar

Stroke in Children

  1. 26.
    Thorvaldsen P, Asplund K, Kuulasmaa K, Rajakangas AM, Schroll M. Multinational comparisons of stroke epidemiology. Evaluation of case ascertainment in the WHO MONICA Stroke Study. World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease. Stroke. 1995;26:355–60.CrossRefPubMedGoogle Scholar
  2. 27.
    Dalal PM, Bhattacharjee M. Stroke epidemic in India: hypertension-stroke control programme is urgently needed. J Assoc Physicians India. 2007;55:689–91.PubMedGoogle Scholar
  3. 28.
    Fullerton HJ, Wu YW, Zhao S, Johnston SC. Risk of stroke in children: ethnic and gender disparities. Neurology. 2003;61:189–94.CrossRefPubMedGoogle Scholar
  4. 29.
    de Veber G, Andrew M, Adams C, Bjornson B, Booth F, Buckley DJ, Camfield CS, David M, Humphreys P, Langevin P, MacDonald EA, Gillett J, Meaney B, Shevell M, Sinclair DB, Yager J, Canadian Pediatric Ischemic Stroke Study Group. Cerebral sinovenous thrombosis in children. N Engl J Med. 2001;345:417–23.CrossRefGoogle Scholar
  5. 30.
    Earley CJ, Kittner SJ, Feeser BR, et al. Stroke in children and sickle cell disease: Baltimore Washington cooperative young stroke study. Neurology. 1998;51:169–76.CrossRefPubMedGoogle Scholar
  6. 31.
    Roach ES, Golomb MR, Adams R, Biller J, Daniels S, Deveber G, Ferriero D, Jones BV, Kirkham FJ, Scott RM, Smith ER, American Heart Association Stroke Council, Council on Cardiovascular Disease in the Young. Management of stroke in infants and children: a scientific statement from a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young. Stroke. 2008;39:2644–91.CrossRefPubMedGoogle Scholar
  7. 32.
    de Veber GA, MacGregor D, Curtis R, Mayank S. Neurologic outcome in survivors of childhood arterial ischemic stroke and sinovenous thrombosis. J Child Neurol. 2000;15:316–24.CrossRefGoogle Scholar
  8. 33.
    Delsing BJ, Catsman-Berrevoets CE, Appel IM. Early prognostic indicators of outcome in ischemic childhood stroke. Pediatr Neurol. 2001;24:283–9.CrossRefPubMedGoogle Scholar

Acute Movement Disorders in Children

  1. 34.
    Sanger TD, Chen D, Fehlings DL, Hallett M, Lang AE, et al. Definition and classification of hyperkinetic movements in childhood. Mov Disord. 2010;25:1538–49.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 35.
    Baxter P. Status dystonicus: under-recognized and under-treated. Dev Med Child Neurol. 2013;55:99.CrossRefPubMedGoogle Scholar
  3. 36.
    Allen NM, Lin JP, Lynch T, King MD. Status dystonicus: a practice guide. Dev Med Child Neurol. 2014;56:105–12.CrossRefPubMedGoogle Scholar
  4. 37.
    Kirkham FJ, Haywood P, Kashyape P, Borbone J, Lording A, et al. Movement disorder emergencies in childhood. Eur J Paediatr Neurol. 2011;15:390–404.CrossRefPubMedGoogle Scholar
  5. 38.
    Yiş U. Status dystonicus and rhabdomyolysis in a patient with subacute sclerosing panencephalitis. Turk J Pediatr. 2012;54:90–1.PubMedGoogle Scholar
  6. 39.
    Phukan J, Albanese A, Gasser T, Warner T. Primary dystonia and dystonia-plus syndromes: clinical characteristics, diagnosis, and pathogenesis. Lancet Neurol. 2011;10:1074–85.CrossRefPubMedGoogle Scholar
  7. 40.
    Lumsden DE, Lundy C, Fairhurst C, Lin JP. Dystonia Severity Action Plan: a simple grading system for medical severity of status dystonicus and life-threatening dystonia. Dev Med Child Neurol. 2013;55:671–2.CrossRefPubMedGoogle Scholar
  8. 41.
    Frucht SJ. Movement disorder emergencies. Curr Neurol Neurosci Rep. 2005;5:284–93.CrossRefPubMedGoogle Scholar
  9. 42.
    Robottom BJ, Weiner WJ, Factor SA. Movement disorders emergencies. Part 1: hypokinetic disorders. Arch Neurol. 2011;68:567–72.PubMedGoogle Scholar
  10. 43.
    Manji H, Howard RS, Miller DH, Hirsch NP, Carr L, Bhatia K, Quinn N, Marsden CD. Status dystonicus: the syndrome and its management. Brain. 1998;121:243–52.CrossRefPubMedGoogle Scholar

Neuromuscular Emergencies in Children

  1. 44.
    Wendell LC, Levine JM. Myasthenic crisis. Neurohospitalist. 2011;1:16–22.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 45.
    Sladky JT. Guillain-Barré syndrome in children. J Child Neurol. 2004;19(3):191–200.PubMedGoogle Scholar
  3. 46.
    Simpson JA. An evaluation of thymectomy in myasthenia gravis. Brain. 1958;81(1):112–44.CrossRefPubMedGoogle Scholar
  4. 47.
    Millichap JG, Dodge PR. Diagnosis and treatment of myasthenia gravis in infancy, childhood, and adolescence: a study of 51 patients. Neurology. 1960;10:1007–14.CrossRefPubMedGoogle Scholar
  5. 48.
    van Doorn PA, Ruts L, Jacobs BC. Clinical features, pathogenesis, and treatment of Guillain-Barré syndrome. Lancet Neurol. 2008;7:939–50.CrossRefPubMedGoogle Scholar
  6. 49.
    Vucic S, Kiernan MC, Cornblath DR. Guillain-Barré syndrome: an update. J Clin Neurosci. 2009;16:733–41.CrossRefPubMedGoogle Scholar
  7. 50.
    Asbury AK, Cornblath DR. Assessment of current diagnostic criteria for Guillain-Barré syndrome. Ann Neurol. 1990;27:S21–4.CrossRefPubMedGoogle Scholar
  8. 51.
    Liu J, Wang LN, McNicol ED. Pharmacological treatment for pain in Guillain-Barré syndrome. Cochrane Database Syst Rev. 2015;4:CD009950.PubMedGoogle Scholar
  9. 52.
    Hughes RA, Swan AV, van Doorn PA. Intravenous immunoglobulin for Guillain-Barré syndrome. Cochrane Database Syst Rev. 2014;9:CD002063.PubMedGoogle Scholar
  10. 53.
    Chaudhuri A, Behan PO. Myasthenic crisis. QJM. 2009;102(2):97–107.CrossRefPubMedGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Department of Pediatric Emergency MedicineInstitute of Child Health and Hospital for Children, Madras Medical CollegeChennaiIndia
  2. 2.Department of Neurological SciencesChristian Medical CollegeVelloreIndia

Personalised recommendations