By Peter L. Heilbroner MD PhD;Glenn Castaneda MD
Geared to basic care practitioners, this easy, useful advisor specializes in review and administration of universal pediatric neurologic stipulations. insurance contains regimen issues reminiscent of complications, ADHD and faculty difficulties, autism, seizures, developmental delays, behavioral difficulties, tics, alterations in gait, and dizziness, in addition to neurologic stipulations encountered within the emergency room. The authors deal with daily questions corresponding to tips to distinguish critical from non-serious stipulations, even if to reserve an EEG or MRI, what to do while a toddler doesn't reply to drugs, and the way to debate universal matters with mom and dad. each one bankruptcy comprises regular case stories.
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Additional info for Pediatric Neurology Essentials for General Practice
If the headaches are associated with focal neurological signs or symptoms, especially hemiparesis or hemiplegia, MRI may be ordered to search for an arteriovenous malformation (AVM; see following section), but the yield is very low. Many patients with a history suggestive of migraine are sent for MRI anyway. Parental anxiety, uncertainty about the diagnosis, misdiagnosis, and medicolegal fears are the usual reasons and are understandable. Repeat MRI studies, however, are not justifiable unless the patient's headaches dramatically change in quality.
Avoidance of caffeinated beverages is often helpful in particular, as rebound from caffeine often causes a headache. In many cases, these modifications decrease the frequency of tension headaches without the need for prescription medication. 42 The treatment of chronic tension-type headaches should always address the source of the patient's stress. Biofeedback sessions, as well as the teaching of stress reduction and pain management techniques, may be helpful. Assistance in school or psychotherapy is often appropriate.
50 Intractable migraine Physicians will occasionally need to treat a patient who is having a severe migraine headache that has not responded to several drugs. ) is often and inappropriately prescribed in this situation. Although the opiate may provide temporary relief, the headache will typically return and worsen after the drug wears off in a few hours. Opiate analgesic medications are not recommended for the treatment of an intractable migraine headache. There are better options. A short course of a corticosteroid (Medrol dosepak, Pharmacia/Upjohn; or prednisone, 60 mg daily for 5 days) should be prescribed and proves to be effective within 24 hours in most cases.
Pediatric Neurology Essentials for General Practice by Peter L. Heilbroner MD PhD;Glenn Castaneda MD