Showing posts from December, 2022

Congenital Hypothyroidism: Screening and Management (AAP 2022 Recommendations)

  Hypothyroidism Newborn screening (NBS) for CH followed by prompt initiation of levothyroxine (L-T4) therapy can prevent severe intellectual disability, psychomotor dysfunction, and impaired growth. The influence of severity at diagnosis, timing of treatment initiation, and L-T4 dose on longterm outcomes remains a matter of debate. Although the majority of treated patients achieve normal cognitive outcomes, the influence of L-T4 therapy on neurologic development is less certain, and some studies show persistent deficits in treated patients compared with euthyroid healthy controls. If a permanent form of CH has not been established, L-T4 treatment is maintained until 3 years of age, after which thyroid function is reevaluated following a 4- to 6-week discontinuation of L-T4. Most common cause - thyroid dysgenesis, dyshormonogenesis. Less common cause - maternal antithyroid medications, TSH receptor-blocking antibodies (TRBAb) acquired through transplacental passagematernal or infant io

Febrile Seizure: Review

Febrile Seizures   What is febrile seizure? Febrile seizures are seizures that are caused by a sudden spike in body temperature with fevers greater than 38C or 100.4F, with no other underlying seizure-provoking causes or diseases such as the central nervous system (CNS) infections, electrolyte abnormalities, drug withdrawal, trauma, genetic predisposition or known epilepsy. There shouldn't be any prior history of afebrile seizure as in such case the fever might be the cause of breakthrough seizure. however , there are no consensus regarding inclusion or exclusion of children with neurodevelopment disorder such as Autism spectrum disorder which has the predisposition to seizures. Age of presentation: As per American academy of Pediatrics: 6 months to 5 years (however cases unto 7 years of age have been diagnosed as FS) As per earlier definition ILAE - infant up to age of 1 month can be diagnosed as FS. As per NIH (National Institute of Health) children between 3 months and 5 years