tonic neck reflex cerebral palsystorage wars guy dies of heart attack

Common viruses, such as the flu, can cause a babys temperature to rise, increasing their risk of a febrile seizure. In moderate to mild cases of Cerebral Palsy, parents are often first to notice if the child doesnt appear to be developing on schedule. For a good discussion of this topic, see Capute AJ, Accardo PJ, eds. Shevell MI, Bodensteiner JB. Ancel PY, Livinec F, Larroque B, Marret S, Arnaud C, Pierrat V, et al. Reflex Some signs will be more apparent when the child is under stress. Appears at Normally appears from birth to 3-4 months Disappear at Sometimes babies that have a fever or high body temperature may develop a febrile seizure. Spec Care Dentist. Read on to learn more about the signs and symptoms of a baby seizure and treatment. 117(3):828-35. Matuszkiewicz M, Gakowski T J Speech Lang Hear Res 2021 Mar 17;64(3):935-948. [QxMD MEDLINE Link]. J Pediatr Health Care. Any information you provide will only be used in accordance with our Terms of Use, Privacy Policy and Disclaimer. Boosara Ratanawongsa, MD Clinical Assistant Professor of Pediatrics, Pennsylvania State University College of Medicine; Pediatric Neurologist, Pediatric Specialists of Lehigh Valley, Lehigh Valley Physician Group 2006 Oct 4. Pediatr Neurol. 18(3):425-36. 382 0 obj <> endobj The symmetrical tonic neck reflex can be tested by placing the child in quadruped position on the floor and passively flexing the head forward and then extend it backwards. What Happens When Your Son Is Circumcised? Full integration means that when your baby is awake, they will not show the fencers pose when they turn their head lying down. Some babies may need long-term treatment to prevent seizures from recurring. The symptoms a baby experiences depend on the type of seizure they have. 2015 Nov. 136 (5):895-904. A doctor will discern signs of a health concern during the exam and testing. Nelson KB. 2nd ed.2001;95-100. In some babies, the asymmetric tonic neck reflex doesnt integrate correctly. ATNR presents as consistent, one-sided movements of the body that go together with proper hand-eye harmonization. Asymmetric crawling or failure to crawl may also suggest cerebral palsy. 0000006780 00000 n Odding E, Roebroeck ME, Stam HJ. http://www.medscape.com/viewarticle/778221, American Association of Neuromuscular and Electrodiagnostic Medicine, American Society for Bioethics and Humanities. Common primitive reflexes that may improperly function or persist include, but are not limited to: Early hand preference can also indicate possible impairments. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. Certain primitive reflexes are present at or shortly after birth, but disappear at predictable stages of development as the child grows. It is also known as the bow and arrow or " fencing reflex " because of the characteristic position of the infant's arms and head, which resembles that of a fencer. Wyatt K, Edwards V, Franck L, Britten N, Creanor S, Maddick A, et al. [QxMD MEDLINE Link]. Cerebral Palsy impairs the physical aspects of speaking by improperly controlling the muscles required to speak. Neurology. The position should enable the child to experience more normal pattern of movements. 0000032664 00000 n . Magnetic resonance image (MRI) of a 9-day-old girl who was born at full term and had a perinatal hypoxic-ischemic event. Woodward LJ, Anderson PJ, Austin NC, Howard K, Inder TE. Allen MC, Capute AJ. They develop the strength, coordination, and balance to accomplish the task when mastering it without the use of their hands. Moster D, Wilcox AJ, Vollset SE, Markestad T, Lie RT. Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Prior results do not guarantee a similar outcome. 2004 Mar. [Phylo- and ontogenetic aspects of erect posture and walking in developmental neurology]. Signs are clinically identifiable effects of brain injury or malformation that cause Cerebral Palsy. 0000015299 00000 n [QxMD MEDLINE Link]. [QxMD MEDLINE Link]. As a child grows, these changes affect skeletal and joint development, which may lead to impairment and possibly deformities. Asymmetrical Tonic Neck Reflex - Clinical Examination AMBOSS: Medical Knowledge Distilled 192K subscribers 451K views 6 years ago Pediatrics - Clinical Examination Tutorials Read more about. 2010 Dec. 30(8):840-5. Infection and injury are common causes of brain seizures. Signs become recognizable as a child learns to sit, rise from a sitting position, and begins crawling or walking. It may be the result of psychological, neurological, or physical conditions or trauma. 