Wrist drop and ankle drop

Introduction Wrist heel sag appears at the distal end of the limb: lead poisoning is rare in childhood. Common symptoms include finger and toe numbness. Most of the lead poisoning in children is caused by ingestion of the digestive tract, and the oral dose causing acute lead poisoning is about 5 mg/kg. Once lead poisoning should be rescued in time, thoroughly remove the poison (stomach, catharsis and skin cleansing), use special antidote, if there are symptoms such as nausea, vomiting, abdominal pain, epilepsy, etc., should actively treat the symptoms, so as not to aggravate the condition. In addition, the prevention of strong children and avoiding exposure to lead can effectively prevent the disease from occurring.

Cause

Infant poisoning is often caused by the lead-containing powder on the mother's face, sucking the lead-containing ointment applied to the mother's nipple and the milk of the lead poisoning mother. When a child's deciduous teeth erupt, they often get caught, and can be poisoned by eating lead-containing paint layers such as bed frames and toys. Children with heterosexual can cause lead poisoning by swallowing large amounts of paint floor or wall coverings. Lead poisoning can also occur in foods or foods that are boiled and contained in lead-containing utensils (the enamel or the enamel of the inferior pottery). The remaining canned food is left in tin cans and stored in the refrigerator is also a cause of lead poisoning.

Inadvertent consumption of excessive lead-containing drugs such as sheep epilepsy, lead, black tin, mito, etc. can cause acute poisoning. Lead poison can also be absorbed by the respiratory tract. For example, lead-containing talcum powder (which can be inhaled by infants), burned battery cartridges, etc., can contain lead-acid smoke, which can cause inhalation poisoning in infants and young children. Children living in an environment with lead dust around them can often inhale a certain amount of lead. Lead workers work clothes have long brought home polluted dust, which can cause their children to inhale lead poisons and cause symptomatic lead poisoning.

an examination

Related inspection

Urine lead serum lead (Pb) cerebrospinal fluid lead

Mainly manifested as severe central nervous system lesions such as epileptic seizures, hyperkinesia, aggressive behavior, language function development delay and even loss, but no signs of acute intracranial hypertension. Such chronic encephalopathy can be a sequela of acute encephalopathy or associated with excessive intake of lead. Epileptic seizures and behavioral changes in lead toxic encephalopathy can be gradually reduced to puberty, but mental retardation persists; severe cases can have blindness and hemiplegia. Recently, it has been found that retinal spotting often occurs before abnormal urine lead excretion, not only for early signs of lead poisoning, but also for patients with lead absorption, but there are also reports of false positives and false negatives.

X-ray examination: The density of the long bones of the patient increased, showing a white band, which was wider and more significant than that seen in the recovery period of the rickets. A large amount of sputum and phosphorus are deposited on the bone end, and the same white shadow can appear, but it is rare. Long bone X-ray changes in children with lead poisoning before 2 years of age are often not obvious, and may not change abnormally even in severe cases. The opaque material is visible in the flat sheet of the sick child.

Differential diagnosis

Acute and severe lead poisoning can be diagnosed according to clinical manifestations and laboratory tests. However, for children with chronic and trace lead poisoning, simple and feasible examination methods are still under investigation, so the intelligence of children with different diseases often has different degrees of backwardness. Therefore, it has caused widespread attention.

When the symptoms of digestive tract are present in the initial stage of lead poisoning, they should be differentiated from acute gastroenteritis and viral hepatitis. In the case of abdominal cramps, it must be differentiated from acute abdomen. Brain disease signs should be distinguished from encephalitis, tuberculous meningitis, brain tumors, and hand and foot spasms. In the case of symptoms and signs of peripheral nerves, it must be distinguished from polio and diphtheria.

In the mouth of children with acute poisoning, there are metallic taste, runny, nausea, vomiting, vomit often white milk block (lead produces white lead chloride in the stomach), abdominal pain, sweating, irritability, refusal to eat. When acute lead toxic encephalopathy occurs, sudden vomiting (may be jetting), accompanied by breathing, pulse increase, ataxia, strabismus, convulsions, coma, etc.; at this time there may be increased blood pressure and optic nerve head Edema. The baby is full and the skull is widened and the head circumference is enlarged. Severe lead poisoning often has paroxysmal abdominal cramps, and can occur with hepatomegaly, jaundice, oliguria or anuria, and circulatory failure. A small number of gastrointestinal bleeding and paralytic ileus. Most of the sick children are not hot or only slightly hot. Patients with longer disease have anemia, and their face is gray (lead capacity) with palpitations, shortness of breath, and fatigue. Teeth and nails are stained black by lead, and the black "lead line" of the gums is rarely seen in young children. The numbness of the extremities and the appearance of wrist sag and sag at the distal end of the limb are rare in infants; numbness of the fingers and toes is the common symptom of the sick child. Sometimes limb paralysis can occur, and if intercostal tendon occurs, breathing difficulties and even respiratory failure can occur. Chronic lead poisoning is more common in children after 2 to 3 years of age, usually from the time of poisoning to the onset of symptoms for about 3 to 6 months.

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