Fatal encephalitis associated with novel influenza A (H1N1) virus infection in a child

A 4-year-old girl presented with fever, coughing, and vomiting; followed by unconsciousness. Magnetic resonance imaging showed hyperintense changes in the thalami bilaterally, brain stem, cerebellum, and subcortical cortex. Novel influenza A (H1N1) virus was identified by polymerase chain reaction in patient’s nasopharyngeal swab specimen. We reported a rare case of clinically severe, novel influenza A-associated encephalitis. Novel influenza A should be considered in the differential diagnosis in patients with seizures and mental status changes, especially during an influenza outbreak

Türk çocuklarında solunum fonksiyon testlerinin normal değerleri ve bunların antrometrik ölçümler ve çevresel faktörlerle ilişkisi

TEZ2062Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 1996.Kaynakça (s. 61-66) var.66 s. ; 30 cm.

Levetirasetam ve valproik asid: Çocuklarda karaciğer fonksiyonları ve amonyak düzeyleri üzerine etkileri

Amaç: Levetirasetam ve valproik asidin, serum amonyak düzeyi ve karaciğer fonksiyon testlerinde bir değişikliğe neden olduğuna dair kanıtlar vardır. Bu çalışmanın amacı, valproik asid tedavisi ile karşılaştırıldığında, levetirasetam ile tedavi edilen epilepsili çocuklarda karaciğer fonksiyon parametreleri ve amonyak düzeyinin belirlenmesidir. Materyal ve Metod: Mart 2010 ve Ekim 2010 tarihleri arasında, epilepsili 42 hasta tedavi ettik. Valproik asit ile tedavi edilen 22 çocuk ve levetirasetam ile tedavi edilen 20 çocuk çalışmaya alındı ve serum antiepileptik ilaç düzeyi, transaminazlar, G-glutamil transferaz ve amonyak düzeyleri değerlendirildi. Bulgular: Valproik asit ile tedavi edilen hastalar ile levetirasetam ile tedavi edilen hastalar arasında serum g-glutamil transferaz ve transaminaz düzeyleri arasında herhangi bir farklılık yoktu. Valproik asit ile tedavi edilen hastalarda hiperamonyemi tespit edildi. Sonuç: Bu sonuçlar, levetirasetam tedavisinin serum amonyak düzeyi ve karaciğer fonksiyonlarını değiştirmediğini düşündürmektedir.Purpose: There is evidence that levetiracetam and valproic acid causes a changes of serum ammonia level and liver function tests. The aim of this study was to evaluate the liver function parameters and ammonia level in children with seizures on treatment with levetiracetam in comparison treated with valproic acid. Materıals and Methods: Between March 2010 and October 2010, we treated 42 patients with epilepsy. We determined the serum concentration of antiepileptic drug, transaminases, g-glutamyl transferase, and ammonia level in 22 children treated with valproic acid, and in 20 children treated with levetiracetam. Results: There were no significant differences in the serum transaminases, g-glutamyl transferase between the patients treated with valproic acid, and the patients treated with levetiracetam. Hyperammonemia was detected in patients treated with valproic acid. Conclusıon: These results suggest that the treatment with levetiracetam does not alter the serum ammonia level, and liver functions

Landau-Kleffner syndrome: Two cases report [Landau-Kleffner sendromu: İki olgu sunumu]

Landau-Kleffner syndrome (LKS) or acquired epileptic aphasia is an acquired aphasia in children showing normal language and motor development. Although its treatment is not standardized till now valproic acid (VPA), high dose methyl-prednisolone, adrenocorticotropic hormone, intravenous immunoglobulin (IVIG), clobazam, sulthiam, levatiracetam and surgical treatment (multiple subpial transections) were used and successful results were reported. We just administered high doses of methyl-prednisolone to our five and eight years old two cases of Landau-Kleffner syndrome as we couldn't recieve response to valproic acid in addition to intravenous immungloubulin treatment. However of the cases who received high dose methyl-prednisolone showed clinical and elektroencephalographical improvement

