acute toxic encephalopathy in children
Introduction
Introduction to acute toxic encephalopathy in children Acute toxic encephalopathy (acutetoxicencephalopathy) is a common central nervous system disease in infants and young children. Its main clinical manifestation is the sudden appearance of central nervous system symptoms in the process of diseases other than the primary nervous system. Similar to encephalitis, such as fever, disturbance of consciousness, lethargy or coma, convulsions and pathological reflexes, but cerebrospinal fluid examination, in addition to increased pressure, often no other abnormal findings, the disease is more common in infants and young children. basic knowledge The proportion of illness: 0.031% Susceptible people: infants and young children Mode of infection: non-infectious Complications: brain edema, cerebral hemorrhage, coma, cerebral palsy
Cause
Causes of acute toxic encephalopathy in children
(1) Causes of the disease
In childhood, many infectious diseases may be associated with symptoms similar to encephalitis, among which pneumonia, dysentery, and sepsis are more common, such as scarlet fever, diphtheria, whooping cough, typhoid fever, cholera, pyelonephritis, flu, hepatitis ( Outbreaks, malaria, etc. can also be associated with significant brain symptoms. In addition, some drugs and poisons such as lead, arsenic, carbon monoxide, mercury, manganese, benzene, alcohol, and mildew can also cause similar symptoms.
(two) pathogenesis
The production of toxic encephalopathy is mainly due to the effects of different toxins produced by different pathogens on the central nervous system caused by different pathogens, rather than direct invasion of pathogens, such as lung disease affecting lung function, reducing oxygen concentration and (or Carbon dioxide accumulation, simple hypoxemia is more serious than carbon dioxide accumulation, can lead to increased intracranial pressure, accompanied by cerebral circulation and cerebral metabolic disorders; ammonia, short-chain fatty acids, thiols, singles produced by diseases that seriously affect liver function Amine, norepinephrine and neurotransmitters, amines and other substances have a significant effect on the central nervous system when the concentration of blood and brain varies greatly. Among them, the abnormal amino acid metabolism plays a leading role in causing encephalopathy. The main cause of encephalopathy caused by kidney disease is Organic acid accumulation, blocking the delivery system of choroid plexus and glial cells, hindering the removal of metabolites in the neurotransmitter, and due to the membrane permeability of the brain tissue, the toxins flood into the brain, leading to the cerebral cortex. Dysfunction, as well as the response of toxins produced by pathogens to the central nervous system, causing cerebrovascular microcirculatory disorders, etc. For the above reasons can lead to cerebral ischemia and hypoxia, pathological changes in the brain parenchyma mainly congestion and edema.
Prevention
Prevention of acute toxic encephalopathy in children
Actively prevent and cure all kinds of infectious diseases, do a variety of vaccination work, talk about hygiene, develop good health habits, strengthen nutrition, enhance children's physical fitness, do not eat unclean and spoiled food, avoid drugs and poisons harm to children Wait.
Complication
Complications of acute toxic encephalopathy in children Complications brain edema cerebral hemorrhage coma
Ischemia, hypoxia can lead to cerebral edema, cerebral hemorrhage and other changes, convulsions and coma, limb paralysis, severe cerebral palsy, renal dysfunction, multiple organ dysfunction, etc., sequelae including insufficiency, blindness, deafness, limbs Tonic, convulsions, epilepsy, respiratory failure, etc.
Symptom
Symptoms of acute toxic encephalopathy in children Common symptoms Meningeal irritation signs high fever irritability coma
Most of them infringe on children aged 1 to 3 years old, and the condition is more serious. The symptoms of brain damage often occur in a few days or 1 to 2 weeks after the primary disease. Because of the different severity of brain lesions, the clinical manifestations are diverse, and most of the symptoms occur. Suddenly high fever (only a few normal or low body temperature), headache, vomiting, irritability or lethargy, cold limbs, pale, oliguria, convulsions and coma, anterior iliac swell, often with generalized tonic tendon, occasionally There are side or bilateral limb paralysis, and meningeal irritation signs are also seen, which are not prominent, and tendon reflexes are enhanced, weakened or disappeared.
Examine
Examination of acute toxic encephalopathy in children
In addition to the characteristics of the primary disease laboratory examination, the cerebrospinal fluid examination of this disease is transparent, the pressure is obviously increased, the cells generally do not increase, the protein only occasionally increases slightly, and there is a small amount of protein in the urine, which is related to the primary infection.
According to different primary diseases, different auxiliary examinations, such as severe pneumonia, were performed by X-ray examination. The brain CT examination showed brain edema in the early stage, brain atrophy in the later stage, brain widening and ventricular enlargement.
Diagnosis
Diagnosis and diagnosis of acute toxic encephalopathy in children
diagnosis
According to the course of acute infection, sudden onset of high fever, headache, vomiting, irritability, convulsions, convulsions and coma, as well as increased cerebrospinal fluid pressure without other changes, can be diagnosed as acute toxic encephalopathy.
Differential diagnosis
It should be differentiated from febrile seizures, viral encephalitis, purulent meningitis, and Reye syndrome. In addition, brain symptoms can also occur in congenital metabolic diseases, such as type VII glycogen storage disease and Leigh disease. Must also be identified.
