The Role of The Child Neurologist In The Diagnosis of Infantile Brain Injury

Administrator: Joseph Scheller

Seizures in suspected abusive head trauma
Joseph Scheller

Infantile seizures can have varying manifestations.Infants admitted for suspected brain injury are typically lethargic, apneic or comatose. There is often no history of trauma, there is often no explanation offered for the symptoms. Sometimes there are varying versions of the medical history. There can be multiple caregivers involved. If a subdural hematoma if found on emergent neuroimaging a child abuse consultant will be notified. Because of neurologic symptoms a child neurologist will be consulted. The speaker will review the published literature on the subject, and go on to discuss symptoms, signs, electroencephalogram patterns and neuroradiology findings in infants suspected of being abused. The importance of suspecting seizures in apneic and lethargic infants will be stressed. The importance of performing a complete history and physical examination will be discussed. Vital blood work studies and Xrays will be discussed. The importance of early EEG monitoring and anticonvulsant use will be emphasized. The MR findings of infants who have frequent seizures will be demonstrated. Short and long term outcomes of these infants will be reviewed.