Febrile seizures are the most common convulsive disorder and one of the most common nervous system diseases in childhood. Generally, the prognosis is good. Recent studies have revealed a greater understanding about many issues related to the diagnosis and treatment of febrile seizures, including the definition of febrile seizures, clinical diagnosis and evaluation, drug treatment, and prevention. Clinicians should note the association between febrile seizures and epilepsy syndromes. Excessive examination and treatment for patients should be avoided. Effective communication with the parents of patients and health education are also the key points of diagnosis and treatment.
Humans ; Recurrence ; Seizures, Febrile ; diagnosis ; therapy

The recognition of epileptic seizures in newborns is challenging as neonates exhibit a variety of paroxysmal motor phenomena, some epileptic but others not. The distinction, frequently requiring video-EEG monitoring, is crucial for management. Causes are often multi-factorial, specific to country/region, and change over time. Hypoxia-ischemia and infection are still common in both developed and developing countries. Venous and arterial strokes are being increasingly recognized. Treatable conditions, including inborn errors of metabolism, must be anticipated and considered early in the course. Etiology is the principal determinant of outcome. Management is based on uncontrolled studies and expert opinions. Information on neonatal seizures is reviewed, and suggestions for management provided. Phenobarbital remains the first anti-epileptic drug of choice, worldwide. Pharmacogenetic information and hepatic or renal dysfunction will influence doses of all drugs. The toxicity of excipients present in intravenous medicines should be kept in mind, especially when infusions are given to critically ill neonates. Therapeutic trials with pyridoxine or ideally pyridoxal phosphate, folinic acid and biotin should be considered early, if seizures are intractable. The management of electrographic seizures without clinical seizures needs critical study. When anti-epileptic drug treatment is required, maintenance should be for a short duration if seizures are of an acute symptomatic nature.
Anticonvulsants ; therapeutic use ; Diagnosis, Differential ; Electroencephalography ; Humans ; Infant, Newborn ; Seizures ; diagnosis ; drug therapy ; etiology

Primary leptomeningeal melanoma is a rare and aggressive tumor that originates from pial melanin-bearing cells typically along the cerebral conveidties or at the. Base of the brain. It has been hypothesized that malignant transformation Of the preexisting precursor cells leads to diffuse infiltration of the meninges by tumor and the onset of neurological symptoms and signs . The typical neurological symptoms and signs include psychiatric disturbances, seizures, and symptoros and signs of raised intracranial pressure secondary to hydrocephalus. Blindness has been reported as a late feature. Radiotherapy and chemotherapy has been using, but prognosis is poor We d be our experience with 24-years-woman in which the diagnosis of primary leptomeningea1 melanoma without melanotic pigmentation of variable areas of the skm was made.
Blindness ; Brain ; Diagnosis ; Drug Therapy ; Hydrocephalus ; Intracranial Pressure ; Melanoma* ; Meninges ; Pigmentation ; Prognosis ; Radiotherapy ; Seizures

Anticonvulsants ; therapeutic use ; Electroencephalography ; Humans ; Infant, Newborn ; Seizures ; diagnosis ; drug therapy ; etiology

This study aimed at identifying the frequency and final diagnoses of stroke mimics (SMs) among suspected stroke cases, and seeking differences in clinical & imaging features between SMs and true strokes. It was retrospective with data taken from an ongoing stroke registry for patients admitted to a Stroke Unit between 1 May and 31 October 2011. Baseline characteristics, clinical & imaging features, complications, and outcomes of SMs were compared to those with true strokes by appropriate statistical tests. The total number of cases admitted was 537. Only 232 (43.2%) of them presented during the critical time thrombolytic intervention. SMs comprised 15.9% of all suspected stroke cases. The commonest mimics were psychiatric disorders (43.2%), migraines (16.2%), seizures (8.1%), brain tumors (5.4%), and systemic infections (5.4%). SMs were younger, more common in females, with less evidence of preexisting hypertension (43.2% vs. 56.9% for true strokes). Hemianopia (p = 0.001), sensory inattention, neglect or both (p < 0.001) were more associated with true strokes, while cerebellar, brainstem signs or both (p = 0.045) excluding dysarthria were linked only to SMs. Acute ischemic signs in imaging scans were found linked to true strokes. Some clinical and imaging characteristics were found to differentiate to some extent between SMs and true strokes.
Brain Neoplasms ; Brain Stem ; Diagnosis ; Diagnosis, Differential ; Dysarthria ; Female ; Hemianopsia ; Humans ; Hypertension ; Migraine Disorders ; Retrospective Studies ; Seizures ; Stroke* ; Thrombolytic Therapy

