Category Archives: Neurology

Tip 61b: benign sleep myoclonus

The myoclonic jerks, mainly affecting the distal upper limbs, can be unilateral or bilateral, and usually last for 10–20 seconds. Sleep is not disturbed and they stop abruptly when the baby is awakened. There are no other clinical manifestations of … Continue reading

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Tip 61a: benign sleep myoclonus

Neonatal benign sleep myoclonus is a common non-epileptic condition, starting between day one and three weeks of age. It normally subsides by a few months of age, with no treatment needed. Reference: Panayiotopoulos, C.P., 2005. The Epilepsies: Seizures, Syndromes and Management. … Continue reading

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Tip 44a: antenatal magnesium sulphate

IV magnesium sulfate for neuroprotection of the baby should be given to women between 24+0 and 29+6 weeks of pregnancy who are in established preterm labour or having a planned preterm birth within 24 hours. It should be considered up to 33+6 weeks. … Continue reading

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Tip 36: sucrose as analgesia

A Cochrane review showed that oral sucrose (with or without non-nutritive sucking) significantly reduced pain scores associated with heel lancing, venepuncture and IM injections but not ROP screening. The effects on extremely preterm infants or the long-term effects on any … Continue reading

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Tip 27b: HIE prognosis

Good prognostic features Stage I encephalopathy Absence of fits in first 24 hours Resolution of fits, off anticonvulsants, by 7 days. Ability to suck and feed by 7 days Poor prognostic features Stage II/III encephalopathy Encephalopathy >5 days Unreactive or … Continue reading

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Tip 27a: HIE prognosis

As a rough guide, the prognoses for different stages of HIE are: 1 (mild) – resolves in 24 – 48h. Almost all normal on follow-up. 2 (moderate) – should resolve within 5 days. Majority normal on follow-up but poor outcome ranges … Continue reading

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Tip 26: hypoxic-ischaemic encephalopathy (HIE) stages

The Sarnat stages of encephalopathy are: 1 (mild) – hyperalert, normal tone, weak suck, normal CFM. 2 (moderate) – lethargic, hypotonic, brisk tendon reflexes, weak or absent suck, clinical or CFM seizures. 3 (severe) – comatose, flaccid, absent tendon & … Continue reading

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