Evaluation of the Frequency of Obesity and Demographic Characteristics of Children with Primary Monosymptomatic Nocturnal Enuresis

Aim: Enuresis is a common problem in childhood. Our aim in our study was to evaluate the relationship between monosypmtomatic nocturnal enuresis and obesity

Sural Sparing Pattern and Sensory Ratio as Electrodiagnostic and Prognostic Markers in Pediatric Guillain-Barre Syndrome

Background We aimed to evaluate the presence of sural sparing pattern (SSP) and sensory ratio in pediatric Guillain-Barre syndrome (GBS), their distribution to subtypes, and their relationship with demographic and clinical features with a focus on the disability and muscle strength. Methods This single-center retrospective study was conducted on pediatric GBS patients of both sexes with 2 years follow-up and two nerve conduction studies in which SSP and sensory ratio were calculated. Three subgroups of SSP were formed by separate calculation of median (SSP-m) and ulnar (SSP-u) and both median and ulnar sensory nerve action potentials (SNAPs; SSP-total). Muscle strength and disability were evaluated with the Medical Research Council (MRC) sum score and Hughes functional grading scale (HFGS), respectively. Results SSP total was identified in 70.6% (n: 24) of the patients, while sensory ratio > 1 was observed in 20 (66.7%) patients. Patients with SSP-m, SSP-u, SSP-total, or sensory ratio > 1 had higher HFGS scores, while patients with SSP-m, SSP-u, or SSP-total had lower MRC sum scores. SSP parameters were significantly associated with muscle strength and disability scores in acute motor axonal neuropathy patients. Conclusion Both SSP and sensory ratio can be used for diagnostic and prognostic purposes. Disability and muscle strength are associated with SSP and sensory ratio in pediatric GBS

Effects of Hemogram Parameters on Remission Durations in Self-Limited Epilepsy with Centrotemporal Spikes

The hemogram parameters have been extensively discussed in numerous diseases, including epilepsy, for their diagnostic and prognostic values. We aimed to investigate the impact of hemogram parameters, namely, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) at the time of the first seizure on the remission durations of the patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). This retrospective study was conducted on patients with SeLECTS with a minimum follow-up of 2 years. We assessed the hemogram parameters obtained from the venous blood samples collected from the patients upon admission. The duration of remission was categorized into two groups for further data analysis: those with a remission period less than 2 years and those with a remission period of more than 2 years. This study involved 122 patients with SeLECTS, of which 85% ( n = 102) had remission durations of & LE;2 years. The analysis revealed that patients with remission durations exceeding 2 years had a significantly higher median leukocyte ( p = 0.009), neutrophil ( p < 0.001), and platelet ( p < 0.001) counts. Additionally, higher levels of NLR and PLR were observed in patients with longer-term remission ( p < 0.001). However, there were no significant differences between the two groups in terms of lymphocyte count, monocyte count, mean platelet volume, or LMR. Leukocyte, neutrophil, platelet, NLR, and PLR counts have shown potential as predictive indicators of remission times in patients with SeLECTS. Neurologists can potentially find value in these easily accessible parameters when evaluating the future trajectory of patients with SeLECTS

Pediatric Pseudotumor Cerebri Syndrome Secondary to Superior Sagittal Sinus Thrombosis Associated with Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Brief Literature Review

Psödotümör serebri sendromu (PTSS), normal beyin parankimi ve beyin omurilik sıvısı (BOS) ortamında artmış kafa içi basıncın varlığı ile tanımlanır. PTSS pediatrik popülasyonda ortaya çıkabilir ve tedavi edilmezse kalıcı görme kaybına neden olabilir. Şiddetli akut solunum yolu enfeksiyonu sendromu-koronavirüs-2 (SARS-CoV-2) enfeksiyonunun hastaları arteriyel ve venöz tromboembolik olaylara yatkınlaştırdığı bilinmektedir. Literatürden çeşitli raporlar, serebral venöz sinüs trombozunun (SVST) SARS-CoV-2’nin 10 doğrudan bir komplikasyonu olabileceğini düşündürmektedir. İlk pediatrik SARS-CoV-2 enfeksiyonu ile ilişkili süperior sagittal sinüs trombozuna sekonder bir PTSS olgusunu sunmayı amaçladık. Daha önce sağlıklı olan 13 yaşında erkek hasta 2022 Şubat ayında son dört gündür baş ağrısı, kulak çınlaması ve çift görme şikayetleri ile acil servise başvurdu. Başvuru sırasında yapılan nörolojik muayenesinde mental durumu ve kraniyal sinir muayenesi normaldi. Fundus muayenesinde bilateral 15 papilödem saptandı. SARS-CoV-2 polimeraz zincir reaksiyonu negatif çıkarken, antiSARS-CoV-2 antikoru pozitif çıktı. Kontrastlı beyin manyetik rezonans görüntüleme intrakraniyal hipertansiyon belirtileri gösterdi ve manyetik rezonans venografi süperior sagittal sinüs trombozu gösterdi. Lomber ponksiyon BOS 73 cm H2 O ölçüldü. Hastamız SARS-CoV-2 enfeksiyonu ile ilişkili SVST’ye sekonder PTSS olarak kabul edildi. SARS-CoV-2 enfeksiyonu ile ilişkili SVST’ye sekonder PTSS tanısı konulan çocuğa oral topiramat 20 ve düşük molekül ağırlıklı heparin tedavisi başlandı. Tedavi sonrasında baş ağrısı ve görme fonksiyonları düzelen çocuk takibe alındı. Klinisyenler SARS-CoV-2 pozitif hastalarda özellikle nörolojik semptomlar gelişirse akut SVST riskini göz önünde bulundurmalıdır. Hızlı tanı ve tedavi görme kaybını önleyebilir Anahtar kelimeler: SARS-CoV-2, psödotümor serebri, papilödem, venöz trombozu, baş ağrısı</p