Wilms' tumor is the most common malignant renal tumor in childhood. The brain metastasis of a Wilms' tumor with anaplastic histopathology is rare. We present the case of an 8-year-old girl with Wilms' tumor, who presented with multiple brain metastases 5 years after her primary diagnosis. The brain masses were diagnosed after a generalized tonic-clonic seizure attack. The big solid mass in the cerebellum was resected, and whole-brain radiotherapy was performed, after which, she succumbed to her disease. In the case of clinical suspicion, cranial surveillance should be included in the routine clinical work-up for Wilms' tumor. Combined aggressive therapy (surgery+radiotherapy+chemotherapy) should be applied whenever possible, for both better survival and palliative aspects.
Brain* ; Cerebellum ; Child ; Diagnosis ; Drug Therapy ; Female ; Glycogen Storage Disease Type VI ; Humans ; Neoplasm Metastasis* ; Radiotherapy ; Seizures ; Wilms Tumor*

Long QT interval is an important finding that is often missed by electrocardiogram interpreters. Long QT syndrome (inherited and acquired) is a potentially lethal cardiac channelopathy that is frequently mistaken for epilepsy. We present a case of long QT syndrome with multiple cardiac arrests presenting as syncope and seizures. The long QTc interval was aggravated by hypomagnesaemia and drugs, including clarithromycin and levofloxacin. Multiple drugs can cause prolongation of the QT interval, and all physicians should bear this in mind when prescribing these drugs.
Adult ; Defibrillators, Implantable ; Electrocardiography ; Heart Rate ; Humans ; Long QT Syndrome ; complications ; congenital ; diagnosis ; therapy ; Male ; Risk Factors ; Seizures ; complications

BACKGROUND: This study is aimed to identify Gaucher disease(GD) patients(pts.) in Korea in order to better understand the incidence, clinical phenotype and its natural history and to establish pt. registry. The registry is to provide collective data, which will lead to early diagnosis, effective treatment and better management of pts. METHODS: (1)Questionnaires designed to identify GD pts. were sent to all members of Korean Pediatric Hemato-Oncology Society in 1997 and other inquiring physicians. (2) All published papers on GD were searched in Korean Medical Journals to Feb. 1988. RESULTS: Review of data obtained from questionnaire survey and literature search yielded a total of 44 pts. in 31 pedigrees. 33 of them were reported as type I(chronic, non- neuronopathic), 6 pts. as type II(acute, neuronopathic) and 5 pts. as type III(subacute, neuronopathic). As for the most common type I pts, all 33 but one were diagnosed in infancy and childhood(7mon~18y.o), 11 of them died during childhood(1yr~18y.o), 10 pts. were not known whether alive or dead and 12 pts. are alive and followed up. All 6 type II pts. were diagnosed during infancy and 4 of them died before age of two. All 5 type III pts. in 2 families developed myoclonic seizures in late teens and two died in early twenties and three of them being followed up by neurologists. CONCLUSION: A total of 44 GD pts. in 31 Korean families are identified, which is consistant with autosomal recessive mode of inheritance pattern in all three clinical phenotypes. As of Feb. 1988, 18 pts. were registered in Korean Gaucher Registry; 12 type I pts, 2 type II pts. and 4 type III pts. In case of type I pts., early onset in younger age and rapid progression of disease resulted in high mortality and morbidity compare to GD pts. among Caucasian esp. the most prevalent Ashkenazi Jewish population. Therefore, early diagnosis and effective treatment with Enzyme Replacement Therapy will be desirable for better management of Korean GD pts.
Adolescent ; Early Diagnosis ; Enzyme Replacement Therapy ; Gaucher Disease* ; Humans ; Incidence ; Inheritance Patterns ; Korea ; Mortality ; Natural History ; Phenotype ; Surveys and Questionnaires ; Seizures

