儿科常见症状儿科专家课件.pptVIP

儿科常见症状 Case 1 Case 2 Intracranial Bacterial meningitis Brain abscess TB Viral encephalitis Cerebral parasitosis Extracranial Respiratory infection Digestive tract infection Urinary tract infection Systemic infection Case 3 Case 4 Case 5 Febrile Seizure Diagnostic Criteria Fever Absence of intracranial infection or severe metabolic derangement No prior history of afebrile seizures Predisposing factors in childhood Excessive neuroexcitation Poor control effect of cerebral cortex on subcortex Maldevelopment of medullary sheath -dysfunctin of isolation and protection Age: 6m-6y, peak incidence is 14-18m Temperation higher than 38℃ Duration 15min Onset within 24hr after onset of fever Generalized tonic-clonic or atonic One seizure per febrile episode Normal neurologic examination EEG normal Family history of febrile convulsions Simple (80%) Age: may 6m or 6y Temperation may lower than 38℃ Onset more than 24hr after onset of fever Duration 15min Partial features or focal seizures ? 2 seizures within 24 hours Neurologic deficits or developmental delay EEG abnormal Family history of nonfebrile seizures Complex (20%) 33% to 50% of children have recurrent FC Strongest risk for recurrence: young age of onset family history of FC Antiepileptics and antipyretics: no prevent Risk factors for epilepsy: Family history of epilepsy Developmental delay Complex febrile seizures Recurrence complications 2岁，女孩，晨起开始发热，39度，轻度咳嗽，午后突然惊厥发作，双眼上翻，呼之不应，四肢强直并有抽动，持续5分钟后经此即人中后缓解，病前无特使病史，生长发育史正常。 查体：T39.5度，神志清楚，反应尚好，皮肤未见出血点及皮疹，咽部稍充血，颈部无抵抗，心肺腹检查未见异常，神经系统检查未见异常。 * 宋红梅 Fever Higher than 37.4℃ (temperature in axillary) (orally 37.5 ℃) (vectal 37.8 ℃) Defination Measurement: Orally, axillary, rectal (difference: 0.3~0.5) Grade: low-grade fever 38 ℃ moderate fever 38~39 ℃