2014 Nov-Dec. 34 (6):298-302. This condition may also present as the persistence of primitive reflexes, such as the Moro (startle reflex) and asymmetric tonic neck reflexes (ie, fencing posture with neck turned in same direction when one arm is extended and the other is flexed). Clinically relevant copy number variations detected in cerebral palsy. Neurology. 0000004791 00000 n To prepare for the EEG, a doctor places metal discs on the babys head that detect and record their brains electrical impulses. Cranial osteopathy for children with cerebral palsy: a randomised controlled trial. An abnormal electrical discharge in the brain causes a seizure. J Child Neurol. The Moro reflex, or startle, reflex is a healthy part of a babys development. Epub 2021 Feb 23 doi: 10.1044/2020_JSLHR-19-00423. -Characterized in infants by lethargy, irritability, bradycardia, tachycardia, apnea, bugling fontanels, setting-sun eyes, vomiting, & hypertension An 8 year old client with a ventriculoperitoneal shunt was admitted for a shunt malfunction. 0000019820 00000 n If a doctor uses forceps or vacuum extractors to help deliver the baby, this may injure the head and cause CSF to accumulate on the brain.Learn more about CSF here. Underdeveloped or lacking postural and protective reflexes are warning signs for abnormal development, including Cerebral Palsy. Symptoms of subtle seizures can include: Tonic means muscle stiffness. The asymmetrical tonic neck reflex ( ATNR) is a primitive reflex found in newborn humans that normally vanishes around 6 months of age. 2007 Feb. 49(2):86-92. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Neonatal Encephalopathy and Cerebral Palsy: Defining the Pathogenesis and Pathophysiology. 0000016037 00000 n There are many tell-tale signs that a child may have Cerebral Palsy, but those factors can be indicative of many conditions. Impairments resulting from Cerebral Palsy range in severity, usually in correlation with the degree of injury to the brain. Infants with cerebral palsy have been known to manifest persistence or delay in the disappearance of primitive reflexes and pathologic or absent postural reactions. Impaired or delayed fine motor skills are an indicator of possible Cerebral Palsy. Comprehensive short-term outcome assessment of selective dorsal rhizotomy. Experts associate this with delays in development, but research around this issue is still in its early stages. Children unable to stand on their own benefit socially from being upright for playing at a table; unsupported many CP children stand with plantarflexed ankles, semiflexed knees and adducted, internally rotated and adducted hips. Age of diagnosis ii. 2008 Aug 28. Factor Analysis of the Einstein Neonatal Neurobehavioral Assessment Scale in Infants with Congenital Heart Disease and Healthy Controls. 2004 Mar. The usual timeframe for ATNR is usually between five to seven months when your child is learning complex motor skills like sitting up. Vincer MJ, Allen AC, Joseph KS, Stinson DA, Scott H, Wood E. Increasing prevalence of cerebral palsy among very preterm infants: a population-based study. Dysarthria is broken into the following subgroups: Drooling is another sign of Cerebral Palsy that results from muscles in the face and mouth not being able to properly control coordination. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE3OTU1NS1jbGluaWNhbA==. As abnormal . %%EOF 0000012006 00000 n These reflexes are crucial because they help your baby to survive. Tonic neck reflex; Recent clinical studies. Tao FB, Xu J, Deng GZ, Ni JF, Zhang HB, Wu XK, Yin HP, Xu ZY. [Full Text]. Because Cerebral Palsy is the result of brain injury, and because the brain continues to develop during the first years of life, early tests may not detect the condition. Seizure Characteristics and Background Amplitude-Integrated Electroencephalography Activity in Neonatal Rats Subjected to Hypoxia-Ischemia. [QxMD MEDLINE Link]. Cognitive and sensory deficits c. Diagnosis: i. Elsevier Health Sciences; 1997. Spastic diplegic cerebral palsy includes the following classic physical presentations: Upper motor neuron findings in the legs more than the arms, Scissoring gait pattern with hips flexed and adducted, knees flexed with valgus, and ankles in equinus, resulting in toe walking, Learning disabilities and seizures less commonly than in spastic hemiplegia. By contacting MyChild or Stern Law, PLLC in any way, including by a link from this website, you certify that you agree to our Terms of Use, Privacy Policy and Disclaimer and wish to be contacted regarding your inquiry. [QxMD MEDLINE Link]. 