Diagnostic Significance of Neonatal Electroencephalography

PURPOSE: This study was performed to determine the sensitivity of neonatal electroencephalography (EEG) in detecting underlying brain disease, to compare the sensitivity and specificity of EEG with those of brain ultrasonography and to determine the prognostic value of EEG for neonatal neurologic diseases. METHODS: Eighty-seven newborn babies were subjected to a electroencephalographic examination for the evaluation of underlying neurological diseases and EEGs were recorded at least before three days of life. The findings of early ultrasonography performed within three days after birth were compared with those of magnetic resonance imaging(MRI) or ultrasonography after seven days of life. RESULTS: The EEG results were more sensitive and specific than ultrasonography for the detection of neonatal brain damage. The EEG results showed 91.7% sensitivity for mild grade neurological sequelae and 100.0% sensitivity for moderate and severe-grade neurological sequelae in predicting the neurological outcome. However, early ultrasonography results showed 20.8% and 18.8% of sensitivity and specificity, respectively. CONCLUSION: EEG is a highly sensitive diagnostic tool for detecting neonatal brain disease and is valuable for predicting the long-term outcome of neurologic sequelae.

Bronchoalveolar Cellularity and IL-8 Levels in Patients with Post-measles Wheezing

PURPOSE: This study was conducted to investigate the pulmonary cellular profiles and IL-8 levels in patients with post-measles wheezing. METHODS: Twelve previously healthy infants with a minimum of three episodes of wheezing after measles pneumonia(Measles wheezing, median age, 1.3 years) were recruited by a retrospective examination of hospital records. They underwent bronchoalveolar lavage(BAL) with flexible bronchoscopy, and high-resolution computed tomography(HRCT) with a mean six(1-15) months interval. Comparisons were made with seven normal controls(Control, median age: 7.4 years). BAL cell counts and differentials were determined. IL-8 levels also were measured by ELISA. RESULTS: The BAL cellular profiles were characterized by a significantly increased percentage of neutrophils in the Measles wheezing group(median 16.0%) compared to the control group(median 3.8%)(P<0.01). IL-8 levels were markedly increased in the Measles wheezing group(mean+/-SD, 512.7+/-324.0 pg/mL) compared to the control group(41.7+/-67.7 pg/mL)(P<0.01). Furthermore, IL-8 levels correlated significantly(r=0.816, P=0.001) with neutrophil percentages in BAL fluids in the Measles wheezing group. Abnormal HRCT findings were mosaic perfusion, bronchiectasis, bronchial wall thickening, and decreased vascularity. CONCLUSION: These results suggest that pulmonary neutrophils and IL-8 may play an important role in the pathogenesis of the post-measles wheezing.

A Case of 4q Deletion with Partial Agenesis of Corpus Callosum

Syndrome of 4q deletion is characterized by an abnormal shape of the skull, craniofacial dysmorphism, cardiovascular malformations, genitourinary defects, limb and digital anomalies, and developmental delay. We experienced a case of 4q interstitial deletion in a 2 day-old female neonate who showed short extremities, partial agenesis of corpus callosum and congenital heart defects. We report the case with a brief review of the literature.

A Study for the Normal Serum Carnitine Levels and the Effect of Anticonvulsants on Serum Carnitine Levels in Pediatric Age

PURPOSE: This study aimed to evaluate the effect of anticonvulsants on serum carnitine levels as well as normal serum carnitine levels. METHODS: We measured the serum carnitine levels in 53 healthy children(34 males, 19 females) and 115 epileptic children(55 males, 60 females) receiving a various antiepileptic drugs. We assessed the effects of antiepileptic drugs on serum carnitine level together with a correlation between serum carnitine level and duration of treatment, and blood level of anticonvulsant. RESULTS: 1.Carnitine levels in healthy children 1)There was a positive correlation between total and free carnitine serum levels and the age of the children. 2)The serum total carnitine levels were increased in age group over 5 years of age and serum free carnitine levels were increased in age group over 1 year of age as compared with those of between 1 month and 12 months age group. 2.Carnitine levels in epileptic children receiving anticonvulsants 1)The serum levels of total and free carnitine were significantly reduced in the patients with valproate monotherapy group, valproate polytherapy group, and polytherapy group without valproate as compared with the control group. 2)The reduction was more significant in the patients of valproate polytherapy group than in those of valproate monotherapy group. 3.There was a significant inverse correlation between the serum carnitine levels and the duration of the valproate treatment but not between serum carnitine levels and the blood level of valproate. 4.Carnitine deficiency was corrected in all cases after oral administration of L-carnitine(50mg/kg/day). CONCLUSIONS: Carnitine deficiency may be suspected in patients taking valproate therapy and regular measurement of carnitine levels appears warranted in these patients. If carnitine deficiency is documented, the patient can be treated by oral carnitine supplementation.