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Children's Palliative Care in Africa$
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Justin Amery

Print publication date: 2009

Print ISBN-13: 9780199567966

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780199567966.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 16 June 2021

Neurological symptoms

Neurological symptoms

Chapter:
(p.171) Chapter 9 Neurological symptoms
Source:
Children's Palliative Care in Africa
Author(s):

Justin Amery

Susie Lapwood

Michelle Meiring

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199567966.003.0009

This chapter notes that neurological problems are relatively common in children's palliative care. Delirium is a common problem in childhood and extremely common in children towards the end of life. Seizures are extremely frightening to the child, family, and health professionals, all of whom may see them as a herald of impending death but most seizures are harmless and self-limiting and one usually does not need to intervene. HIV encephalopathy may be at least partly reversible, but only by ART. Unless the child is close to death, ART should be started as soon as possible, irrespective of CD4 counts. Delay risks further irreversible neurological destruction. Meanwhile, dystonia is extremely painful but often overlooked as it is usually present in children with global neurological impairment, who cannot easily communicate their pain. It is difficult to treat and usually requires a full range of non-pharmacological, pharmacological, and even surgical interventions.

Keywords:   neurological problems, palliative care, delirium, seizure, dystonia, HIV encephalopathy

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