Journal Detail Information

1

Cite

Share

A Case of Enterovirus 71 Infection Presented with Acute Flaccid Paralysis.

Hyun Kyung KIM ; Kang Won RHEE ; Kyung Yeon LEE ; Ki Won OH ; Ja Hyeong KIM ; Jin Young JEONG ; Sang Kyu PARK ; Seong Hoon CHOI

Journal of the Korean Child Neurology Society.2011;19(1):61-66.

Hand-foot-mouth disease (HFMD) is characterized by distinctive skin lesions on the hand, foot, and mouth and in general, recovery occurs within one week. However, in cases of HFMD by enterovirus 71 (EV71) infection, the development of neurologic complications such as brainstem encephalitis, acute flaccid paralysis, and aseptic meningitis has been common. Moreover, it has been reported that some patients with neuologic complications have expired in severe cases. Here, we report a case of EV71 infection presented with acute flaccid paralysis of a single similar to paralytic poliomyelitis.
Animals ; Brain Stem ; Encephalitis ; Enterovirus ; Enterovirus A, Human ; Foot ; Foot-and-Mouth Disease ; Hand ; Humans ; Meningitis, Aseptic ; Mouth ; Paralysis ; Poliomyelitis ; Skin

2

Cite

Share

Neurologic Complications of Novel Influenza A (H1N1) Virus Infection from 2009-2011.

Ran Hee KIM ; Young Mi KIM ; Soo Eun PARK ; Hye Young KIM ; Yoon Jin LEE ; Tae Hyoung KIM ; Sang Ook NAM

Journal of the Korean Child Neurology Society.2011;19(1):54-60.

PURPOSE: To describe the characteristics and incidence of neurologic complications related to the novel influenza A (H1N1) virus. METHODS: We reviewed the medical records of 752 children and adolescence (< or = 18 years of age) who had been diagnosed as novel influenza A (H1N1) infection through positive results of influenza A (H1N1) RT-PCR and hospitalized or visited the outpatient clinic and emergency department of Pusan National University Hospital from July 2009 to January 2011. RESULTS: We identified 15 patients who had experienced a neurologic symptom with a mean age of 8.8 years. There were 10 (66.7%) males and five (33.3%) females. Nine patients (60.0%) presented with seizures, two (13.3%) with decreased mentality, two (13.3%) with visual hallucination, and one (6.7%) with vertigo. The mean duration from onset of respiratory illness to the beginning of neurologic symptoms was 2 days (range: 0-4 days). Three patients (patient 2, 7, and 13) (20.0%) had abnormal results on cerebrospinal fluid analysis; however, novel influenza A (H1N1) was not detected. Further, one patient (6.7%) had abnormal MRI. Antiviral therapy (oseltamivir) was administered to fourteen patients (93%) and all patients recovered fully and had no neurologic sequelae. CONCLUSION: Novel influenza A (H1N1) was a cause of neurologic symptoms during the outbreak. Pediatricians should consider influenza virus infection in the differential diagnosis for children with neurologic symptoms during an epidemic of influenza.
Adolescent ; Ambulatory Care Facilities ; Child ; Diagnosis, Differential ; Emergencies ; Female ; Hallucinations ; Humans ; Incidence ; Influenza, Human ; Male ; Medical Records ; Neurologic Manifestations ; Orthomyxoviridae ; Seizures ; Vertigo ; Viruses

3

Cite

Share

Relationship of Calcitonin Gene-Related Peptide and Pediatric Headache in Obesity.

Soo Hee JEE ; Young Il RHO

Journal of the Korean Child Neurology Society.2011;19(1):47-53.

