The thalamic vascular supply is categorized into the anterior, paramedian, inferolateral, and posterior territories. The artery of Percheron (AOP), a solitary trunk that is an uncommon anatomic variant, provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The case described herein is of a patient with AOP who presented with the sudden onset of lethargy.
Arteries ; Humans ; Infarction ; Lethargy ; Mesencephalon ; Thalamus

The thalamic vascular supply is categorized into the anterior, paramedian, inferolateral, and posterior territories. The artery of Percheron (AOP), a solitary trunk that is an uncommon anatomic variant, provides bilateral arterial supply to the paramedian thalami and the rostral midbrain. Occlusion of this artery results in bilateral thalamic and mesencephalic infarctions. The case described herein is of a patient with AOP who presented with the sudden onset of lethargy.
Arteries ; Humans ; Infarction ; Lethargy ; Mesencephalon ; Thalamus

Desmoplastic cerebral astrocytoma of infancy is a massive cystic tumor, typically occurring in the cerebral hemisphere and a rare intracranial tumor that arises in subjects usually below the age of 18 months and shows a favorable prognosis. A 5.5-month-old boy was presented with a rapidly increasing head circumference and lethargy. A computerized tomography scan revealed a large, multicystic, partially enhancing right parieto-occipital mass with hydrocephalus. This patient was treated with a surgery and a firm plaque-like tumor along withmulticystic component was gross totally removed. The tumor mass was firmly attached to the dura and extended in fingerlike projections onto the cortical surface. The infant underwent no further therapy and has developed normally during 6 months after surgery. Desmoplastic cerebral astrocytoma of infancy is a rare intracranial tumor but recognition of this tumor should be appreciated because, despite its massive size and rapidly growing characterstics, this tumor often has a relatively benign clinical course.
Astrocytoma* ; Cerebrum ; Head ; Humans ; Hydrocephalus ; Infant ; Lethargy ; Male ; Prognosis

A case of isolated hypoaldosteronism 5 month old male infant was presented. He was admitted to the pediatric ward with the chief complants of frequent vomiting, dehydration, lethargy and failure to thrive. The diagnosis was established by salt-losing manifestation, laboratory fiding and good response after salt-retaining steroid therapy. A brief review of related literatures were also presented.
Dehydration ; Diagnosis ; Failure to Thrive ; Humans ; Hypoaldosteronism ; Infant ; Lethargy ; Male ; Vomiting

OBJECTIVES: We assessed the availability of Aberrant Behavior Checklist (ABC) for the evaluation of the pharmacological effect in autistic disorder. METHODS: A retrospective review of the medical records of 27 children with autistic disorder, who visited the department of child and adolescent psychiatry of Kyungpook National University Hospital, from October 2011 to February 2013, was conducted. After treatment with risperidone, changes in the severity and improvement of symptoms were measured using ABC at the baseline, 2nd visit and 3rd visit, respectively. RESULTS: The mean daily dose of risperidone increased from 0.66+/-0.27mg (baseline, initial dose) to 1.02+/-0.50mg, 2nd visit, and 1.19+/-0.50mg, 3rd visit. According to ABC, irritability, lethargy, hyperactivity, and inappropriate speech subscale scores decreased significantly from the baseline to 2nd visit. Irritability and Hyperactivity subscale scores decreased significantly from the 2nd to 3rd visit. All subscales and total scores of ABC decreased significantly from the baseline to 3rd visit. CONCLUSION: The results of this study suggest that ABC can be used as an efficient tool to measure the symptoms of autistic disorder and to evaluate the medication effect on continuous treatment.
Adolescent ; Adolescent Psychiatry ; Autistic Disorder* ; Checklist* ; Child* ; Humans ; Lethargy ; Medical Records ; Retrospective Studies ; Risperidone

A clinical and laboratory study was conducted on 58 children who had been admitted to out pediatric department from February to September 1979, under the clinical diagnosis of septicemia. Following results were obtained: 1. Boys were affected more frequently than girls(1.3:1), and highest incidence was noticed in newborn period, comprising 50% of the total cases. 2. The common clinical manifestations, in order of frequency, were fever, lethargy, jandice, poor sucking and abdominal distension, and hyperbilirubionemia was the most common assocaited disease, followed by anemia and leukemia. 3. Clinical course revealed death in 6 patients(10.3%), discharge against advice in 7cases(21.1%) and complete recovery in the remaining 45 cases(77.6%). 4. Peripheral blood count showed leukocytosie in 40%, leukopenia in 12.1% and thrombocytopenia was seen in 45% of cases. 5. Gram staining of buffy coat smear showed bacteria in 34.5% and especially high ratio was noticed in newborn infants(48.3%). 6. Positive blood culture was seen in 39.7% with highest ratio of 45% in newborn infants. In positive blood culture group, toxic granules were noted in 32.8%, shift to left in 25.9%, hrombocytopenia in 18.9% and positive buffy coat smear in 15.5%. In summary, thrombocytopenia, toxic granules, shift to left were quite helpful in early diagnosis of sepsis. In addition to diagnostic value, examination of buffy coat smear could aid physician to select appropriate antibiotic regimen especially in sepsis of newborn period.
Anemia ; Bacteria ; Child* ; Diagnosis ; Early Diagnosis ; Fever ; Humans ; Incidence ; Infant, Newborn ; Lethargy ; Leukemia ; Leukopenia ; Sepsis* ; Thrombocytopenia

