Brain Abscess in a Child. Case Report

Brain abscesses in children are rare, but can lead to severe complications, especially if they are not recognized and treated promptly.We present the clinical case of a four-year-old girl who was admitted in the Second pediatric clinic at St. Marina University hospital in Varna because of attacks of severe frontal headache, sometimes accompanied by vomiting. The child was first hospitalized at the Infectious disease clinic for a bacterial intestinal infection, but during the hospital stay the attacks became more frequent. After the child was discharged, the parents noticed that the movements of the left limbs were severely impaired, with the left leg being swayed during walking. At the Second pediatric clinic, the child was conscious, afebrile, with normal general exam, but with pronounced syndrome of meningeal irritation and with left hemiparesis. Blood tests showed evidence of bacterial infection. Computed tomography was performed, where a large cystic formation (70/50 mm) was visualized in the right cerebral hemisphere, corresponding to an abscess with severe dislocation, requiring surgery to be performed urgently. The child had a smooth post-operative period, with no evidence of infection and no seizures. The focal neurological signs regressed over the following few days. A repeat CT scan of the head showed complete evacuation of the abscess and reduction of the edema. The girl was discharged on the fifteenth day, in good overall condition, with no headaches, and with fully restored motor activity. We discuss the diagnosis, differential diagnosis, the role of timely imaging and the treatment applied for the good prognosis of the patient

Headache in Children with Epilepsy

Headache is a common comorbidity in pediatric epileptic patients. The relationship between headache and epilepsy is considered complex and though there is evidence of association, its mechanisms are not yet completely clear. Numerous studies of comorbidity focus on primary headaches, such as migraine and tension-type headache, describing them as the most prevalent in patients with epilepsy. Some authors, though, report similar prevalence of headache and specifically migraine in epilepsy patients as compared to that of the general population. When describing this comorbidity, it should be noted that secondary headaches can also be frequent in patients with structural epilepsy, e.g. in brain tumors or other space-occupying lesions.In this paper we summarize literature data on the problem of epilepsy and headache comorbidity, and also present two clinical cases of patients with tension-type and with secondary headache, respectively

KINDLR questionnaire for quality of life in children: translation and adaptation in Bulgarian

Health-related quality of life can be assessed using specially developed instruments. One of these questionnaires, specific to pediatric practice, is KINDLR. It is a short, methodologically suitable, psychometrically sound and flexible tool, available in three versions which cover the different age groups and stages of development of children and adolescents between 3 and 17 years. This paper describes the translation and adaptation of the questionnaire in Bulgarian. The process was conducted according to an approved procedure developed by the authors of the original version and followed when the instrument was translated into other languages. The generic questionnaires KiddyKINDL, KidKINDL, and KiddoKINDL, the additional scales for long-term illness and hospitalization, as well as the module for epilepsy have been requested and approved for translation and adaptation in Bulgarian. In its final form in Bulgarian, the KINDLR questionnaire is approved for use in research and in practice. It is relatively short, easy to use, but also convenient in terms of processing the results. Tables for data entry in a format directly compatible with popular statistical software are publicly accessible. The availability of many other language versions, norms, and published results in the literature provides opportunities for conducting comparative studies of health-related quality of life in children on a national and international level