No abstract available.
Neurology*

The authors present a case of spontaneous discitis in a 1-year-old female who presented with fever and limping gait. The erythrocyte sediment rate was increased. The roentgenograms revealed normal appearnce, and radioactive bne scan showed increased uptake at the affected level. Discitis should be considered in any child with limping gait or leg pain, refusal to walk, or abdominal pain. Early recognition may avoid unnecessary diagnotic and treatment procedures.
Abdominal Pain ; Child* ; Discitis* ; Disulfiram ; Erythrocytes ; Female ; Fever ; Gait ; Humans ; Leg

No abstract available.

Acute disseminated encephalomyelitis(ADEM) and acute relapsing disseminated encephalomyelitis(ARDEM) are representative demyelination diseases that occur among young children with a fulminant onset similar to encephalitis or meningitis. The diseases often occur after some viral infection of immunization and the etiology of these diseases is considered to be an autoimmune response because of the similarity in pathologic findings to experimental allergic encephalomyelitis. Cerebral computed tomography(CT) findings of demyelination in ADEM or ARDEM show normal to low density areas in the white matter. In cerebral MRI findings, a scattered distinct high intensity lesion considered to be demyelination is observed in 72-weighted imaging even in the early stages. ADEM is usually monophasic, but recurrent episodes may occure. When ADEM is reccurent, the distinction from multiple sclerosis becomes difficult. We report here a case of acute relapsing disseminated encephalomyelitis(ARDEM) in a 9 years old male child who experence ADEM, 3 times.
Autoimmunity ; Child ; Demyelinating Diseases ; Encephalitis ; Encephalomyelitis, Acute Disseminated* ; Encephalomyelitis, Autoimmune, Experimental ; Humans ; Immunization ; Magnetic Resonance Imaging ; Male ; Meningitis ; Multiple Sclerosis

No abstract available.

No abstract available.

Cockayne syndrome is a rare autosomal recessive disorder that results in postnatal growth failure and progressive neurological dysfunction. Associated clinical features are gait disturbance, progressive pigmentary retinopathy and other ocular anomalies such as cataracts and optic disk atrophy, sensorineural hearing loss, dental caries and cutaneous photosensitivity. The disease is clinically heterogeneous with a wide range in the type and severity of symptoms. We experienced a case of Cockayne syndrome in 13 year-old male, who had delayed development, hypophasia, characteristic physical appearance, cutaneous photosensitivity, dental caries. We reported the case with review of literatures.
Adolescent ; Atrophy ; Cataract ; Cockayne Syndrome* ; Dental Caries ; Gait ; Hearing Loss, Sensorineural ; Humans ; Male ; Optic Disk ; Retinitis Pigmentosa

PURPOSE: This study was performed to correlate clinical behaviours with either a temporal or frontal site of origin and then to identify behaviours that might have a significant practical value in differentiating a temporal from a frontal focus and thus reduce the need for invasive monitoring. METHODS: We analysed 129 seizures that occured during video-EEG monitoring in 13 patients with temporal lobe epilepsy (TLE) and in 9 patients with frontal lobe epilepsy (FLE) as well as neuroimaging studies. We compared first the clinical behaviours that occurred in frontal lobe seizures to those of temporal lobe seizures (second stage analysis). To eliminate clinical behaviours that could occur as the discharge propagated another lobe, we compared only clinical seizure events in which we had no evidence of spread to other regions, or that spread only to the homologous contralateral lobe (first stage analysis). The Fisher exact test was used for analysis. RESULTS: Although staring, sitting up, leg movement, and tonic-clonic movement, generalization occurred more frequently in FLE, and oral, alimentary and hand automatisms were more frequent in TLE, no statistically significant difference was found between the two groups. In second stage analysis, sitting up, tonic-clonic movement were seen only in FLE and oral, alimentary and hand automatisms only in TLE. Staring, hand posturing occurred more frequently in FLE. CONCLUSION: We therefore conclude that the reliability of clinical behaviour alone to predict the site of origin of an epileptic discharge is limited when the surface EEG is equivocal or neuroradiologic evidence of a focus is not clear.
Child ; Electroencephalography ; Epilepsy, Frontal Lobe ; Epilepsy, Temporal Lobe ; Frontal Lobe* ; Generalization (Psychology) ; Hand ; Humans ; Leg ; Neuroimaging ; Seizures* ; Temporal Lobe

