6 hours / Neonate

Born to a mother from rural background

No homoeopathic orientation

Call received at 1 am in the night for stabilizing a neonate

having respiratory distress and convulsions immediately after

birth following difficult labor.

CASE 1 Paedatric Emergency

A/F: BIRTH TRAUMA + BIRTH ASPHYXIA

PRESENTATION

NO AURA

ICTAL PHASE- BITING LIPS

TWITCHING FACE DISTORTION FACE

HEAD ROLLING TO SIDES

TONIC CLONIC MOVEMENTS OF EXTREMITIESCLENCHED FIST

POST ICTAL – PROSTRATION

PUPILS DILATED

CASE 1 Paedatric Emergency

General condition: Poor Peripheral cyanosis

Heart rate: 160 / minute Heart sounds Normal

Respiratory Rate: 60/ minute Conducted sounds and crepitation

CASE 1 Paedatric Emergency

Examination:

CNS: Generalized tonic - colonic movements of upper and lower extremities, facial distortion and frothing at mouth

Hyper tonic spasm Plantars extensor

Investigation :

Serum Glucose : Normal Serum Calcium : Normal

STRUCTURESTRUCTURE

FORMFORM FUNCTIONFUNCTION

TIMETIME

CASE 1 Paedatric Emergency

Brain Oedma and Hypoxia

Cerebral irritation A/F: Birth Trauma and asphyxiaConvulsions Status epilepticus Facial distortion

6 hours

TOTALITYA/F: Cerebral Concussion

Facial distortion

Pupils dilated

Head turning sides

Prostration

CASE 1 Paedatric Emergency

Pace of disease : Rapid

Pathology : Acute Oedma of brain

Vitality : Compromised

Characteristic : Present

Correspondence : Adequate

200 C frequently

1 hrly---4 hrly

CICUTA

SUSCEPTIBILITY ASSESSMENT

Ancillary measures

Continuous Oxygen

Radiant warmer

Intermittent Naso – Oral Suction

Naso gastric Intubations

Intra Venous fluids

CASE 1 Paedatric Emergency

FOLLOW UP

CHILD RELAXED

1st hr. Convulsions better in Freq.

2nd hr. Convulsions better 50%

5th hr. Convulsions better 75%

Only facial twitching

Child appeared PEACEFUL

8th hr. Convulsions – NIL

24th hr. CHILD ACTIVE

CASE 1 Paedatric Emergency

Conclusion

• Long term evaluation and management of this child would only require constitutional treatment.

• The possible long-term brain damage was contained and cured within 24 hours, quite a feat considering that this child may not have survived at all!