PURPOSE: Both headache and obesity are prevalent and chronic conditions among children. A well-known pathophysiology of migraine is that calcitonin gene-related peptide (CGRP) is an important postsynaptic mediator of trigemino-vascular inflammation. Plasma CGRP levels have been shown to increase in obese individuals during the headache phase of migraines. The purpose of this study was to assess the relationship between headache and plasma CGRP levels in obese children. METHODS: We prospectively studied plasma CGRP levels in 33 patients (20 overweight and obese subjects without headache, 13 overweight and obese subjects with headache) who visited Chosun University Hospital from March 2009 to September 2009. Blood samples were collected from cubital veins and plasma levels of CGRP were measured by radioimmunoassay. RESULTS: The mean age was 12.3+/-2.3 (range 6-15 years) and mean CGRP level was 19.1+/-2.5 pg/ml in the overweight and obese with headache group and 17.4+/-5.1 pg/mL in the overweight and obese without headache group. In the group CGRP levels lower than 19 pg/mL, mean headache frequency per month, mean severity, and mean disability were 17.0+/-18.4, 4.0+/-2.8 and 2.0+/-0.0, respectively. In the group with CGRP levels of 19 or greater pg/ml, levels were 11.0+/-9.8, 5.6+/-1.0, and 23.1+/-8.2, respectively. CONCLUSION: The mean CGRP level in overweight and obese children with headache was not significantly higher than in those without headache (P =0.202). Further, there was no significant correlation between CGRP level and frequency, severity of headache, and disability due to headache (P > 0.05). Further studies are needed to access the relationship of CGRP and pediatric headache in obese subjects.
Calcitonin ; Calcitonin Gene-Related Peptide ; Child ; Headache ; Humans ; Inflammation ; Migraine Disorders ; Obesity ; Overweight ; Plasma ; Prospective Studies ; Veins

4

Cite

Share

Correlation between Patterns of Focal Epileptiform Discharges and Brain Lesions in Children with Focal Epilepsy.

Tae Hyoung KIM ; Yun Jin LEE ; Young Mi KIM ; Sang Ook NAM

Journal of the Korean Child Neurology Society.2011;19(1):40-46.

PURPOSE: The objective of this study was to evaluate the correlation between patterns of focal epileptiform discharge (ED) and brain lesions diagnosed by MRI in children with focal epilepsy. METHODS: We retrospectively reviewed routine scalp EEGs, medical records, and results from brain MRIs in 149 children who had been diagnosed as epilepsy with focal epileptiform discharges in our hospital between 2008 and 2010. We classified the patterns of focal ED into spikes, sharp waves, and polyspikes. EEGs with homogenous patterns of ED were termed single-form ED and those with heterogenous patterns of ED were termed multi-form ED. We evaluated the relationship between the specific patterns of focal ED and brain lesions in pediatric epilepsy. RESULTS: Fifty-six of 149 (37.6%) patients had brain lesions on brain MRI. 67.8% (101/149) patients exhibited single-form ED and 32.2% (48/149) patients revealed multi-form ED. Thirty of 48 patients (62.5%) with multi-form ED showed brain lesions, which was higher than those for patients with single-form ED (25.7%, 26/101) (P <0.001). 27.5% (41/149) patients had and 25/41 (61.0%) also had brain lesion, which was higher than those for patients without polyspikes (28.7%, 31/108) (P <0.001). 19 of 82 patients (23.2%) with single-form ED with spikes only had brain lesion on brain MRI, which was significantly lower than those of remaining patients (55.2%, 37/67) (P <0.001). CONCLUSION: We suggest that a heterogenous pattern of ED or polyspikes lead to a higher incidence of brain lesions in children with focal epilepsy.
Brain ; Child ; Electroencephalography ; Epilepsies, Partial ; Epilepsy ; Humans ; Incidence ; Medical Records ; Retrospective Studies ; Scalp

5

Cite

Share

Relationship between Initial EEG and the Prognosis of Acute Encephalitis.

Jae Min OH ; Seom Gim KONG ; Yun Jin LEE ; Sang Ook NAM

Journal of the Korean Child Neurology Society.2011;19(1):33-39.

PURPOSE: This study aimed to identify the usefulness of initial electroencephalograms (EEG) in the prediction of neurological outcomes of acute encephalitis. METHODS: Thirty-one patients diagnosed with acute encephalitis between January 2007 and March 2010 were included in the study, all of whom were less than 18 years old. Patients were divided into two groups. Those who had recovered completely were designated group A, and those who had neurological sequalae were designated group B. We compared the severity of EEG background abnormalities according to the Synek classification, and the incidence of interictal epileptiform discharges, electrographic seizures, normal sleep features, and EEG reactivity to pain stimuli between the two groups upon initial EEGs. RESULTS: Compared with group A, group B showed a higher grade of EEG background abnormalities (P = 0.004). The incidence of interictal epileptiform discharge (P = 0.004) and electrographic seizure (P = 0.049) were also higher in group B. Further, Group A had more EEG reactivity (P = 0.002) and the incidence of normal sleep features tended to be higher in group A (P = 0.081). CONCLUSION: Initial EEG features including the severity of EEG background abnormalities are helpful in predicting the prognosis of acute encephalitis.
Electroencephalography ; Encephalitis ; Humans ; Incidence ; Prognosis ; Seizures

6

Cite

Share

Levetiracetam Monotherapy In Children with Epilepsy.

