Monday 24 June 2013

COMA IN PEDIATRICS!

*STATE OF UNRESPONSIVENESS DUE TO DIFFUSE LESIONS OF HEMISPHERES / BRAIN STEMS: 1.Structural lesions bleeding, tumour, abscess, hydrocephalus
2. Non-structural lesions (95%) seizures, drugs / poisons infection (meningitis, encephalitis, HUS) metabolic (hypoglycaemia, DKA, Reye) renal failure, hepatic coma endocrine (Addison)

*ASSESSMENT AND DIAGNOSIS:
 1.Rapid History and General Examination:
 Skin (trauma, petechiae, bleeding)
 Sutures in infant and neck stiffness, systemic, AF 
2.CNS examination:
 GCS, Gag R, Blinking
 Pupils Reaction, EOM Palsy, Fundi, Dolls Eye
 Motor- Posture, Tone, Symmetry/Lateralizing signs
 Reflexes- DTR, Plantars
 Pain, Grimace, Flexion, Extension, None
 Assess level of Central Dysfunction

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