Carbon monoxide intoxication has long been one of the most serious public health problems in Korea. This is mainly due to the wide use of anthracite coal briquettes as domestic fuel for cooking and under-the floor heating. One hundred and seven cases of CO intoxicated children hospitalized at Yonsei Medical center from January 1970 to December 1986 have been investigated clinically. The sex ratio was 1.3:1 (male 60 cases, female 47 cases) with the peak incidence occuring in patients between 12 and 14 years of age (28%). The most common symptoms were vomiting convulsions and headache; and the most frequent signs were altered mental state, increased deep tendon reflex and a positive Babinski sign. The outcome of patients was as follows: 4 cases (3.7%) expired, 77 cases (72.0%) recovered without neurologic sequelae and 26 cases (24.3%) survived with neurologic sequelae. The neurologic sequelae included persistent convulsions (7 cases), cortical blindness (3 cases), peripheral neuropathy (2 cases) and delayed neurologic sequelae (11 cases). Neurologic sequelae occurred most frequently in comatose patients (45.5%) and least often in mentally alert patients (6.1%), more frequently m patients exposed to CO gas for more than 8 hours than in those exposed for less than 8 hours, and in patients who did not receive hyperbaric oxyen therapy(29.4%) than in those who did(19.6%). Delayed neurologic sequelae were mental retardation (72.7%), epilepsy (36.4%), mutism (18.2%) etc. The lucid interval in 11 cases of delayed neurologic sequelae ranged from 2 to 20 days. The results of this study suggest that every patient exposed to CO gas should receive prompt and efficient oxygenation including hyperbaric oxygen therapy and that expeditious reduction of cerebral edema maybe of value. The importance of providing follow-up facilities in anticipation of a relapse of the delayed neurologic sequelae has been established.
Adolescent ; Carbon Monoxide Poisoning/complications* ; Carbon Monoxide Poisoning/radiography ; Carbon Monoxide Poisoning/therapy ; Central Nervous System Diseases/chemically induced* ; Child ; Child, Preschool ; Female ; Human ; Hyperbaric Oxygenation ; Male ; Tomography, X-Ray Computed

Diaphragnatic hernia is one of the surgical emergencies of the childhood because of the life-threatening cardiorespiratory embarrassment frequently associated with it. This congenital condition is characterized by varying degrees of protrusion of the abdominal viscera into the thoracic cavity through an abnormal opening in the diaphragm this opening results from a defect in the complex embryologic developement of the diaphragm between the thoracic and abdominal cavities. We expenienced 16 cases of congenital diaphragmatic hernia which were diagnosed at Severance Hospital from May 1964 to April 1977, and obtained the following results. 1) In 16 cases, male were ten and female were six. They were eleven cases of bochdalek hernia, two cases of diaphragmntic eventration, one case of hiatal and two undetermined. 2) Onset of symptoms were within 24 hours in 7 cases and in the rest cases symptoms were occured up to 24 months. 3) Most common symptoms were dyspnea and cynosis. 4) Most common signs were decreased breathing sound on affected lung, PMI shifting, scaphoid abdomen and subcostal retraction. 5) Combined anomalies were band adhesion of intestinal loop, hypoplasia of left lung etc. 6) Small intestine were more frequently herniated as well as large intestine. 7) mortality rate between abdominal procedure and thoracic procedure was equal. 8) Cases whose symptoms were occured within 24 hours were 7, 5 of these 7 were expired, Expired cases were associated with marked respiratory difficulties and pulmonary hypoplasia.
Abdomen ; Abdominal Cavity ; Diaphragm ; Dyspnea ; Emergencies ; Female ; Hernia ; Hernia, Diaphragmatic* ; Humans ; Intestine, Large ; Intestine, Small ; Lung ; Male ; Mortality ; Respiratory Sounds ; Thoracic Cavity ; Viscera