PURPOSE: Respiratory syncytial virus(RSV) mainly brings about respiratory complication, but it can also be related to neurologic complication. We have studied clinical aspect and incidence of neurologic complication associated with RSV infection. METHODS: We reviewed the medical records of 732 children with RSV infection who were admitted to the department of pediatrics, Hanyang University hospital from November 2002 to June 2007 and studied on existence of neurologic complication, age, sex, clinical symptom, characteristics of seizure, and laboratory findings. RESULTS: Neurologic complications were occurred in 52 patients(7.1%) among 732 patients. Among them, 14 patients(1.9%) had seizure and 38 patients(5.2%) had alteration of mental status such as drowsy, lethargy. Age distribution of patients with neurologic complication was from 1 month to 5 years(mean 16.4 months). There were 30 boys and 22 girls. Among 14 patients who had seizure, 2 patients had convulsion disorder, 3 patients had febrile convulsion, and 9 patients had no seizure before. Their age distribution was from 1 months to 4 years(mean 18.4 months) and there were 8 boys and 6 girls. All of 14 patients showed generalized tonic clonic seizure and durations were from 30sec to 15 min(mean 4.4 min). All of the investigations were normal. None of 52 patients had recurrence and neurologic sequelae. CONCLUSION: It is important to know that RSV can cause CNS complications because we know how many patients infected by RSV. RSV-related seizure can be considered as benign seizure which does not need any long-term antiepileptic medication.
Age Distribution ; Child ; Humans ; Incidence ; Lethargy ; Medical Records ; Pediatrics ; Recurrence ; Respiratory Syncytial Viruses ; Seizures ; Seizures, Febrile

Isovaleric acidemia is an inborn error in metabolism due to a defect in isovaleryl-CoA dehydrogenase. Accumulation of serum isovaleric acid causes poor feeding, vomiting, lethargy, hypothermia, convulsion, mental retardation, etc. It is inherited as an autosomal recessive trait. Since the first reports of isovaleric acidemia by Tanaka et al in 1966, more than 60 cases have been reported. There are two clinically different presentations of isovaleric acidemia, with about half the patients presenting with an acute severe neonatal form and about half with a chronic intermittent forrn. The difference in clinical presentation may not be a consequence of differing severities of the causative mutation, but a result of the timing of application of catabolic stress or the ability to form isovalerylglycine. We described here clinical and organic acid analytical findings of brothers with chronic intermittent form of isovaleric acidemia. (J Korean Pediatr Soc 2000;43:828-831)
Humans ; Hypothermia ; Intellectual Disability ; Isovaleryl-CoA Dehydrogenase ; Lethargy ; Metabolism ; Seizures ; Siblings* ; Vomiting

Metastatic involvement of the central nervous system during the course of leukemia is an increasingly frequent occurrence because of the longer survival time brought about by the efficacious cytotoxic therapy available today. The onset of acute leukemia may be abrupt with a great variety of clinical manifestations. Most commonly, such as vomiting, headache, papilledema, lethargy and vertigo, are referable to increased intracranial pressure caused by infiltration of the cortex and meninges. The acute paraplegia as the initial symptom of acute leukemia is very rare. A case in which acute paraplegia occurred as the initial symptom of acute leukemia in a 15-year-old boy is reported.
Adolescent ; Central Nervous System ; Headache ; Humans ; Intracranial Pressure ; Lethargy ; Leukemia* ; Male ; Meninges ; Papilledema ; Paraplegia* ; Vertigo ; Vomiting

Metastatic involvement of the central nervous system during the course of leukemia is an increasingly frequent occurrence because of the longer survival time brought about by the efficacious cytotoxic therapy available today. The onset of acute leukemia may be abrupt with a great variety of clinical manifestations. Most commonly, such as vomiting, headache, papilledema, lethargy and vertigo, are referable to increased intracranial pressure caused by infiltration of the cortex and meninges. The acute paraplegia as the initial symptom of acute leukemia is very rare. A case in which acute paraplegia occurred as the initial symptom of acute leukemia in a 15-year-old boy is reported.
Adolescent ; Central Nervous System ; Headache ; Humans ; Intracranial Pressure ; Lethargy ; Leukemia* ; Male ; Meninges ; Papilledema ; Paraplegia* ; Vertigo ; Vomiting