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Alterations of Neurologic
Function in Children
Chapter 19
1
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
2
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Structure and Function of the
Nervous System in Children






Sulcus limitans
Basal plate
Alar plate
Sutures
Fontanelles
Myelin sheath
3
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Structure and Function of the
Nervous System in Children
4
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Structure and Function of the
Nervous System in Children
5
Mosby items and derived items © 2006 by Mosby, Inc.
Structural Malformations

Defects of neural tube closure




Anencephaly
Encephalocele
Meningocele
Myelomeningocele


Arnold-Chiari type II malformation
Tethered cord syndrome
6
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Structural Malformations
7
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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)
8
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Axial Skeleton Malformations
9
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Encephalopathies

Static encephalopathies

Cerebral palsy



Static cerebral palsy
Dyskinetic cerebral palsy
Ataxic cerebral palsy
10
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Encephalopathies

Inherited metabolic disorders

Defects in amino acid metabolism

Phenylketonuria (PKU)


Hyperphenylalaninemia
Defects in lipid metabolism


Lysosomal storage diseases
Tay-Sachs disease
11
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Seizure Disorders

Epilepsy



Partial seizures
Generalized seizures
Unclassified epileptic seizures





Infantile spasms
Lennox-Gastaut syndrome
Juvenile myoclonic epilepsy
Status epilepticus
Benign febrile seizures
12
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Acute Encephalopathies


Reye syndrome
Meningitis


Bacterial meningitis
Viral meningitis
13
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Children and HIV

HIV infections in children



Perinatally through the placenta
Exposure to infected maternal blood and vaginal
secretions
Postpartum ingestion of breast milk
14
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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
15
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Childhood Tumors

Brain tumors



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
Medulloblastoma
Ependymoma
Astrocytoma
Brainstem glioma
Optic nerve glioma
16
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Childhood Brain Tumors
17
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Childhood Tumors

Embryonal tumors


Neuroblastoma
Retinoblastoma
18
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Childhood Tumors
19
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