74(4):336-43. Signs to look for when a child sits include: Other signs to look for include, but are not limited to: Balance is often the same whether a childs eyes are open or closed. Some may be task related, such as reaching for an object. Examination of the patient at 1 year revealed findings consistent with a mixed quadriparetic cerebral palsy notable for dystonia and spasticity. 0 JAMA. Patients have a delay in developing gross motor skills. Before Cerebral palsy: defining the problem. 34(6):547-51. A child with Cerebral Palsy may demonstrate any combination of these signs. Primarily physical, abnormal gait, abnormal positioning of limbs ii. When the choice doesnt come automatically, the child makes very conscious moves, which can be confusing. The Primitive Reflex Profile was studied in 53 cerebral palsied patients to assess both the feasibility of its administration and its usefulness in discriminating functional levels of ambulation. If the delivery was traumatic, or if significant risk factors were encountered during pregnancy or birth, doctors may suspect Cerebral Palsy immediately. . We avoid using tertiary references. Copy number variations in cryptogenic cerebral palsy. Hyperreflexia are excessive reflex responses that cause twitching and spasticity. Pediatr Neurol 2004; 31:1. . 2006 Feb. 48(2):90-5. [25]. Some seizures only last a few minutes and occur once, leaving no lasting damage. Physiopedia articles are best used to find the original sources of information (see the references list at the bottom of the article). The hip-joints are one area where this is often prominent in instances of Cerebral Palsy. Deep brain stimulation for dystonia due to cerebral palsy: A review. The child might also experience: Your child may also show some characteristics similar to ADD and ADHD but this theory needs more research. A doctor needs to know the exact cause of the seizures before prescribing an effective treatment plan. Please confirm that you would like to log out of Medscape. Startle reflex: Any . A child normally develops hand preference in his or her second year. It is common for a child to experience different types of impaired muscle control in opposite limbs. Depending on your child's condition and progress, they may recommend evaluation by an occupational therapist.. [QxMD MEDLINE Link]. 13% (69/532) 3. 2021. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association: Role of the asymmetrical tonic neck reflex in hand visualization in normal infants., Archives of Medical Science: Persistence of primitive reflexes and associated motor problems in healthy preschool children., Australasian Journal of Early Childhood: Retained primary reflexes in pre primary-aged Indigenous children: The effect on movement ability and school readiness., Handbook of Neurolinguistics: Brain Lateralization across the Life Span., Integrated Learning Strategies: ATNR: Studies Show 50% of Kids with a Retained ATNR Primitive Reflex Struggle with Dyslexia., International Journal of Environmental Research and Public Health: Primitive Reflex Activity in relation to the Sensory Profile in Healthy Preschool Children., International Journal of Neuroscience: Asymmetric tonic neck reflex and symptoms of attention deficit and hyperactivity disorder in children., JOURNAL OF NEUROPHYSIOLOGY: POSTURAL REFLEXES AND GRASP PHENOMENA IN INFANTS., Journal of Speech, Language and Research: Developmental Language Disorder and Uninhibited Primitive Reflexes in Young Children., Optometrists Network: What are Retained Primitive Reflexes?, Physical Therapy and Rehabilitation Science: Primitive Reflex Integration in Intensive Physical therapy and Gross Motor Function in Children with Cerebral Palsy: A Case Report., PLoS ONE: Biomechanics of fencing sport: A scoping review., Rhythmic Movement Training International: Asymmetrical Tonic Neck Reflex., Stanford Medicine: Neuro/Reflexes.. Causes may include brain injury, infection, and underlying health conditions, such as cerebral palsy. 