Gi Youn SIM ; Won Seop KIM

Journal of the Korean Child Neurology Society.2011;19(1):26-32.

PURPOSE: Levetiracetam hasa been used in adjuvant therapy. It has also been used in monotherapy in other countries and therefore, we also studied the effect and efficacy of Levetiracetam monotherapy. METHODS: We retrospectively studied the types of epilepsy, EEG, and drug dosage. We studied 101 epilepsy children treated by Levitiracetam monotherapy who had visited our hospital from August 2007 to July 2009. RESULTS: Participants were aged one month to 20 years. The mean age of Levetiacetam therapy was initially 11+/-4 years (from 3 years to 21 years), and the type of epilepsy was partial in 57.4% and generalized in 42.6%. The mean dose I initially began at 6+/-4 mg/kg/day (from 2 mg/kg/day to 30 mg/kg/day) with a mean final dose of 30+/-8 mg/kg/day (from 6 mg/kg/day to 60 mg/kg/day), a mean duration of therapy of 21+/-11months, and a duration of therapy ranging from one to 38months. Further, 60.3% of patients became seizure free and 96.9% exhibited at least a 50% reduction in seizure over a 12 month period. Side effects included behavioral change (8), asthenia (2), cognitive change (1), rash (2), headache (5), inadequate seizure control (2), and increased seizure (5). Levetiracetam was discontinued due to inadequate seizure control (2), increased seizure (5) and side effects (2). CONCLUSION: We studied the efficacy and tolerability of monotherapy of Levetiracetam and found that it was effective and tolerable in monotherapy for epilepsy.
Aged ; Anticonvulsants ; Asthenia ; Child ; Electroencephalography ; Epilepsy ; Exanthema ; Headache ; Humans ; Piracetam ; Retrospective Studies ; Seizures

7

Cite

Share

A Study of the Clinical Features of Benign Convulsions with Acute Gastroenteritis in Children.

Eun Jeong LEE ; Sung Joon PANG ; Hwang Jae YOO

Journal of the Korean Child Neurology Society.2011;19(1):18-25.

PURPOSE: We investigated the complexities of benign convulsions associated with gastroenteritis in children. METHODS: We selected children diagnosed as afebrile convulsion with acute gastroenteritis from June 2006 to May 2008 who had been admitted to the Kwandong Medical College Myongji Hospital. We investigated clinical features, EEGs, and brain imaging results for patients exhibiting complex-type seizures (Group B) and compared the data with that from patients with simple seizures (Group A). The statistical significance between the two groups was subsequently examined. RESULTS: A total of 43 patients showed afebrile benign convulsions with acute gastroenteritis, and 18 patients were diagnosed as CwG (benign convulsions with acute gastroenteritis). The median age of Group B was 26.3 month which was significantly higher than that of Group A (P < 0.05). The gender ratio was 3.5 times more in higher female of Group A compared to Group B (P < 0.05). The most common type of seizure in both groups was generalized tonic convulsions, and there were no statistical differences in the laboratory results between the two groups. Further, Group B showed more frequent abnormal findings than Group B with respect to EEG and brain imaging studies (P < 0.05). All of the abnormal findings in brain imaging studies were structural abnormalities unrelated with CwG, and patients with abnormal EEGs showed no recurrent seizure attacks and exhibited normal follow-up EEGs after discharge. CONCLUSION: CwG with complex-type seizure frequently occurred in children older than three years of age regardless of gender, and also in patients with underlying CNS diseases. Regardless of recurrent seizures or seizures lasting more than 15 minutes, patients diagnosed as CwG would receive a favorable prognosis.
Central Nervous System Diseases ; Child ; Electroencephalography ; Female ; Follow-Up Studies ; Gastroenteritis ; Humans ; Neuroimaging ; Prognosis ; Seizures

8

Cite

Share

Clinical Review of Children Diagnosed as Specific Language Impairment.

