Conscious Level Assessment in Infants

J Gordon Millichap

doi:10.15844/pedneurbriefs-2-5-5

Abstract

Neurosurgeons at the Adelaide Children’s Hospital, King William Street, North Adelaide, SA 5006, Australia have used a paediatric version of the Glasgow Coma Scale since 1977 for assessing conscious level in infants and young children.

Highlights

Of 738 children with head injuries (0-16 yrs) admitted to the Children's Memorial Hospital, Chicago, IL, during a 5-year period from 1981-85, 318 (43%) were less than 3 years of age and almost half of the younger group were under 1 year
Neurosurgeons at the Adelaide Children's Hospital, King William Street, North Adelaide, SA 5006, Australia have used a paediatric version of the Glasgow Coma Scale since 1977 for assessing conscious level in infants and young children
A disadvantage of the scale is the reduced sensitivity, especially in the neonate

Summary

HEAD INJURY IN INFANTS AND CHILDREN

Of 738 children with head injuries (0-16 yrs) admitted to the Children's Memorial Hospital, Chicago, IL, during a 5-year period from 1981-85, 318 (43%) were less than 3 years of age and almost half of the younger group were under 1 year. Post-traumatic seizures developed more commonly in children under 2 yrs (16%) than in older children (9%, entire group). The mortality of the entire group with severe head injury was 22%. (Hahn YS et al Head injuries in children under 36 months of age. COMMENT: A modified Glasgow Coma Scale — Children's Coma Scale — was developed as an objective neurological assessment and prognostic indicator for the children under 3 yrs of age in this study. When children were comatose longer than 6 hrs, 75% (12/16) had a poor outcome with a 50% (8/16) mortality

CONSCIOUS LEVEL ASSESSMENT IN INFANTS

ALPHA COMA IN THE EEG

Findings

DYSTONIA AND BIOPTERIN DEFICIENCY