effect of ibuprofen on intractable epileptic attacks in children

Background and Purpose: It seems that during seizures special inflammatory processes remain in the epileptic tissues and can induce still another attack. Based on this hypothesis many studies have been conducted to determine the efficacy of non-steroidal anti-inflammatory drugs on controlling seizures and have obtained different results. so we decided to perform this research. Therefore the present research was conducted to investigate the effect of ibuprofen on controlling intractable epileptic attacks in children

Methods and Materials: This quasi-experimental double-blind study was conducted in 2006-2007 on 30 patients [3-13 years old] with intractable epilepsy. The patients were observed for one month; then they were given ibuprofen syrup [30 mg/k/day divided into 3 doses] for two months; taking ibuprofen syrup was paused for one month; placebo was given for two months with a similar dosage. Patients simultaneously received their previous anticonvulsant drugs during the study period. In each stage the frequency duration and probable complications of each attack were recorded. The obtained data were analyzed in SPSS using paired t-test and chi-square

Results: Patients' mean age and mean seizures onset age were 7.23?3.22 and 2.73?2.43 years respectively. Partial complex epilepsy occurred in 13 cases [43.3%] and 17 patients [56.7%] experienced myoclonic epilepsy. Ibuprofen decreased frequency of attacks in 8 cases [26.7%] and even stopped them in 4 cases. However placebo just decreased attacks in 4 cases [13.3%] but the observed difference was not statistically significant [P=0.434]

Conclusion: Based on the findings there was no statistically difference between effects of Ibuprofen and placebo on controlling epileptic attacks

Epilepsy surgery in children

In the majority of patients with intractable epilepsy, seizures can be well controlled with appropriate medication. However, current estimates indicate that some of patients with epilepsy are refractory to all forms of medical therapy. The surgical treatment of intractable epilepsy in children has evolved with advances in technical innovations. These medically intractable patients are candidates for surgical treatment in an attempt to achieve better seizure control. The definitive successful outcome of epilepsy surgery is a seizure-free state without significant neurological impairments. In this article, we will outline the essential elements of presurgical evaluation and describe a variety of therapeutic surgical options, and the related indications, techniques, results and complications of each procedure

Simple febrile seizure: the role of serum sodium levels in prediction of seizure recurrence during the first 24 hours

Simple febrile seizures are the most common form of childhood seizures, often recurring within the first twenty-four hours. This study was conducted to determine the probable role of low serum sodium levels in predicting seizure recurrence in febrile children. For the study, 226 patients with seizures, aged between 6 months to 5 years, were divided into 3 groups of simple febrile seizure, simple febrile seizure with recurrence, and the control group of afebrile patients with seizures. For all groups, serum sodium levels were evaluated. The mean age of our cases, predominantly male, was 22 months. No significant difference was observed in the serum sodium levels between the simple febrile seizure and the simple febrile seizure with recurrence groups [P value 0.465]; however a significant relative hyponatremia was observed in the simple febrile seizure group as compared to the afebrile seizure control group [P value: 0.016]. Based on the findings, although serum sodium levels cannot assist in prediction of recurrence of simple febrile seizures in children, relative hyponatremia may predispose the febrile child to occurrence of simple febrile seizure

Rosa Damascena oil: an adjunctive therapy for pediatric refractory seizures

Several investigations have demonstrated that Rosa damascena has an inhibitory effect on the hypothalamus and on pituitary system reactivity in the rat; it ahs also been shown that the essential oil of Rosa damascena has significant antiepileptic effects on pentylentetrazole [PTZ] induced seizures in rats. We aimed at assessing the effects of the essential oil of Rosa damascena when used as an adjunct treatment to treat children with refractory seizures In this double-blind clinical trial, conducted as a pilot study between April 2004 and March 2005, we administered essential oil of Rosa damascena to sixteen children with refractory epilepsy as an adjunct therapy, and evaluated its effects. 16 patients, age range 3-13 years, were enrolled; 56.3% [n=9] girls and 43.8% [n=7] boys. All has been under treatment for 3-6 weeks [baseline phase]. They received either the essential oil or placebo for a period of 4 weeks and in between these periods, they took only their pre-existing antiepileptic drugs for two weeks [washout phase]. The mean frequency of seizures in those using essential oil, showed significant decrease as compared to the controls using placeboes [p=0.00]. It can be concluded that the essential oil of Rosa Damascena has beneficial antiepileptic effect in children with refractory seizures

Goldenhar syndrome and pericentric inversion of chromosome 9

Oculo-auriculovertebral dysplasia [Goldenhar] is a congenital syndrome. Its phenotype differs from craniofacial anomalies to cardiac, vertebral or central nervous system defects. This syndrome is rare and its etiology is not apparent yet. Pericentric inversion of chromosome 9 is one of the most common structural balanced chromosomal aberrations with its incidences 15% to 25%. Herein we present a case of Goldenhar syndrome in a oneyr- old girl with pericentric inversion of chromosome 9. We used the patient's peripheral blood and studied 30 metaphase spreads on the basis of G-bands by trypsin using Giemsa [GTG] technique at 400 band resolution that revealed a pericentric inversion of chromosome 9 with break points at p11 and q13

