PURPOSE: To find out the characteristic MR findings of reversible posterior leukoen-cephalopathy syndrome (RPLS) due to various causes in children. MATERIALS AND METHODS: Eight children with RPLS underwent MR imaging, and the findings were retrospectively analyzed. All eight were acutely hypertensive at the time of a neurotoxic episode. Three had intra-abdominal tumors (one adrenal pheochromo-cytoma, one para-aortic paraganglioma and one para-aortic ganglioneuroma encasing the left renal artery); three were being treated with cyclosporine; one was being treat-ed with steroid; and one had hemolytic uremic syndrome. Initial cranial MR images were analyzed with particular emphasis on the distribution of the lesions. To assess possible sequelae, follow-up MR images were obtained in seven patients at least one week after the treatment of hypertension. Four underwent proton MR spectroscopy. RESULTS: Characteristic distribution of lesions in the occipital and posterior parietal lobes was identified in all cases regardless of the causes of RPLS. The cerebellum, basal ganglia, anterior parietal, and frontal lobe were involved in four, two, one, and one case, respectively. Cortical gray matter involvement was predominant in six and subcortical white matter involvement predominated in two patients. The distribution of lesions was bilateral and asymmetric. Gyriform enhancement was identified in six cases, and small hemorrhage was noted in one. In seven patients, the clinical and MR findings improved without sequelae on follow-up study. In one, proton MR spectroscopy demonstrated a high lactate peak at the time of the neurologic event. Nearnormal spectra were noted in three children who underwent proton MR spectroscopy after recovery. CONCLUSION: The MR findings of RPLS are characteristic in that lesions are distributed in the posterior region of the brain and they are reversible on follow-up study. In children with RPLS due to unknown causes, the possibility of intra-abdominal tumors should also be considered.
Basal Ganglia ; Brain ; Cerebellum ; Child* ; Cyclosporine ; Follow-Up Studies ; Frontal Lobe ; Ganglioneuroma ; Hemolytic-Uremic Syndrome ; Hemorrhage ; Humans ; Hypertension ; Lactic Acid ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Paraganglioma ; Parietal Lobe ; Posterior Leukoencephalopathy Syndrome* ; Protons ; Rabeprazole ; Retrospective Studies

PURPOSE: Febrile seizures(FS) are the most common form of childhood seizures and their prognosis are favorable. Despite the fact, there are still some concerns that prolonged febrile seizures may cause brain damages or neurological sequelae, which may be associated with the development of mesial temporal sclerosis and intractable temporal lobe epilepsy in later life. The aim of this study was to evaluate the clinical characteristics and outcomes in children with febrile status epilepticus(FSE). METHODS: 39 children aged 6 months to 5 years were enrolled in this study, who presented with FSE at Kyungpook National University Hospital, from January, 2000 to December, 2004. They were compared with 250 children who presented with the first episodes of FS at the same period. We reviewed retrospectively the medical records for the clinical characteristics and outcomes of the two groups. RESULTS: There were no statistically significant differences between the two groups in terms of age, etiology, degree and duration of fever, type of seizure, family history of FS or epilepsy, EEG and MRI findings, and recurrence rates of FS. Children with FSE were more likely to have neurological sequelae(12.5% vs. 2.4%; P=0.008), to develop afebrile seizures(21% vs. 4%; P=0.00) and to take anticonvulsants chronically(33% vs. 2%; P=0.00) than children with FS. CONCLUSION: Our results indicate that prolonged febrile seizures are associated with unfavorable neurological outcomes compared with simple febrile seizures. However, long-term, and extensive follow-up studies are needed to find out the relationship between prolonged febrile seizures and subsequent mesial temporal sclerosis as well as intractable temporal lobe epilepsy.
Anticonvulsants ; Brain ; Child* ; Electroencephalography ; Epilepsy ; Epilepsy, Temporal Lobe ; Fever ; Follow-Up Studies ; Gyeongsangbuk-do ; Humans ; Magnetic Resonance Imaging ; Medical Records ; Prognosis ; Recurrence ; Retrospective Studies ; Sclerosis ; Seizures ; Seizures, Febrile ; Status Epilepticus*