2006 Aug 17. Sitting becomes a truly functional position for play when a child is about 8-9 months old. Hoda Z Abdel-Hamid, MD Associate Professor, Department of Pediatrics, University of Pittsburgh School of Medicine; Director of EMG Laboratory and Neuromuscular Program, Director of Pediatric MDA Clinic, Division of Child Neurology, Childrens Hospital of Pittsburgh, University of Pittsburgh Medical Center However, common signs include loss of consciousness and jerking of the arms and legs. %PDF-1.7 % Dev Med Child Neurol. Extensor thrust. Moro reflex. Brain injury or poor oxygen supply during and immediately following birth b. 349(18):1765-9. Review the patient's equipment or need for equipment such as adaptive and communication devices (eg, computer-assisted speech programs), orthotics (eg, ankle-foot orthoses, walkers, wheelchair), and/or seating (may require straps to keep in place). Anderson P. FDA Clears Stimulation System for Foot Drop in Children. The child may present as either hypotonic or, more commonly, hypertonic with either decreased or increased resistance to passive movements, respectively. Brain damage occurs due to the frequent disruption of brain oxygen levels and excessive brain cell activity. Gross motor function Most patients with spastic quadriplegic cerebral palsy have some cognitive impairment and demonstrate the following classic physical presentations: All limbs affected, either full-body hypertonia or truncal hypotonia with extremity hypertonia, Multiple medical complications (see Complications under Prognosis), Legs generally affected equally or more than arms, Categorized as double hemiplegic if arms more involved than legs. However, in some cases, your baby may need a year for ATNR to fully integrate. Asymmetrical posture means the right and left limbs will not mirror one another. 13(3):240-6. Muscle tone Most experts agree; the earlier a Cerebral Palsy diagnosis can be made, the better. ICRC Cerebral Palsy Content Development Project, https://www.physio-pedia.com/index.php?title=Positioning_the_Child_with_Cerebral_Palsy&oldid=326257, Normalizing tone or decreasing its abnormal influence on the body, Preventing or accommodating skeletal deformity, Providing a stable base of support to promote function, Promoting increased tolerance of the desired position, Facilitating normal movement patterns or controlling abnormal movement patterns, Managing pressure or preventing the development of pressure sores, Enhancing autonomic nervous system function (cardiac, digestive and respiratory function), Facilitating maximum function with minimum pathology, Symmetry and alignment should be respected as much as possible in all positions. Retained Primitive Reflexes and Potential for Intervention in Autistic Spectrum Disorders. 2nd ed. 2009 Mar. 0000009170 00000 n 0000002090 00000 n (n.d.). The asymmetrical tonic neck reflex is activated as a result of turning the head to one side. The arm and leg on the opposite side flex. The effect of cerebellectomy on the tonic labyrinth and neck reflexes in the decerebrate cat Article Mar 1981 Mayank B Dutia K W Lindsay Jay Robert Rosenberg View Show abstract The. Early interventions and therapies have proven to help a child maximize their future potential. Use cabinet locks, doorknob covers, and gates where Postural control requires achieving normal developmental milestones and includes the maturing of postural reactions (righting, protective and equilibrium reactions), the integration of primitive reflexes (Asymmetrical Tonic Neck Reflex, Symmetrical Tonic Neck Reflex, Tonic Labyrinthine Reflex), as well as normal muscle tone, normal postural tone and intentional voluntary movements[1]. 2011 Jul 30;64(7-8):239-47. and transmitted securely. By clicking Subscribe, I agree to the WebMD, Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Smoking Pot Every Day Linked to Heart Risks, Artificial Sweetener Linked to Heart Risks, FDA Authorizes First At-Home Test for COVID and Flu, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox, Symptoms of Retained Asymmetric Neck Tonic Reflex. Based on clinical and research evidence, it is widely accepted and common practice for the general goals of seating and positioning to include: Moreover, adequate positioning facilitate eye contact, child communication and social interaction. 2009 Jun. 2009 Nov. 13(6):511-5. Muthusamy K, Recktenwall SM, Friesen RM, Zuk J, Gralla J, Miller NH, et al. Disabil Rehabil. 