Evaluation of the Pediatric Neurology Consultations Requested from the Pediatric Emergency Service: A Single-Center Experience

Objective: Pediatric neurology opinion is one of the most frequently requested consultations in emergency service practice. Symptoms and/or signs such as headache, altered consciousness, seizures, and focal neurological deficits are the most common consultation reasons. We aimed to retrospectively evaluate patients who were consulted with the pediatric neurology department in the pediatric emergency service. Method: This is a descriptive cross-sectional study in which the consultation notes of patients who presented to the pediatric emergency service and required a consultation with the pediatric neurology department between June 2016 and November 2019 were analyzed retrospectively. Results: The number of the consulted patients was 1,265. Sixteen patients left the hospital after their parents signed treatment and examination rejection form, 1,249 consultations were included. The most common reasons for consultation were seizure, routine follow-up of patients that receive home mechanical ventilator support, and headache. The rate of emergency neurological pathologies detected in brain computed tomography and magnetic resonance imaging was 1.7%. The most common electroencephalographic abnormality was focal epileptic discharges. Consultation rate requiring emergent intervention was 14.8% and status epilepticus, central nervous system infections, intracranial masses were the most common causes. Conclusion: The most common reason for consultation was seizure. The rate of consultations requiring acute intervention was low. We think that the emergency service admissions of patients that need examination and treatment in the outpatient clinic may harm the routine functioning of the emergency service. Community education for the use of the emergency room only when necessary is essential

Evaluation of the Genetically Diagnosed Mitochondrial Disease Cases with Neuromuscular Involvement

Objective: Due to the fact that mitochondrial diseases can involve different organ systems, neuromuscular involvement is frequently observed and has a substantial place in clinical practice. In this study, the clinical, radiological, electrophysiological and imaging features of the patients with mitochondrial disease with neuromuscular involvement were investigated. Method: The clinical, radiological and genetic features of 16 patients with genetically diagnosed mitochondrial disease followed in the Departments of Pediatric Neurology and Pediatric Metabolism and Nutrition in Dokuz Eylul University Faculty of Medicine were retrospectively evaluated. Results: The cases were between 3-17 years of age (mean: 8.8 +/- 4.2 years). 44% (n=7) of the cases were male. Clinical findings started at a mean age of 30 months (2-132 months). There was consanguineous marriage in 81% (n=13) of the cases. Leigh syndrome (LS), Charcot-Marie-Tooth disease (CMT) 2A, and CMT disease-axonal-type 2K were diagnosed in 5, 4, 2 cases, respectively. Alpers syndrome, combined oxidative phosphorylation deficiency-13, megalencephaly without cystic leukoencephalopathy, mt.9804G>A and m.11696G>A mutations which could not be phenotyped syndromicly were detected in one case each. SURF1 (n=2), MTATP6 (n=2) and PDSS2 (n=1) mutations were found in the patients with LS. NARS2, PNPT1, and RNASET2 mutations were found in the patients with Alpers syndrome, combined oxidative phosphorylation deficiency-13, cystic leukoencephalopathy without megalencephaly, respectively. Muscle weakness, developmental delay and skeletal deformity were the most common findings. The most common finding in brain magnetic resonance imaging was increased T2 signal in bilateral basal ganglia. Conclusion: The most common genetically diagnosed mitochondrial disease was LS, the most common mutation was MFN2, and the most common clinical finding was muscle weakness