PURPOSE: A number of emotional, behavioral, cognitive conditions co-occur with ADHD(Attention Deficit/Hyperactivity Disorder). These conditions were commonly unrecognized due to the lack of appropriate questioning and evaluation. Thus, This study is aimed to evaluate the comorbidity of ADHD using K-CBCL(Child Behavior Check List). METHODS: Among the patients diagnosed with ADHD by using DSM-IV. A total of 41 patients(11 female and 30 male) were examined by K-CBCL. They ranged in age from 4 years to 14 years with a mean age of 8 years. They were classified into three clinical types; Inattentive, Hyperactive/Impulsive, and Combined type. They were subgrouped again by the presence of Learning Disability(LD). The Scores were compared among the groups and the data were analyzed with Mann-Whitney test, Kruskal-Wallis test, and post hoc analysis. RESULTS: Fifty-six percent of the cases scored greater than 70 on at least one factor measured, and 27% seemed to have LD. Female patients were more likely to have social withdrawal and thought problems(P<0.05), and Hyperactive/Impulsive type was more likely to have aggression as compared with Inattentive type(P<0.01). The patients with LD scored worse on the item of attention compared with the cases without LD(P<0.05). CONCLUSION: Comorbidity of ADHD is relatively common and may have a significant impact on functioning, management, and prognosis of patients with ADHD. Rating scales such as K-CBCL can provide a lot of information at a relatively low cost and help sketch the clinical pictures of patients.
Aggression ; Comorbidity* ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Learning ; Prognosis ; Weights and Measures

No abstract available.
Breast* ; Glucuronidase* ; Lipase* ; Milk, Human*

Mental retardation(MR) is one of the most common developmental disabilities, which is characterized by deficits in intellectual and adaptive functions. Most children with MR have cognitive limitation in the mild range. With respect to the etiology, it is believed that genetic and environmental factors are interrelated and show variable pictures. Most children with MR present with speech and language delay during the early years. The diagnosis can be made by clinical features and neuropsychological tests of intelligence and adaptive functioning. The treatment is limited, but many associated problems are amenable to multidisciplinary interventions. The article will review the recent advances in the management of MR and other neurodevelopmental disorders in children.
Child ; Developmental Disabilities ; Diagnosis ; Humans ; Intellectual Disability* ; Intelligence ; Language Development Disorders ; Neuropsychological Tests

No abstract available.
Pulmonary Artery*

No abstract available.
Amniotic Fluid* ; Female ; Meconium*

Rigid posterior fixation of the atlas to the third and fourth cervical spine was achieved in a patient in whom axis pedicle fracture and dislocation of axis on the third cervical spine. Althouth there was no evidence of neurologic disorder, marked instability of axis on the third cervical spine should inevitably be fused in any procedures. An anatomically contoured loop was secured to the posterior arch of the atlas and the laminae of the third and the fourth cervical spine by sublaminar wirings. The technique has the advantage over bone graft, either alone or with cement, in that it affords rigid stabilization, allows early mobilization and some flexion movement of atlanto-occipital joint.
Atlanto-Occipital Joint ; Dislocations ; Early Ambulation ; Humans ; Nervous System Diseases ; Spine ; Spondylolisthesis ; Transplants

Antiepileptic drugs (AEDs) can adversely affect cognitive function by suppressing neuronal excitability or enhancing inhibitory neurotransmission. The main cognitive effects of AEDs are impaired attention, vigilance, and psychomotor speed, but secondary effects can manifest on other cognitive functions. Although the long-term use of AEDs can obviously elicit cognitive dysfunction in epilepsy patients, their cognitive effects over short periods of up to a year are inconclusive due to methodological problems. In general, the effects on cognition are worse for older AEDs (e.g., phenobarbital) than for placebo, nondrug condition, and newer AEDs. However, topiramate is the newer AED that has the greatest risk cognitive impairment irrespective of the comparator group. Since the cognitive impact of AEDs can be serious, clinicians should be alert to adverse events by evaluating cognitive function using screening tests. Adverse cognitive events of AEDs can be avoided by slow titration to the lowest effective dosage and by avoiding polytherapy.
Anticonvulsants ; Cognition ; Epilepsy ; Fructose ; Humans ; Mass Screening ; Neurons ; Synaptic Transmission

PURPOSE: Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children. METHODS: From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy . RESULT: Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures. CONCLUSION: In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it.
Anticonvulsants ; Antiviral Agents ; Cerebrospinal Fluid* ; Child ; Emergencies ; Epilepsy ; Humans ; Leukocytosis* ; Medical Records ; Mortality ; Prognosis ; Retrospective Studies ; Seizures ; Spinal Puncture ; Status Epilepticus*