2007 May-Jun. Especially lying face down is a good position for a child to begin to develop control of the head, shoulders, arms, and hands, and also to stretch muscles in the hips, knees and shoulders. This site needs JavaScript to work properly. [QxMD MEDLINE Link]. Reaching the expected developmental benchmarks of infancy and childhood sitting, rolling over, crawling, standing and walking are a matter of great joy for parents, but what if a childs developmental timetable seems delayed? Its an important type of reflex that helps your baby move through the birth canal during vaginal birth. Learn more about epilepsy in children here. Early diagnosis also helps families qualify for government benefit programs to pay for such measures. eCollection 2022. The site is secure. It becomes hard for them to cross the midline of their bodies, for example, and they can't handle objects with both hands. The neurologic evaluation includes close observation and a formal neurologic examination. Cognitive impairment is present in approximately 30% of spastic diplegic patients. Various primitive reflexes are being assessed in CP Semin Pediatr Neurol. Later, however, the same test may, in fact, reveal the issue. Asymmetric tonic neck reflex: When a . Delgado MR, Tilton A, Russman B, Benavides O, Bonikowski M, Carranza J, et al. This condition may also present as the persistence of primitive reflexes, such as the Moro (startle reflex) and asymmetric tonic neck reflexes (ie, fencing posture with neck turned in same direction when one arm is extended and the other is flexed). 341:c4990. The attorney responsible for this Website is Kenneth A. Stern of the law firm, Stern Law, PLLC, Learn more about seizures in babies here. Babies tend to outgrow this reflex at 36 months. If you log out, you will be required to enter your username and password the next time you visit. 1992 Jun. 15). This primitive reflex first develops in the womb and helps the baby coordinate their eyes and control fine movement. Coordination and control can likewise be affected differently in each limb. Melillo R, Leisman G, Machado C, Machado-Ferrer Y, Chinchilla-Acosta M, Kamgang S, Melillo T, Carmeli E. Front Neurol. When a baby experiences frequent seizures, they must receive treatment to prevent brain damage. Dolk H, Pattenden S, Johnson A. Cerebral palsy, low birthweight and socio-economic deprivation: inequalities in a major cause of childhood disability. Pediatrics. Asymmetric tonic neck reflex. Safety of Botulinum Toxin Type A for Children With Nonambulatory Cerebral Palsy. Jan 25 2013. 2006 Dec. 87(12):1551-8. Eur J Paediatr Neurol. As this is a wide timeframe and rough average, development of hand preference, especially if it is early preference, is cause for concern. Researchers are unsure of the exact cause of cerebral palsy. Du RY, McGrath CP, Yiu CK, King NM. Cerebral palsy among term and postterm births. All rights reserved. [QxMD MEDLINE Link]. For example, the "dystonic attacks" with kinetic type of asymmetric tonic neck reflex (ATNR) and versive tonic . Ann M Neumeyer, MD Medical Director, Lurie Family Autism Center/LADDERS; Assistant Professor of Neurology, Harvard Medical School, Ann M Neumeyer, MD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society, and Massachusetts Medical Society, Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference. [QxMD MEDLINE Link]. StatPearls Publishing. Muscle tone is usually normal or can be decreased during sleep. Knee Flexion and extension with valgus or varus stress occur. 0000038716 00000 n Medscape Medical News. Arcilla, C., Vilella, R. Tonic Neck Reflex. 2004 Feb;25(2):127-30. Would you like email updates of new search results? Epub 2022 Aug 2. However, these signs may resemble usual, everyday movements and may be difficult to spot. Blackmore AM, Boettcher-Hunt E, Jordan M, Chan MD. 0000004110 00000 n Cerebral palsy frequently manifests as early hypotonia for the first 6 months to 1 year of life, followed by spasticity. [QxMD MEDLINE Link]. Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, Child Neurology SocietyDisclosure: Have stock (managed by a financial services company) in healthcare companies including Allergan, Cellectar Biosciences, CVS Health, Danaher Corp, Johnson & Johnson. Pediatr Phys Ther. Take note, though, that not all occupational therapists believe in the connection between developmental delays and the presence of retained ATNR. Babies may demonstrate this reflex up to 9 months old. As a child develops, signs of impaired or delayed gross motor function may be noticeable. The ability to make large, coordinating movements using multiple limbs and muscle groups is considered gross motor function. Is the ketogenic diet right for autoimmune conditions? Although often seen in children with cerebral palsy (CP), it is an uncommon finding in term neonates and infants. Signs of oral motor function impairment include, but are not limited to difficulty with: Speech requires proper intellectual and physical development. The combined examination is also useful in developed countries because many developmental disorders such as cerebral palsy appear in nonrisk groups whereas others are not detected by metabolic screening programs. Bernyi M, Katona F, Sanchez C, Mandujano M. Ideggyogy Sz. What is the latest research on the form of cancer Jimmy Carter has? Neonatal MRI to predict neurodevelopmental outcomes in preterm infants. 