Paradoxical therapy consists of suggesting that the patient intentionally engages in the unwanted behaviour such as performing compulsive ritual or wanting a conversion attack. In this study, the subjects were selected by the emergency unit psychiatrist from patients who were admitted to the emergency unit with pseudoseizure. The diagnoses was based on DSM-IV criteria. Paradoxical intention was applied to half of the 30 patients with conversion disorders; the other half were treated with diazepam in order to examine the efficiency of the paradoxical intention versus diazepam. In both groups the differences of the anxiety scores at the beginning of the study were found to be insignificant (z=1.08, p=0.28). Of the 15 patients who completed paradoxical intention treatment, 14 (93.3%) responded favorably to paradoxical intention. On the other hand of 15 patients who completed diazepam therapy, 9 (60%) responded well to therapy and 6 patients carried on their conversion symptoms at the end of 6 weeks. Paradoxical intention-treated patients appeared to have greater improvements in anxiety scores (z=2.43, p<0.015) and conversion symptoms (t=2.27, p=0.034) than the diazepam-treated patients. The results of the present study are encouraging in that paradoxical intention can be effective in the treatment of conversion disorder.
Adolescent ; Adult ; Anticonvulsants/*therapeutic use ; Anxiety ; Anxiety Disorders/therapy ; Conversion Disorder/*therapy ; Diazepam/*therapeutic use ; Female ; Human ; Male ; Psychotherapy ; Seizures/*diagnosis/*therapy ; Wounds and Injuries

OBJECTIVES: Gliomatosis cerebri is an uncommon primary brain tumor characterized by diffuse neoplastic proliferation of glial cells, with the preservation of the underlying cytoarchitecture. The aim of this study is to evaluate clinical features, outcome of surgical treatment and adjuvant therapy of gliomatosis cerebri. METHODS: Between Jan. 1990 and Dec. 2000, 12 patients were diagnosed with gliomatosis cerebri based on characteristic radiological and histological findings. The patients' age ranged from 18 to 77(mean 44) years and the male to female ratio was 7: 5. Nine patients underwent decompressive surgery and three, biopsy only. Postoperative radiation therapy was given in all cases except three. In addition to radiation therapy, four patients received chemotherapy. The mean duration of follow-up period was 18.8 months. RESULTS: The most common presenting symptom were seizure and motor weakness. The mean duration of symptom was 5.9 months. There was 5 bilateral lesions and tumor involved corpus callosum in 5, basal ganglia-thalamus in 4, and brain stem in 2. There was no operative mortality but four patients died during the follow-up. The mean survival period for 11 patients was 20.5 months from the time of diagnosis. In univariate analysis, the lesion involving corpus callosum, basal ganglia-thalamus and brain stem correlated significantly with the short length of survival(p<0.05). Also, postoperative radiation as a adjuvant therapy prolonged the patient's survival(p<0.05). CONCLUSIONS: In the management of gliomatosis cerebri patients, early detection by MR imaging, active management of increased intracranial pressure, decompressive surgical removal and postoperative adjuvant therapy such as radiation is thought to be a good treatment modality.
Biopsy ; Brain Neoplasms ; Brain Stem ; Corpus Callosum ; Diagnosis ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Intracranial Pressure ; Magnetic Resonance Imaging ; Male ; Mortality ; Neoplasms, Neuroepithelial* ; Neuroglia ; Prognosis* ; Seizures