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[Ischemic anoxic cerebral crises in children. Electrophysiological aspects]
A J Pozo-Alonso1, D Pozo-Lauzán, G Alvarez-Flores
1Servicio de Neuropediatría, Hospital Pediátrico Universitario William Soler, La Habana, Cuba. pozo@infomed.sld.cu
Insights
The ocular compression test can identify vagal hypersensitivity in children experiencing cerebral crises. This finding is crucial for diagnosis and prognosis, linking heart rate pauses to clinical symptoms.
Area of Science:
- Neurology
- Pediatrics
- Cardiology
Context:
- Ischemic anoxic cerebral crises are associated with cardio-inhibition due to vagal hypersensitivity.
- Cerebral ischemia can result from such events.
Purpose:
- To describe clinical and electrophysiological features during the ocular compression test.
- To evaluate the test's utility in diagnosing cerebral crises in children.
Summary:
- The ocular compression test was performed on 200 children with suspected ischemic anoxic cerebral crises.
- The test provoked signs and symptoms in 48.5%–62.5% of patients, with hypotonia and loss of consciousness being most common.
- Clinical changes correlated with the duration of heartbeat pauses and electroencephalographic findings.
Impact:
- Identifying vagal hypersensitivity aids in the differential diagnosis of pediatric cerebral crises.
- This assessment holds significant prognostic value for affected children.
Introduction:
Ischemic anoxic cerebral crises are linked to cardio-inhibition in response to vagal hypersensitivity which causes cerebral ischemic.
Objective:
In this paper we proposed to describe the clinical and electrophysiological features seen during the ocular compression test.
Patients And Methods:
We studied 200 children with clinical findings suggesting ischemic anoxic cerebral crises with positive results on ocular compression testing.
Results:
The ocular compression test provoked signs and symptoms, on average, in between 48.5% and 62.5% of the patients; generalized hypotonia and loss of consciousness were the most frequent signs. We found that the presence of clinical changes depended on the duration of the pause in heartbeat. There was also an association between the duration of the pause in heartbeat and the electroencephalographic findings.
Conclusions:
Identification of a state of vagal hypersensitivity is of considerable value in the positive differential diagnosis of cerebral crises in children, and of definite prognostic value.