Department of Paediatric Neurology, Sheffield Children’s Hospital, NHS Foundation Trust, Sheffield, UK.
Arch Dis Child. 2012 May;97(5):452-8. doi: 10.1136/adc.2011.300998. Epub 2011 Dec 27.
Childhood encephalopathy is an uncommon but significant paediatric presentation and is associated with significant mortality and long-term morbidity in survivors. By definition it is a somewhat non-specific presentation with a wide differential diagnosis and long list of possible investigations. Choice of investigation, including neuroimaging modality, can be a daunting prospect for the clinician faced with the encephalopathic child and it is important to select appropriately for a high diagnostic yield. Initial management centres on good emergency care irrespective of cause. More specific therapies however vary enormously, and appropriate treatment is important and influences outcome. Evidence exists for management of many of the individual conditions causing encephalopathy. This review aims to outline a clinical approach to selecting investigations to identify a specific cause and provides an overview of the treatment for the commoner causes of encephalopathy that a general paediatrician may reasonably expect to be faced with.
儿童脑病是一种罕见但严重的儿科疾病，幸存者的死亡率和长期发病率都很高。从定义上讲，它的表现有些非特异性，鉴别诊断广泛，可能的检查项目很多。面对脑病患儿，临床医生选择检查方法，包括神经影像学模式，可能会感到不知所措，为了获得高诊断率，选择合适的检查方法非常重要。初始治疗的重点是无论病因如何，都要进行良好的急救护理。然而，更具体的治疗方法差异很大，适当的治疗非常重要，并影响结果。对于引起脑病的许多特定疾病，都有相关的治疗证据。本综述旨在概述一种临床方法，通过选择检查来确定特定病因，并提供更常见的脑病病因的治疗概述，这是普通儿科医生可能会遇到的。
