Pregledni rad
https://doi.org/10.26800/LV-145-supl5-7
Acute ataxia in paediatric emergency department – diagnostic and therapeutic approach
Nina Barišić
orcid.org/0000-0002-8839-1522
; Dječja bolnica Srebrnjak, Hrvatsko društvo za dječju neurologiju Hrvatskog liječničkog zbora
Sažetak
Ataxia is the second most common in the clinically and genetically very heterogeneous group of hyperkinetic movement disorders. Ataxia represents a disorder of coordination, control of and the inability to perform voluntary movements of the head, trunk (truncal ataxia) and limbs, broad base gait, dysmetria, dysdiadochokinesis, nystagmus and dysarthria, tendon reflexes can be decreased or absent, or increased, or of the pendular type. Ataxia In emergency department can be manifested as acute or chronic – progressive and nonprogressive, it can be localized or generalized, unilateral or bilateral. Ataxia becomes clearly visible and recognizable when the child acquires the ability to sit, or later to stand and walk unassisted. Acute ataxia etiologically includes acquired: infectious, post-infectious or immune-mediated, intoxication, caused by brain tumours, head/ brain trauma, strokes, paraneoplastic or functional/psychogenic ataxias. The most common of acquired acute ataxias is acute, post or para-infectious ataxia, ataxia caused by intoxication or brain tumour. For the appropriate diagnosis and treatment of ataxia, first of all, a thorough clinical and neurological examination and a detailed medical history are required. Brain MR (or brain CT imaging in emergency department) and toxicological screening in urine sample and blood glucose level are mandatory indicated in children with acute ataxia. Diagnostic procedures in acute ataxia includes lumbar puncture and cerebrospinal fluid examination, optic fundi exam, EEG and ENT exam. Electromyoneurography is informative in the diagnosis of both acquired and genetic causes of acute ataxia, primarily of motor and sensory polyneuropathy, radiculopathy and myelopathy, though is not an urgent investigation. Vestibular lesions, vestibular and basilar migraine can be clinically manifested secondary.
Ključne riječi
ATAXIA, acute, acquired, genetic treatable; DIAGNOSTICS; GUIDELINES; THERAPY
Hrčak ID:
308854
URI
Datum izdavanja:
10.10.2023.
Posjeta: 259 *