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Handbook of Pediatric Electroencephalography by Veena Kander now on ICNApedia VLE

Investigations in Child Neurology

Investigations

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The MRI can be used to meet the dissemination in space requirement if the McDonald criteria for a positive MRI are applied. The MRI must show three of the following four features: (1) nine or more white matter lesions or one gadolinium-enhancing lesion, (2) three or more periventricular lesions, (3) a juxtacortical lesion, (4) an infratentorial lesion. The combination of an abnormal CSF finding and two lesions on the MRI, of which one must be in brain, can also meet the dissemination in space criteria; the CSF must...
 
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CT Brain, with contrast is around 85% sensitive for a diagnosis of CVST. If there is doubt MR Venography should be undertaken Negative CT in the context of persistent neurological impairment should prompt further investigation with MRI or, if this proves impossible, repeat CT, as pathologies such as arterial ischaemic stroke become more apparent on CT with time. In Arterial ischaemic stroke (AIS) as well as brain imaging, investigation should include evaluation for thrombophilia (including anticardiolipin antibodies). The history should include enquiry...
 
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Nonspecific combinations of epileptic and non-epileptic phenomena Condition Epileptic component Non-epileptic component Investigations ...
 
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Paroxysmal non-epileptic events Category Condition Clinical features Investigations ...
 
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Differential diagnosis of seizures with fever The following diagnostic possibilities exist, these not being mutually exclusive. 1. The convulsion is not an epileptic seizure nor an anoxic seizure but is a rigor or an hallucination or febrile myoclonus or febrile ataxia. 2. The seizure is a febrile syncope similar to a syncope suffered by adults with influenza and fever. 3. The seizure is a syncope due to ventricular tachyarrhythmia precipitated by fever Brugada syndrome (a sodium channelopathy with several...
Investigating epilepsies
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Some genetic, structural and metabolic epilepsy associations Condition Clinical Investigations Down...
EEG
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EEG pattern in common epileptic seizures Seizure type Semiology Ictal EEG Ictal EMG (both deltoids) Comments ...
 
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Ischaemic forearm test
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This test measures basal and post-exercise venous lactate and ammonia levels. The blood lactate is measured after the fist has been clenched repeatedly for 1 minute with the arm made ischaemic using a sphygmomanometer. Samples are taken at -10 minutes (pre-exercise) and at 0, 1, 3, 5, 10 and 20 minutes following release of the cuff. A normal response is characterized by a lactate increase of 3-5 fold over baseline with a peak at 1-3 minutes post-exercise, while ammonia increases 5-10 fold over the same time. An absent or inadequate (less than 1.5-fold) increase in lactate is...
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