0000007667 00000 n 2003 Oct 30. In such a case, the doctor will explore several potential treatment options for the signs and symptoms your child shows. Cystic encephalomalacia in the left temporal and parietal regions, delayed myelination, decreased white matter volume, and enlarged ventricles can be seen in this image. Thus, the classic physical presentations of dyskinetic cerebral palsy include the following: Early hypotonia with movement disorder emerging at age 1-3 years, Deep tendon reflexes usually normal to slightly increased, Risk of deafness in those affected by kernicterus, These patients with dyskinetic cerebral palsy may have decreased head and truncal tone and defects in postural control and motor dysfunction such as athetosis (ie, slow, writhing, involuntary movements, particularly in the distal extremities), chorea (ie, abrupt, irregular, jerky movements) or choreoathetosis (ie, combination of athetosis and choreiform movements), and dystonia (ie, slow, sometimes rhythmic movements with increased muscle tone and abnormal postures, eg, in the jaw and upper extremities). Pediatrics. The clinical significance of asymmetric tonic neck reflex, Moro, palmar grasp, plantar grasp, Galant, Babinski, Rossolimo, crossed extensor, suprapubic extensor, and heel reflex, alone or in combination, as well as their contribution to the early diagnosis and differential diagnosis of cerebral palsy, have been demonstrated in a number of studies. By this time the typical child has good trunk control, balance in sitting and hip mobility. An official website of the United States government. extended while a patient is lying on his or her back, the legs and arms also extend, and the back and neck arch. Definite hand preference before age 1 year is a "red flag" for possible hemiplegia. Jones M & Gray S (2005) Assistive technology: Positioning and Mobility. However, some caution against making a diagnosis too early, and warn that other conditions need to be ruled out first. 2007 Oct. 49(10):781-90. Children with cerebral palsy may have an early period of hypotonia followed by hypertonia. 4th ed. Intention tremors, where a task becomes more difficult as it gets closer to completion, is one such sign. Cerebral Palsy is a symptom rather than a specific disease. Intelligence is normal in 78% of patients with athetoid cerebral palsy. Because Cerebral Palsy is a group of conditions, signs and symptoms vary from one individual to the next. It is quick and easy to perform, both in nonhospital environments and in underdeveloped countries, where time and specific recourses are limited. 2023 Jan 28;20(3):2322. doi: 10.3390/ijerph20032322. Patients with cerebral palsy may show increased reflexes, indicating the presence of an upper motor neuron lesion. What are the signs and symptoms of a baby seizure? Hutton JL, Pharoah PO. Treatment of epilepsy in combination with cerebral palsy strictly requires an individual approach due to the form of epilepsy, seizure types, age of the patient, comorbidity, and somatic and mental condition of the patient. 2015 April. https://www.ncbi.nlm.nih.gov/books/NBK559210/, https://www.cdc.gov/ncbddd/cp/causes.html, https://www.epilepsy.com/learn/types-seizures/clonic-seizures, https://www.epilepsy.com/living-epilepsy/epilepsy-and/parents-and-caregivers/about-newborns-and-infants/diagnosis-infant-seizures, https://www.ncbi.nlm.nih.gov/books/NBK542173/, https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Febrile-Seizures-Fact-Sheet, https://neoreviews.aappublications.org/content/19/8/e467, https://www.aafp.org/afp/2012/0115/p149.html, https://www.ncbi.nlm.nih.gov/books/NBK554535/, https://www.epilepsy.com/article/2014/3/medications-neonatal-seizures-and-infantile-spasms, https://www.ilae.org/files/ilaeGuideline/Classification-of-seizures---modification-for-neonates-epi.16815-2021-02.pdf?fbclid=IwAR3v7l4Lh0wCzjdKv7pLXbzWca5w6heildq_uC7Fgi-8bJ-3HsNcaXH2cJI, https://www.epilepsy.com/learn/seizures-youth/about-newborns-and-infants/seizures-newborns, Cardiovascular health: Insomnia linked to greater risk of heart attack.

Art Institute Lawsuit Documents, Articles T