1.Posterior reversible encephalopathy syndrome: Malaysian haemato-oncological paediatric case series
Choong Yi Fong ; Chaw Su Hlaing ; Aye Mya Min Aye ; Chee Geap Tay ; Hany Ariffin ; Lai Choo Ong
Neurology Asia 2015;20(3):275-281
Background & Objective: Posterior reversible encephalopathy syndrome (PRES) is associated with
immunosuppressive agents used in children with haemato-oncological diseases. There are no reports
to date from the South Asia and South East Asia region. We report a Malaysian tertiary centre case
series of children with haemato-oncological disease who developed PRES. Methods: Retrospective
study of children seen with haemato-oncology diseases seen at the University Malaya Medical Centre
Kuala Lumpur who developed PRES from 2011 – 2013. Clinical details were obtained from medical
records and brain neuroimaging was reviewed. Results: Five patients met the inclusion criteria. All
5 patients had significant hypertension acutely or subacutely prior to neurology presentation. Four
presented with acute seizures and the remainder 1 presented with encephalopathy.Three patients
were on chemotherapy, 1 had renal impairment and 1 had prior immunosupression for bone marrow
transplantation. A full recovery was seen in 4 patients and 1 patient had mild residual quadriplegia.
Conclusion: Our case series expands the clinico-radiological spectrum of PRES in children with
underlying haemato-oncological disorders. It is the first to show that prior cyclosporin intake as long
as 2 months is a potential risk factor for PRES. Clinicians need to be vigilant for development of
PRES and closely monitor the blood pressure in these children who are receiving or recently had
immunosuppressive drugs and present with acute neurological symptoms.
Posterior Leukoencephalopathy Syndrome
;
Brain Diseases
2.Validity and reliability of the Chinese parent proxy and child self-report health related quality of life measure for children with epilepsy (CHEQOL-25) in Malaysia
Su Woan Wo ; Pauline Siew Mei Lai ; Lai Choo Ong ; Wah Yun Low ; Kheng Seang Lim ; Chee Geap Tay ; Chee Piau Wong ; Ranjini Sivanesom
Neurology Asia 2016;21(3):235-245
Objective: To determine the validity and reliability of the Chinese parent proxy and child self-report
health related quality of life measure for children with epilepsy (CHEQOL-25) in Malaysia. Methods:
Face and content validity of the Chinese parent proxy and child self-report CHEQOL-25 was verified
by an expert panel, and piloted in five children with epilepsy (CWE). The Chinese CHEQOL-25 was
then administered to 40 parent proxies and their CWE (aged 8-18 years), from two tertiary hospitals,
at baseline and 2 weeks later. Results: Forty parents and their CWE were recruited. Cronbach’s alpha
for each subscale ranged from 0.56-0.83. At test-retest, the interclass correlation for all items ranged
from 0.68-0.97. Items 8 and 25 were removed as their corrected item-total correlation values were
<0.3. Epilepsy severity, the number of anti-epileptic drugs taken daily, number of close friends and
number of time spent with friends were found to be associated with the parent proxy CHEQOL-25
score. Duration of epilepsy, child’s cognitive ability, number of close friends and number of time spent
with friends were associated with child self-report CHEQOL-25. The parent proxy and the child selfreport
showed high to fair agreement on the “interpersonal/social” [Intraclass correlation coefficient
(ICC)=0.670, p<0.001] and “epilepsy secrecy” subscale (ICC=0.417, p=0.048).
Conclusions: Our small study found that the Chinese CHEQOL-25 was a valid and reliable questionnaire
to assess the quality of life of children with epilepsy from the parent prospective and child self-report
when items 8 and 25 were removed.
Epilepsy