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Paediatrics
Cerebral Palsy and CNS Infections in Paediatrics Complete Guide Causes Symptoms Diagnosis Treatment
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Cerebral palsy is a group of non progressive disorders of movement and posture caused by injury to the developing brain in the antenatal perinatal or early postnatal period.
Common causes include prematurity birth asphyxia intrauterine infections placental insufficiency and postnatal infections like meningitis.
Spastic cerebral palsy is the most common type accounting for about 70 to 80 percent of cases.
Delayed developmental milestones especially delayed motor milestones are usually the earliest sign.
Diagnosis is mainly clinical supported by MRI brain which helps identify the underlying brain injury.
Physiotherapy is the cornerstone of management along with medications like baclofen botulinum toxin and supportive therapies.
CNS infections include infections of the brain and meninges such as meningitis encephalitis brain abscess and tubercular meningitis.
Common causes include Streptococcus pneumoniae Neisseria meningitidis and Haemophilus influenzae while neonates commonly have Group B Streptococcus and E coli.
Symptoms include fever neck stiffness vomiting altered sensorium and in neonates poor feeding and bulging fontanelle.
Diagnosis is confirmed by lumbar puncture and cerebrospinal fluid analysis showing characteristic changes in cells protein and glucose.
Treatment includes intravenous antibiotics such as ceftriaxone or cefotaxime with vancomycin and supportive care.
Encephalitis is inflammation of brain tissue most commonly caused by viruses especially herpes simplex virus.
Intravenous acyclovir is the first line treatment and should be started immediately.
Brain abscess is a localized collection of pus in the brain usually due to infection from ear sinus or congenital heart disease.
CT or MRI shows a ring enhancing lesion with surrounding edema.
It is a chronic form of meningitis caused by Mycobacterium tuberculosis characterized by gradual onset cranial nerve palsies and hydrocephalus.
CSF shows lymphocytic predominance very high protein and low glucose levels.
Complications include seizures hydrocephalus hearing loss cognitive impairment and death if untreated.
Steroids like dexamethasone reduce inflammation and complications especially in bacterial meningitis.
Prevention includes vaccination hygiene early treatment of infections and antenatal care.