Jae Yong CHOI ; Cheol Am KIM ; Ick Jin SONG ; Kyun Woo LEE ; Min Jung GANG ; Min Ji JUNG ; Byeong Hee SON

Journal of the Korean Child Neurology Society.2011;19(1):8-17.

PURPOSE: The purpose of this study was to evaluate the clinical characteristics of children who had been diagnosed as specific language impairment as outpatients. METHODS: One hundred twenty-five speech- or language-delayed patients were enrolled in Dae-Dong Hospital from July 2007 to June 2008. Fifty-one of 125 children were diagnosed as specific language impairment in whom clinical factors such as duration of therapy and progress after therapy were evaluated. Data were obtained from telephone or direct personal interviews. RESULTS: Among 51 children diagnosed as specific language impairment, 39 (76.5%) had mixed receptive-expressive-type language disorder and 12 (23.5%) had expressive-type language disorder. Thirty children in total were studied as ten children were unavailable for follow-up and eleven dropped out during treatment. The final 30 children consisting of 23 with mixed receptive-expressive type language disorder and seven children with expressive-type language disorder were treated after diagnosis. Total average treatment duration of children with mixed receptive-expressive-type and expressive-type language disorder were 18.1 months and 8.6 months, respectively, a statistically significant difference (P = 0.014). Thirteen (57%) of 23 children with mixed receptive-expressive-type language disorder and all (100%) seven children with expressive-type language disorder completed speech therapy with an average treatment duration of 12.2 and 8.6 months, respectively; however, this difference was not statistically significant(P = 0.287). CONCLUSION: Classifying patients with specific language impairments into mixed receptive-expressive-type and expressive-type language disorder in an outpatient department can be useful for predicting duration of and prognostic effects of language therapy, as our study and other previous articles have shown. More attention is needed from pediatricians to ensure the effective assessment and management of specific language impairment.
Child ; Dietary Sucrose ; Follow-Up Studies ; Humans ; Language Disorders ; Language Therapy ; Outpatients ; Speech Disorders ; Speech Therapy ; Telephone

9

Cite

Share

The Application of Quantitative Electroencephalogram and Cognitive Evaluation in Childhood Epilepsy.

Deok Soo KIM

Journal of the Korean Child Neurology Society.2011;19(1):1-7.

Cognitive dysfunction has been commonly reported in epilepsy and should be appropriately evaluated for children with epilepsy due to their developing cognition. Neuropsychological tests have been often performed to reveal the objective status of cognitive function. Advances in computer science has allowed quantitative electroencephalography (qEEG) to be widely used in various fields examining neuropsychiatric disorders. As such, we can investigate brain function through qEEG in a different manner and more fully understand the cortical network while performing tasks. Among qEEG methods, the frequency analysis is a method for looking at the mean or peak frequency, absolute or relative spectral power, and amplitude of each frequency band in the EEG. The qEEG analysis may help us evaluate cognitive dysfunction in childhood epilepsy, although some limitations and difficulties may exist.
Brain ; Child ; Cognition ; Electroencephalography ; Epilepsy ; Humans ; Neuropsychological Tests

10

Cite

Share

A Case of Septo-Optic Dysplasia.

Jong Geun KIM ; Yoon Kyung LEE ; Byung Joon CHOI ; In Goo LEE ; Kyung Tai WHANG

Journal of the Korean Child Neurology Society.1999;6(2):400-403.

The septo-optic dysplasia, or de Morsier syndrome is a developmental anomaly characterized by involvement of the septum pellucidum, optic system and hypothalamic-pituitary axis. We had experienced a case of septo-optic dysplasia in 8 month-old female. A magnetic resonance imaging of the brain showed isolated absent septum pellucidum. And ophthalmoscopic examination showed right optic nerve hypoplasia, exotropia of right eye.
Axis, Cervical Vertebra ; Brain ; Exotropia ; Female ; Humans ; Infant ; Magnetic Resonance Imaging ; Optic Nerve ; Septo-Optic Dysplasia* ; Septum Pellucidum

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share