Anoxia means lack of sufficient oxygen, an essential component of the normal ongoing chemistry of the cell. Cerebral nerve cells are amongst the highest consumers of oxygen in the body, as reflected in the fact that a quarter of all arterial blood goes to the brain. If the oxygen supply is cut off, then damage to nerve cells occurs after a few minutes. Some die, but others are damaged in such a way that they may paroxysm ally discharge in subsequent life.

Anoxia may occur at birth. During each uterine contraction in a prolonged labour the fetal heart rate slows, and the supply of oxygenated blood to the brain is reduced. The umbilical cord may become tightly wound around the baby’s neck. The placenta may separate prematurely. After birth, for a variety of reasons, the child may not breathe for a few minutes. These are four examples of how anoxic brain damage can occur at birth. If severe, the brain damage results in severe learning difficulties, cerebral palsy, or epilepsy. However, as has already been mentioned, the cause of these three is often due to antenatal factors rather than problems with the birth itself.

Anoxia also occurs in febrile convulsions, as has already been discussed. During a seizure the oxygen requirements of brain nerve cells are enormously increased, and yet the resulting convulsion interferes with normal respiration, so that the blood leaving the lungs picks up insufficient oxygen. The combination of excessive demand and inadequate supply may on rare occasions result in anoxic damage to cerebral nerve cells. The nerve cells which seem most susceptible to damage, at the age at which febrile convulsions occur, are in the temporal lobe.

A stroke is usually due to an obstruction to an arterial vessel to one particular part of the brain, so nerve cells in the territory supplied by the blocked vessel either die as a result of lack of oxygen, or become damaged in such a way that they may form a focus for paroxysmal discharges later. Most strokes occur in late adult life, and cerebrovascular disease accounts for much of the epilepsy beginning in old age. Occasionally, however, a stroke may occur in a young adult or even in a child.

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Symptoms: general weakness and bodily discomfort; sore throat; pus on tonsils; prolonged fever; swelling of lymph glands; prolonged fatigue; mottled red rash.

Home care

Rest, aspirin or paracetamol, and a general diet as tolerated are necessary.

If your doctor finds that the child’s spleen is enlarged, the child’s activities should be restricted.

Precautions

-    If a child who is being treated with antibiotics for a strep throat does not respond to the medication within 24 to 48 hours, inform the doctor; the child may have mono in addition.

-    Do not allow a child who has had mono to return to school or work until weakness and fatigue disappear.

-    Do not allow a child with an enlarged spleen to take part in contact sports or other strenuous activity until the spleen returns to its normal size.

Infectious mononucleosis – often called “mono” – is a fairly common contagious disease. It’s caused by the Epstein-Barr (EB) virus and is transmitted by secretions from the nose and throat -which is why it’s also commonly known as the “kissing disease.” Mono can occur at any age from infancy on, but is most often seen among young people of high school or university age. The disease appears one to six weeks after exposure to the virus, and one attack generally makes a person immune to (able to resist) further bouts.

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