- Medical treatment of hydrocephalus.

Medical treatment of hydrocephalus

*Aim:-

Medical treatment is used to delay surgical intervention.

*Medical treatment is not effective in long-term treatment of chronic hydrocephalus. It may induce metabolic consequences and thus should be used only as a temporizing measure.

*Lines of TTT:- "Fair"

• Furosemide:1mg/kg/day.(Decreasing CSF secretion).
• Acetazolamide 5mg/kg/day.(Decreasing CSF secretion).
• Isosorbide (Increasing CSF reabsorption).
• Restriction of water and salts.

Dr Ibrahim

- Skull causes of macrocephaly.

Skull causes of Macrocephaly.

"Oscar"

Osteogenesis imperfecta.
Secondaries especially neuroblastoma.
Chronic hemolytic anemia.
Achondroplasia.
Rickets.

Dr Ibrahim

-Guillain Barr� syndrome.

Guillain Barr� syndrome

Aetiology(theories):-

• Postinfection:50% of cases have preceding respiratory or GIT viral infection.
• Post vaccination:following vaccination against swine flu virus.
• Lymphoma.
• Autoimmune theory.

Clinical Picture:-
1-Initial febrile illness.
2-Motor affection:-

• Bilateral symmetrical ascending affection of both lower limbs,trunk,upper limbs,Bulbar muscles,facial muscles then diphragm and respiratory muscles.
• The Affection is proximal more than distal in adult.
• The Affection is proximal more than distal in infant and childrens.
• Weakness is associated with hypotonia and areflexia.
  

Read more �

-Lambert-Eaton syndrome.

Lambert-Eaton syndrome
or
Myasthenic-myopayhic syndrome.

*Pathophysiology:-

• a myasthenic syndrome due to autoimmune orocess targeting the mechanism of releasing A.CH from nerve terminals.
• It often associated with bronchogenic carcinoma or other malignancies.

*Clinical picture:-
Proximal weakness,wasting and fatigue but with less common ocular and bulbar affection than Myasthenia.

*Diagnosis:-

• EMG:- shows paradoxical increase  in successive muscle contractions.
• No significant response to prostigmine,but respond to guanidine HCL 20 mg/Kg/day or prednisolone+imuran.
• No acetylecholine receptor antibodies.
• CXR to determine if associated with bronchogenic carcinoma or not.

*Treatment:-

• Treatment of the underlying neoplasm.
• Plasmapheresis.
• Immunosuppression.

Dr Ibrahim

Return to list of medical syndromes here

-Poisons with charachteristic odour.

Poisons with charachteristic odour

"Phenol"

Phenol,Phosphorus.

Hydrocarbons.
Hydrocyanic acid(Bitter almond).
Hydrogen sulphide(Rotten egg).

Ethanol and methanol.
Nicotine.

Opium.
Organophosphorus,arsenic (Garlic odour).

Liquid of salicylate"oil of winter green".

Dr Ibrahim

-Indications of heamodialysis.

Indications of heamodialysis
"Unstable"

Uraemia.
No response to conventional therapy.
Salicylates.
Theophylline.
Alcohols,Acetaminophen.
Boric acid,Barbiturates.
lithium.
Ethylene glycol.

Dr Ibrahim

-Substances not adsorbed by Activated Charcoal.

Substances not adsorbed by Activated Charcoal
"Phials"

Pesticide,potassuim
Hydrocarbons.
Iron,Insecticide.
Acids,Alkali,Alcohols.
Lithium.
Solvents.

Dr Ibrahim