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Encephalopathy in children: an approach to assessment and management
  1. Emily Davies1,
  2. Daniel J Connolly2,
  3. Santosh R Mordekar1
  1. 1Department of Paediatric Neurology, Sheffield Children's Hospital, NHS Foundation Trust, Sheffield, UK
  2. 2Department of Paediatric Neuroradiology, Sheffield Children's Hospital, NHS Foundation Trust, Sheffield, UK
  1. Correspondence to Santosh R Mordekar, Department of Paediatric Neurology, Sheffield Children's Hospital, NHS Foundation Trust, Ryegate Children's Centre, Tapton Crescent Road, Sheffield, S10 5DD, UK; santosh.mordekar{at}


Childhood encephalopathy is an uncommon but significant paediatric presentation and is associated with significant mortality and long-term morbidity in survivors. By definition it is a somewhat non-specific presentation with a wide differential diagnosis and long list of possible investigations. Choice of investigation, including neuroimaging modality, can be a daunting prospect for the clinician faced with the encephalopathic child and it is important to select appropriately for a high diagnostic yield. Initial management centres on good emergency care irrespective of cause. More specific therapies however vary enormously, and appropriate treatment is important and influences outcome. Evidence exists for mana©gement of many of the individual conditions causing encephalopathy. This review aims to outline a clinical approach to selecting investigations to identify a specific cause and provides an overview of the treatment for the commoner causes of encephalopathy that a general paediatrician may reasonably expect to be faced with.

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  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.