BACKGROUND: Nerve conduction studies play a diagnostic role in the clinical evaluation of neuromuscular disorders in children. Reference ranges define the expected parameter values in disease-free children.

OBJECTIVE: To propose reference values for sensory and motor nerve conduction and late responses in upper and lower limb peripheral nerves in Filipino children 5 years and below.

METHODS: Sensory nerve conduction studies on median, ulnar, superficial peroneal, and sural nerves and motor nerve conduction and late response studies on median, ulnar, peroneal and posterior tribal nerves were done using standardized techniques among 100 healthy Filipino children.

RESULTS: Subjects were stratified according to age groups. Reference values for the following parameters: (1) sensory conduction velocity and amplitude; (2) motor conduction velocity, amplitude and latency at distal sites;  (3) F-wave latency; and (4) H-reflex latency were summarized. These were expressed as mean ±standard deviation or median (range) for values that follow Gaussian and non-Gaussian distributions. The 5th and 95th percentile values were likewise reported. Age had direct correlation with various nerve conduction parameters. Height was directly correlated with F-wave parameters of median, ulnar and peroneal nerves but not posterior tribal nerve.

CONCLUSIONS: Reference standards for nerve conduction studies of commonly tested nerves of Filipino children are presented. Values are comparable to reference ranges elsewhere except for the H-reflex latency which is higher in this study.

Human ; Reference Values ; Infant, Newborn ; Cross-sectional Studies ; Philippines

OBJECTIVE: To present a case of pediatric cerebellar glioblastoma multiforme

CASE: This is a case of an eight-year-old, right-handed female who presented with progressive occipital headache relieved by vomiting, esotropia, wide-based gait, and generalized tonic-clonic seizure. Pertinent neurologic examination showed intact higher cortical function, papilledema, bilateral lateral rectus palsy, bilateral dysmetria and dysdiadochokinesia, truncal and gait ataxia, hyperreflexia of both lower extremities and bilateral extensor toe signs. Cranial CT-scan showed posterior fossa mass with obstructive hydrocephalus probably medulloblastoma, astrocytoma or ependymoma. Patient underwent tumor debulking and ventriculoperitoneal shunting. Histopathology result showed glioblastoma multiforme. Craniospinal MRI showed evidence of tumoral dissemination via the CSF pathway involving the sellar and suprasellar compartments, meningeal carcinomatosis within the basilar cistern, and drop metastasis within the spinal canal along the dorsal surface of the thoracic spinal cord at the T8 level. Due to the low general condition of the child, she was managed conservatively with anti-edema and anticonvulsant medications but succumbed to death within a few days.

CONCLUSION: Glioblastoma multiforme should be kept in mind in the differential diagnosis of the lesions in the posterior fossa. Anti-edema therapy with anticonvulsants and partial resection of the tumor prolongs survival marginally.

Human ; Glioblastoma