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Alterations of Neurologic Function in Children. Chapter 19. Structure and Function of the Nervous System in Children. Develops from a dorsal thickening of the ectoderm (neural plate) Neural groove and folds Neural tube Neural crest Mesoderm
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Structure and Function of the Nervous System in Children • Develops from a dorsal thickening of the ectoderm (neural plate) • Neural groove and folds • Neural tube • Neural crest • Mesoderm • Blood vessels, microglial cells, dural and arachnoid layers of the meninges, the capsule of some peripheral nerve endings, and nerve coverings
Structure and Function of the Nervous System in Children • Sulcus limitans • Basal plate • Alar plate • Sutures • Fontanelles • Myelin sheath
Structural Malformations • Defects of neural tube closure • Anencephaly • Encephalocele • Meningocele • Myelomeningocele • Arnold-Chiari type II malformation • Tethered cord syndrome
Axial Skeleton Malformations • Spinal bifida occulta • Vertebral defect that allows the protrusion of the neural tube contents • Cranial deformities • Acrania • Craniosynostosis • Microcephaly • Congenital hydrocephalus • Macewen sign (“cracked-pot” sign)
Encephalopathies • Static encephalopathies • Cerebral palsy • Static cerebral palsy • Dyskinetic cerebral palsy • Ataxic cerebral palsy
Encephalopathies • Inherited metabolic disorders • Defects in amino acid metabolism • Phenylketonuria (PKU) • Hyperphenylalaninemia • Defects in lipid metabolism • Lysosomal storage diseases • Tay-Sachs disease
Seizure Disorders • Epilepsy • Partial seizures • Generalized seizures • Unclassified epileptic seizures • Infantile spasms • Lennox-Gastaut syndrome • Juvenile myoclonic epilepsy • Status epilepticus • Benign febrile seizures
Acute Encephalopathies • Reye syndrome • Meningitis • Bacterial meningitis • Viral meningitis
Children and HIV • HIV infections in children • Perinatally through the placenta • Exposure to infected maternal blood and vaginal secretions • Postpartum ingestion of breast milk
Cerebrovascular Disease • Cerebrovascular disease in children differs in adults in three ways: • Absence of predisposing factors • Differences in the clinical response • Anatomic site of the pathologic condition • Occlusive cerebrovascular disease • Hemorrhagic cerebrovascular disease
Childhood Tumors • Brain tumors • Medulloblastoma • Ependymoma • Astrocytoma • Brainstem glioma • Optic nerve glioma
Childhood Tumors • Embryonal tumors • Neuroblastoma • Retinoblastoma