Guillain-Barr, syndrome in children

WOS: 000290545700003PubMed ID: 20953812Guillain-Barr, syndrome (GBS) is one of the reasons of acute polyneuropathy causing severe morbidity and mortality. Forty-six patients with GBS were included in our study. Clinical, laboratory, electrophysiological and prognostic features of the patients were evaluated retrospectively. Patients were divided into two groups. Group A consisted of children who attained a full recovery within 2 months from onset of the disease; group B consisted of children who experienced complete or partial recovery beyond 2 months from onset of the disease. Acute inflammatory demyelinating polyradiculoneuropathy was found in 56.5% of patients and axonal form in 43.5% patients. Antecedent events were found in 28 (60.9%) patients. Five patients (10.8%) needed mechanical ventilation and one patient (2.1%) died. Poor outcome was related with clinic stage and electrophysiological subtypes (axonal form). In our study, poor prognostic factors were related with clinic stage and electrophysiological subtypes (axonal form)

Evaluation of sixteen children with pseudotumor cerebri

PubMedID: 21534340Pseudotumor cerebri (PTC) is a clinical condition characterized by signs and symptoms of increased intracranial pressure, such as headache and papilledema. A total of 16 patients diagnosed with PTC [12 (75%) female; 4 (25%) male] were included in the study. The age of onset of symptoms was 123.4±34.3 months (range: 60-168 months). Obesity was found in four (25%) of them. Two patients had venous sinus thrombosis, two had corticosteroid withdrawal, and one had posttraumatic PTC. The most common symptom was headache, recorded in 93.8% of the patients. All patients were treated medically. Two patients in our group also required a lumboperitoneal shunt. In conclusion, PTC in children is rare. Both papilledema and sixth nerve palsy resolved rapidly with treatment. However, children can sustain loss of visual field and visual acuity despite treatment

Çocuklarda iskemik inme sonrası epilepsi için risk faktörleri

Amaç: Bu çalışma, çocukluk çağı iskemik inme sonrasında nöbet, epilepsi ve epilepsi insidansı ile risk faktörlerinin saptanması için yapıldı.Yöntem: Çalışmada, iskemik inme geçiren çocukların verileri retrospektif olarak analiz edildi.Bulgular: İskemik inme geçiren 102 hastanın yaş ortalaması 67,32± 25,48 ay (1-180 ay) idi. Elli altısı (%54,9) erkek ve 46'sı ise (%45,1) kız idi. Yüz iki hastanın, 39'u (%38,2) nöbet geçirmişti. Yirmi yedi (%69,2) hastanın nöbeti erken başlangıçlı iken, 12 (%30,8) hastanın nöbeti geç başlangıçlıydı. Hastaların 17'sinde (%16,7) epilepsi gelişmişti. Bunların 8'i erken başlangıçlı nöbeti olan hastayken, 9'u ise geç başlangıçlı nöbeti olan hastalardı. Lezyonun lokalizasyonu ve nöbet başlama zamanı epilepsi için risk faktörü saptandı. Sonuç: İnme sonrası nöbetler ve epilepsi çocuklarda sık görülür. Bu nedenle, bu populasyonda, inme sonrası epilepsi gelişme riskini saptamak için daha fazla çalışmaya gereksinim vardır.Objective: We performed this study to determine the incidence of seizures and poststroke epilepsy and risk factors of post-stroke epilepsy after childhood ischemic stroke.Methods: In this study, we retrospectively analyzed data from children who had ischemic stroke.Results: Of the one hundred and two children, mean age of stroke onset was 67.32± 25.48 months (1-180 months). There were 56 (54.9%) boys and 46 (45.1%) girls in the study . Of the 102 patients, 39 (38.2%) had seizures. Twenty seven (69.2%) had earlyonset post-stroke seizures, and 12 (30.8%) had late-onset post-stroke seizures. Epilepsy were detected in 17 (16.7%) of the patients. Eight of them had early-onset and nine had late-onset post-stroke seizures. We found that cortical involvement and late onset post-stroke seizure are predictors of the development of post-stroke epilepsy.Conclusions: Post-stroke seizures and epilepsy in children are common. Therefore, further studies are needed to describe risk factors for the development of post-stroke epilepsy in this population

