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Download Neurología pediátrica clínica. Un Enfoque por Signos y by Gerald M Fenichel MD PDF

By Gerald M Fenichel MD

Vanderbilt kid's health center, Nashville, TN. Spanish translation of the unique English textual content which indexed in AP 2005-16. Brandon/Hill scientific record choice (#381). offers a pragmatic, symptom-based method of universal difficulties of kids with issues of the apprehensive method. earlier version: c1997. DNLM: worried process Diseases--diagnosis--Child

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Extra resources for Neurología pediátrica clínica. Un Enfoque por Signos y Síntomas

Example text

Los factores determinantes con posible importancia incluyen signos neurológicos, historia familiar y factores precipitantes conocidos. Un testigo ocular que describa signos focales al comienzo de la crisis, o la TABLA 1-11 Consideraciones diagnósticas ante una primera convulsión tónico-clónica no febril después de los 2 años de edad Convulsión aislada inexplicada Convulsión parcial de cualquier causa con generalización secundaria Encefalopatía o encefalitis aguda (véase capítulo 2) Epilepsia generalizada primaria Trastorno progresivo del sistema nervioso (véase capítulo 5) Capítulo 1: Trastornos paroxísticos presencia de un aura, indican una crisis parcial con generalización secundaria.

La dosis inicial es de 15 mg/kg/día en tres tomas fraccionadas. Evite la administración nocturna si el fármaco causa insomnio. Para obtener el control de las convulsiones, utilice incrementos semanales de la dosificación, de 15 mg/kg, si son necesarios, hasta una dosis total de aproximadamente 45 mg/kg/día. La toxicidad limita la dosis total, y las mediciones de la concentración sanguínea no son útiles. EFECTOS ADVERSOS. Los datos iniciales sugirieron que los efectos adversos del felbamato eran leves y relacionados con la dosis (náuseas, anorexia, insomnio, pérdida de peso), excepto en combinación con otros anticonvulsivos.

CUADRO CLÍNICO. El comienzo puede ocurrir en cualquier momento después del período neonatal, pero la epilepsia generalizada primaria sin ausencia suele comenzar durante la adolescencia. Cuando existen ausencias, la edad de comienzo más frecuente cambia a la primera década. La pérdida brusca de conciencia es la manifestación inicial. El niño cae al suelo y el cuerpo aparece rígido (fase tónica). Siguen movimientos convulsivos repetidos de los miembros (fase clónica); esos movimientos son rápidos y rítmicos al principio, y después se convierten en más lentos e irregulares conforme termina la crisis.

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