Seizure-related death in children with epilepsy

Children with epilepsy have a significantly higher rate of death than the general population. The cause of premature death among epileptics is contributed by the underlying cause, coexisting neurologic compromise and the epilepsy itself. Mortality directly related to seizures in paediatric epilepsy is the subject of this review. Seizure-related deaths in epileptics arise from status epilepticus, aspiration pneumonia, as well as sudden and unexpected death in epilepsy (SUDEP). Epilepsy per se enhances the risks of accidents and suicide. Children with epilepsy who are otherwise neurologically intact and with normal neuroimaging findings have an exceedingly low risk of seizure-related death. Poor compliance to antiepileptic drugs (AED) , poor ly co nt rol led (intractable and refractory) seizures, impaired cognition, structural/ metabolic aetiology and antiepileptic drug polypharmacy tend to carry poor prognosis. Therefore, parents need to be appropriately advised about the risk of seizurerelated premature death. Early identification, compliance with AED prescription, and treatment of comorbid conditions can reduce mortality risk and improve health outcomes in children with epilepsy. Children with intractable types of epilepsy may benefit from medical marijuana and neurosurgery

Recurrent erythema multiforme

The case of a three-and-half year old male child with the severe form of erythema multiforme (EM) major (Stevens-Johnson syndrome) is described. From the past medical history; the child had seven previous attacks of a similar disease in the immediate past 24 months. The first four attacks of the disease were considered; by their description; to be mild EM minor; as the lesions were limited to the skin; while the next four recurrences; including the present one; were regarded as severe; with extensive involvement of the skin; mucosae of the mouth; nose; eyes and urethral orifice; that required hospitalization

Pattern of dysphagia in Calabar

A retrospective study of dysphagia in 55 children; aged between six months and 12 years (mean age 4.3 years) in Calabar; has revealed foreign body impaction in the throat to be the commonest cause; occurring in 40.0 percent of the cases. Children; aged between five and 10 years; were commonly involved in foreign body impaction which was caused by coins and food (meat and fish bones) in 31.8 and 27.3 percent respectively; of the 22 cases. Oesophageal stricture due to accidental ingestion of caustic soda was found in 14.5 percent of the cases and involved children in the age group; six to eight years. The cause of dysphagia was however; unknown in 25.5 percent of the patients. Malnutrition (56.4 percent) and aspiration pneumonia (27.3 percent) were the major complications in the series. It is concluded that most of the causes of dysphagia in the series are preventable