Two different nervous system complications of mycoplasma pneumoniae

Mycoplasma pneumoniae, üst ve alt solunum yolu infeksiyonlarına sebep olan önemli bir etkendir. Solunum sistemi dışında da bazı klinik tablo ve komplikasyonlara yol açabilir. Meningoensefalit, ensefalit, transvers miyelit, akut dissemine ensefalomiyelit, beyinde infarkt ve Gullian-Barre sendromu etkenin sinir sisteminde sebep olduğu hastalıklar olarak belirtilebilir. Bu çalışmada Mycoplasma pneumoniae infeksiyonuna bağlı meningoensefalit ve Gullian-Barre sendromu gelişen iki vaka sunulmuştur.Mycoplasma pneumoniae is an important agent of the lower and upper respiratory system infections. It may result in some complications and clinical conditions other than infections. Meningoencephalitis, encephalitis, transverse myelitis, acute disseminated encephalomyelitis, cerebral infarction and Gullian-Barre syndrome are major neurological complications. We present here two cases with meningoencephalitis and Gullian-Barre syndrome secondary to Mycoplasma pneumoniae infection

Landau-Kleffner syndrome: two cases report

Landau-Kleffner sendromu veya edinsel epileptik konuşamama (afazi) normal dil ve motor gelişimi gösteren çocuklarda ortaya çıkan kazanılmış bir konuşamama halidir. Henüz bilinen bir tedavisi olmamasına rağmen, şimdiye kadar valproik asit, yüksek doz metil-prednizolon, adrenokortikotropin hormon, damar içi immünglobülin, klobazam, sultiyam, levatirasetam ve cerrahi tedavi (mutiple subpial transection) kullanılmış ve başarılı sonuçlar bildirilmiştir. Biz de beş ve sekiz yaşında Landau-Kleffner sendromu tanısı konulan iki olgumuza valproik asit ile birlikte önce damar içi immünglobülin, yanıt alamadığımız için sonra yüksek doz metil-prednizolon uyguladık. Damar içi immünglobülin tedavisine iki olgumuzda da yanıt alamadık. Ancak yüksek doz metil prednizolon uyguladığımız olgularımızdan birisinde hem klinik, hem de elektroansefalogram bulgularında düzelme saptadık.Landau-Kleffner syndrome (LKS) or acquired epileptic aphasia is an acquired aphasia in children showing normal language and motor development. Although its treatment is not standardized till now valproic acid (VPA), high dose methyl-prednisolone, adrenocorticotropic hormone, intravenous immunoglobulin (IVIG), clobazam, sulthiam, levatiracetam and surgical treatment (multiple subpial transections) were used and successful results were reported. We just administered high doses of methyl-prednisolone to our five and eight years old two cases of Landau-Kleffner syndrome as we couldn't recieve response to valproic acid in addition to intravenous immungloubulın treatment. However of the cases who received high dose methyl-prednisolone showed clinical and elektroencephalographical improvement

Hypohidrosis and hyperthermia during topiramate treatment in children

PubMedID: 23427516Topiramate is one of the newer generation antiepileptic drugs with a beneficial clinical effect on various seizure types. In this study, we present the clinical findings of hypohidrosis and hyperthermia with topiramate in pediatric patients. The data were collected retrospectively on 173 patients diagnosed as epilepsy on topiramate treatment, and hypohidrosis-related symptoms induced by topiramate were found in 22 patients. Their mean age was 64.45±56.63 months. The mean duration of topiramate treatment was 7.09±2.46 months, and the mean dose was 5.37±1.75 mg/kg/day. All of the patients complained of hypohidrosis and hyperthermia. Six (27.2%) of them had facial flushing, 4 (18.1%) had heat sensation and only 1 (4.5%) had lethargy. Hypohidrosis-related symptoms resolved after discontinuation of the medication. In conclusion, children treated with topiramate should be cautioned regarding these potential adverse effects and advised to avoid its use during the hot summer season