Torticollis caused by neuroenteric cyst of upper cervical region

Torticollis is a symptom that can be related to different pathological mechanisms ranging from simple to life-threatening conditions. Here we report a child with torticollis caused by a neuroenteric cyst in the upper cervical region; this is a very rare condition in childhood and in this case, it was successfully resolved by surgery. A 2.5 year old boy presented with a 2 month-history of torticollis, he had developed paraparesia 2 weeks before admission. At examination he was found to be quadriparetic. Radiographic study of the cervical spine revealed widening of the cervical canal. Brain and spinal magnetic resonance imaging revealed a hypointense lesion on the T1 at the craniovertebral junction having a compressive effect on the anterior aspect of the brain stem and spinal cord. The patient underwent surgery. After craniotomy and opening of the dura, a cystic lesion was seen; clear fluid was aspirated and the cyst wall was removed. Considering the quadriparesis and torticollis, the patient improved significantly within the first few days after surgery. No relapse of symptoms occurred during the follow up period. This is the first case report of a child in whom torticollis was due to a neuroenteric cyst of the upper cervical intradural region

Outcome of patients with meningomyelocele

Meningomyelocele is the most common congenital anomaly of the central nerves system [CNS].It is not only a spinal cord anomaly; associate hindbrain abnormalities, hydrocephalus, bladder, and bowel disturbance, and orthopedic deformities make a team effort necessary. We reviewed our patients with meningomyelocele and evaluated their early and long-term outcomes. We included 45 patients with meningomyelocele operated on between 1990 and 2004 in this study. The medical records were reviewed from the aspects of neurological and physical findings, surgery performed, and complications. Parental age and education were analyzed when available. The chiary-square test was used for the statiscal analyses. There werel9 boys [42.2%] and 26 girls [57.8%]. The lumbar region was the site of the meningomyelocele in 27 patients [62%].Patients with cervical and sacral meningomyelocele had a higher rate of normal motor function than those with meningomyelocele at other levels [p=0.0001].We also noted that the higher the location of meningomyelocele, the greater the control of both sphincters [p=0.0013]. The management of children with meningomyelocele needs a team approach. The majority of patients can have a normal IQ and a socially acceptable degree of continence and be able to walk. The patients should be treated with aggressive therapies whenever possible

Neurological signs and symptoms in cervical spondylosis

Introduction: According to high prevalence of cervical spondylosis and many questions about indications of surgery we decided to sudy its signs and symptoms especially those that lead to surgery

Material and method: This is a desciptive study on 54 patients that operated on in Qaem Hospital between 1991-2001. Special data collection sheets that included personal informations, signs and symptoms, evolution, neuro-imaging findings and indications of surgery. All data were analyzed using statistical tests

Results: In 54 patients who were studied, the results were as followsimale was predominant significantly [81.5% versus 18.5%], all patients'age was above 40 years [average 58.9 years],the course of disorder was slowly progressive in 89% and acute in 11%. Hyperreflexia 92.5% Babinski sign 70%, Hoffmann sign 52%, clonus 41%, fasciculation 11%, paresthesia 63%, vague sensory level 44.5% proprioceptive sensory loss 22%, cervical dermatome sensory loss 52%, gait disorder 85%, motor weakness 85% [tetraparesis was the most common], neck pain 63%, Radicular pain 40.5%. hand atrophy 37% and sphincteric disorder 33%. MRI findings Was: 96% of patients had canal stenosis [12.5% of them had one level stenosis and 87.5% had multiple level stenosis]. The most common level of stenosis was C5-C6, C6-C7, C4-C5, and C3-C4 respectively. Indications of surgery were as follows; progressive motor weakness 96%, intractable pain 56% and sphincteric disorders 33%. Some of patients had more than one indication

Conclusion: male to female ratio was more than4, the most common level of compression were C5-C6, C6-C7, and in comparison with other data, we had a higher incidence of neck pain, spastic tetraparesis, Hoffmann sign, hand atrophy and spastic gait

[Acute otitis media in children with febrile convulsion]

Objective: the aim of this study was prevalence of acute otitis media in children [6mo.-6yr.] with febrile convulsion admitted to the Pediatric Ward of Hospital, 2001-2002 [Khordad 1380- 81]

Method: fifty children [6mo.-6yr.] with febrile convulsion were admitted to the Pediatric Ward of Ghaem Hospital between the 15'h of Khordad 1380 to the 15th Khordad 1381. All of them were examined within the first six hours of admission. A questionnaire was filled for each child

Results: the patients' mean age was 27.59 months [range 6.5mo.-5yr.] 35 patients were male, and 15 were female. Fifty-four percent of all patients had simple and 46% had complex febrile convulsions. The most common disease was acute otitis media [36%], followed by upper respiratory tract infections [34%], and gastroenteritis [30%]. Association of acute otitis media with febrile convulsion in males was more in females [88.9% vs 11.1%, P = 0.029] There was not significant statistical relation between acute otitis media and febrile type convulsions [simple-complex] [P= 0.87]

Bruxim in 3-6 year-old children

This cross sectional study has bees done in nine randomly selected Kindergartens of Mashhad. The purposes of this research were to obtain prevalence of bruxism and it's relationship with dental complications, and temporom and ibular disorders in 3-6 year-old children. 70 [9%] out of 772 [3-6 year-old] children had bruxism in view of parent's reports and oro-dental examinations. The most current age for the spreading bruxism was 4-5 years-old [37.1%]. All affected children had nightly bruxism. In 35/5% of affectes children and in 11.1% of unaffected children family histories were positive. In 38/5% of affected children and in 54.1% of unaffected children, mother had a job. In 75.5% of affected children there were no dental problems, pain in facial muscles or at jaw opening observed. In 4.2% of the children there pain on was temporom and ibular joint movement