RESUMEN
The aim of this study was to describe the abnormalities associated with migraine aura lasting 1-24 h in children as shown by EEG, trancranial Doppler (TCD) and single photon emission computed tomography (SPECT). In this retrospective study, 11 patients each underwent EEG, TCD and brain SPECT on the day of admission and the day thereafter. On the day of admission, the migrainous hemisphere of all patients showed that the mean velocities were decreased in the middle cerebral artery by TCD, slow-wave abnormalities were recorded after several hours of aura by EEG and the SPECT showed hypoperfusion. On the day after, in the same hemisphere, slow waves were recorded only in the occipital area by EEG, and SPECT showed slight hyperperfusion. In these patients, there was a clear sequence of EEG, TCD and SPECT abnormalities.
Asunto(s)
Trastornos Cerebrovasculares/diagnóstico , Trastornos Cerebrovasculares/fisiopatología , Electroencefalografía/métodos , Migraña con Aura/diagnóstico , Migraña con Aura/fisiopatología , Tomografía Computarizada de Emisión de Fotón Único/métodos , Ultrasonografía Doppler Transcraneal/métodos , Adolescente , Niño , Femenino , Humanos , Masculino , Estudios RetrospectivosRESUMEN
The medical part of the activity in the emergency units increased and has been ascribed to the raised number of infants or children admitted for acute dyspnea. This review is based on the published reports and the experience from the paediatric emergency unit from the Rouen area with 450,000 inhabitants, in France. We put forward the known epidemiological data and discussed the available means for the practitioner, which could help him in the decision to hospitalize. This review suggests that algorithms of treatment and severity evaluations must be set up in paediatric emergency units in order to validate them and specify the children who requires hospitalisation.
Asunto(s)
Trastornos Respiratorios/diagnóstico , Trastornos Respiratorios/epidemiología , Factores de Edad , Algoritmos , Asma/complicaciones , Preescolar , Disnea/diagnóstico , Disnea/epidemiología , Disnea/etiología , Urgencias Médicas , Femenino , Francia/epidemiología , Hospitalización , Humanos , Lactante , Laringitis/complicaciones , Masculino , Valor Predictivo de las Pruebas , Trastornos Respiratorios/etiología , Índice de Severidad de la Enfermedad , Factores SexualesAsunto(s)
Asma/diagnóstico , Asma/fisiopatología , Oxígeno/sangre , Ápice del Flujo Espiratorio , Niño , Preescolar , Urgencias Médicas , Femenino , Humanos , Masculino , Oximetría , Presión ParcialRESUMEN
The increase in frequency of anaphylaxis, an acute allergic reaction which may be fatal, might be explained by the rise in food allergy. We report a cohort of 44 children, aged 2 months to 15.5 years, who were admitted in a pediatric emergency unit for serious allergic events. Thirty-two percent, 86% and 66% presented hypotension, severe edema and respiratory distress, respectively. Three patients were admitted to the ICU. One-fourth of all children had an angioneurotic edema history, 1/3 were asthmatics and 41% had known allergy. Etiologies were: food allergy (42.5%), drugs (14.8%), respiratory allergy (9%), miscellaneous (14.8%), idiopathic (6.4%) and unknown because of incomplete investigations (12.4%). Three-fourths of food allergies were comprised of the expected protein categories (milk, nuts, eggs and fish). Nine children had an allergic relapse during the following months. We otherwise assessed that adrenaline was underused by the medical staff.