儿童共济失调的护理实践

D. Zawadzki, Mariusz Ciastkowski, Agnieszka Ciastkowska-Berlikowska
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摘要

共济失调包括协调性和平衡性受损,以及对预期运动缺乏肌肉控制。小脑共济失调最常见的体征和症状是步态共济失调(颤抖,基础广泛),由于缺乏适当的肌肉协调而导致的运动障碍,测量障碍,运动分解,意图震颤和运动障碍(交替运动障碍)。临床症状因损伤部位而异:小脑半球、小脑蚓部、深部感觉通路损伤或小脑额叶束和额叶中枢损伤。儿童急性共济失调最常见的原因是药物过量、中毒和感染后小脑炎。值得记住的是,共济失调的许多原因是代谢和免疫的。有急性共济失调,间歇性和复发性共济失调,慢性进行性和非进行性共济失调。应该记住,每一个儿童急性共济失调需要诊断和住院治疗。有必要对共济失调发作的时间和情况、伴随症状、持续和暂时服用的药物、这些症状本身可能的既往发作和目前的健康状况进行详细的访谈。
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Ataxia in children in the practice of a paramedic
The term ataxia includes impaired coordination and balance, and a lack of muscle control over intended movements. The most common signs and symptoms of cerebellar ataxia are ataxic gait (shaky, broad-based), movement disorders resulting from lack of proper muscular coordination, dysmetria, movement decomposition, intention tremor, and dysdiadachokinesia (disorder of alternating movements). Clinical symptoms vary depending on the damaged element: cerebellar hemisphere, cerebellar vermis, damage to the deep sensory pathways or damage to the cerebellar-frontal tracts and frontal centers. The most common causes of acute ataxia in children are drug overdoses, poisoning, and post-infectious cerebellitis. It is worth remembering that many causes of ataxia are metabolic and immunological. There are acute ataxias, intermittent and recurrent ataxias, chronic progressive and non-progressive ataxias. It should be remembered that each child with acute ataxia requires diagnosis and hospitalization. It is necessary to conduct a detailed interview regarding the time and circumstances of the onset of ataxia, accompanying symptoms, continuously and temporarily taken medications, possible previous episodes of these the symptoms themselves and the current state of health.
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