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
Keywords
Related Articles
- EP ID EP503418
- DOI 10.1016/j.jped.2017.06.003
- Views 70
- Downloads 0
Aggregation of risk indicators to cardiometabolic and musculoskeletal health in Brazilian adolescents in the periods 2008/09 and 2013/14
Objective To assess the occurrence of an aggregate risk to cardiometabolic and musculoskeletal health of Brazilian adolescents in the period 2008/09 and 2013/14 and to identify whether there are differences in risk betwe...
Risk of recurrence after a first unprovoked seizure in children
Objectives This study aimed to evaluate the first episode of unprovoked epileptic seizure in children and assess recurrence risk factors. Methods This was a retrospective observational study, based on the analysis of me...
Leisure-time physical activity and cardiometabolic risk among children and adolescents
Objective To assess the effect of Leisure-time physical activity (LTPA) on cardiometabolic risk by nutritional status in Mexican children and adolescents. Methods This was a cross-sectional study conducted with 1,309 pa...
Brazilian adaptation and validation of the Empowerment of Parents in the Intensive Care-Neonatology (EMPATHIC-N) questionnaire
Objectives Considering the lack of questionnaires that propose to evaluate parental satisfaction with the Neonatal Intensive Care Unit (NICU) in Brazil, this study aimed to carry out the translation of the EMPATHIC-N que...
Validation of a subjective global assessment questionnaire
Objective To validate the Subjective Global Nutritional Assessment (SGNA) questionnaire for Brazilian children and adolescents. Methods A cross-sectional study with 242 patients, aged 30 days to 13 years, treated in ped...