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

A ventriculo-peritoneal shunt is a standard surgical management for hydrocephalus, but complications may impede the management of this disease. Obstruction of the catheter is one of the most common complications and manifests clinically in various ways. Intraparenchymal cyst development after shunt malfunction has been reported by several authors, but the underlying mechanism and optimal treatment methods are debatable. The authors report a case of intraparenchymal cyst formation around a proximal catheter in a premature infant after a ventriculo-peritoneal shunt and discuss its pathogenesis and management.
Catheters ; Humans ; Hydrocephalus ; Infant, Newborn ; Infant, Premature ; Ventriculoperitoneal Shunt

Dyke-Davidoff-Masson Syndrome (DDMS) is a rare condition characterized by asymmetry of cerebral hemispheric growth with atrophy on one side, ipsilateral compensatory osseous hypertrophy, and contralateral hemiparesis. We experienced a 17 month-old male who presented with left focal clonic or tonic-clonic seizures accompanied by left hemiparesis and developmental delay. Brain MRIs demonstrated progressive atrophy of the right cerebral hemisphere with dilatation of the lateral ventricle, expansion of the ipsilateral frontal sinus with calvarial thickening, and elevation of the petrous pyramid and orbital roof. Brain SPECT showed a decreased volume of the right hemisphere with reduced blood flow. We therefore report a case of DDMS with a review of the literature.
Atrophy ; Brain ; Cerebrum ; Dilatation ; Frontal Sinus ; Hemiplegia ; Humans ; Hypertrophy ; Infant ; Korea* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Male ; Orbit ; Paresis ; Petrous Bone ; Seizures ; Tomography, Emission-Computed, Single-Photon