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

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

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*

No abstract available.
Pulmonary Artery*

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

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*

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

PURPOSE: Bacterial meningitis in neonates and young infants is one of the most serious conditions that can lead to severe neurological sequelae despite the appropriate treatment. This study aimed at evaluating the clinical manifestations and treatment outcomes in patients under the age of three months, who had been diagnosed with bacterial meningitis. METHODS: A total of twelve patients with bacterial meningitis under the age of three months from January 1997 to June 2010 were retrospectively evaluated through a review of their medical records. Patients who showed positive culture results were included in the study. RESULTS: A total of 12 patients (6 males and 6 females, mean age 44.2+/-30.0 days) were enrolled in the study. All patients had fever upon admission. But most of them were unremarkable upon physical examination (75%). Streptococcus agalactiae was the most common organism cultured from CSF (7cases; 58.3%). Six cases showed positive results on CSF culture as well as on blood culture. Cefotaxime and ampicilin/sulbactam or cefotaxime and ampicilin were given as initial treatment with a mean treatment duration of 15.1+/-6.0 days. Neurological complications and sequelae included subdural effusion and hearing disturbance in two cases (16.7%). Nine cases (75%) showed excellent outcomes without neurological deficits, and none were left with a severe degree of sequelae. CONCLUSION: The study showed that neonates or young infants with bacterial meningitis almost always present with fever and that S. agalactiae was the most common causative organism. In addition, the final outcome for these patients may be improved with early and appropriate treatment.
Cefotaxime ; Female ; Fever ; Hearing ; Humans ; Infant ; Infant, Newborn ; Male ; Medical Records ; Meningitis, Bacterial ; Physical Examination ; Retrospective Studies ; Streptococcus agalactiae ; Subdural Effusion ; Treatment Outcome

PURPOSE: This study was aimed to evaluate the value of electrophysiologic tests for determining prognosis in children with facial nerve palsy. METHODS: We retrospectively analyzed 37 children diagnosed as the facial nerve palsy at the pediatric neurology clinic, Kyungpook National University Hospital from January 1, 2000 to March 31, 2007. RESULTS: A total of thirty seven children were involved in the study(male to female 21:16, and the mean age 87.5 months). Among those twenty one had electrophysiologic tests. As compared with the normal values, the amplitude decreased by 54.5%(0.6+/-0.5 mV) and the latency was prolonged by 11.0%(3.6+/-0.5 msec) in electroneurography(ENoG). Early response(R1) was absent in 15 out of 21(71.4%) and ipsilateral response(R2) was absent in 19 children(90.5%). As compared with the children who had the decrease of amplitude 90% or less in ENoG, the children with the decrease of amplitude greater than 90% showed poor recovery(100% vs 60%, P<0.05) and longer duration of follow-up(43.7+/-30.0 days vs 184.00+/-196.8 days, P<0.05). All children who had R1 and R2 responses in the Blink test were completely recovered from the illness, but they were not statistically different from the other groups. CONCLUSION: Decrease of amplitude in ENoG and responsiveness in the Blink test can be important prognostic determinants in children with facial nerve palsy, but further studies are needed.
Child* ; Facial Nerve* ; Female ; Gyeongsangbuk-do ; Humans ; Neurology ; Paralysis* ; Prognosis ; Reference Values ; Retrospective Studies