The Levels of Zinc and Neuron-specific Enolase in Febrile Convulsion / 소아과

PURPOSE: To determine the role of zinc in febrile convulsion and to evaluate whether febrile convulsion causes neuronal damage, serum and cerebrospinal fluid(CSF), zinc and CSF neuron-specific enolase(NSE) levels were measured in patients with febrile convulsion, epilepsy and aseptic meningitis. METHODS: Three groups were formed as follows: group I:53 children with febrile convulsion; group II:34 children with epilepsy; and group III, 40 children with aseptic meningitis. Serum and CSF zinc and CSF NSE levels were measured in each groups. RESULTS: The serum zinc levels of groups I, II and III had a mean of 74.71+/-18.26 microgram/dL, 104.35+/-31.43 microgram/dL and 87.03+/-24.47 microgram/dL, respectively, and the values of group I were significantly lower than those of the other two groups. The CSF zinc levels of groups I, II and III were found to have a mean 27.72+/-17.93 microgram/dL, 44.73+/-26.72 microgram/dL and 54.44+/-28.43 microgram/dL, respectively. In group I, the CSF zinc levels were significantly lower than those of other two groups. The CSF NSE levels of groups I, II and III had a mean of 11.61+/-2.96 ng/mL, 16.51+/-5.46 ng/mL and 14.60+/-3.02 ng/mL respectively and the values of group I were significantly lower than those of others. CONCLUSION: We confirmed that low zinc levels in serum and CSF are participants in the pathogenesis of febrile convulsion, but we could not find out the evidence of neurologic damage in patients with febrile convulsion using NSE levels in CSF.

A Case of Ophthalmoplegic Migraine Developed in Infancy / 대한소아신경학회지

Ophthalmoplegic migraine is defined as recurrent unilateral headaches associated with extraocular muscle palsies. This disorder is more common in older children, but it may begin in infancy. Neuroimaging study should be performed to rule out conditions resulting in third nerve compression, such as intracranial aneurysm or mass lesions. Early treatment with corticosteroids could shorten the duration of the ophthalmoplegia and relieve the pain. We report a 8 year old boy who had severe headache with recurrent ipsilateral ophthalmoplegia that developed at the age of 2. The pediatrician should be aware that ophthalmoplegic migraine may occur in infancy and that early systemic steroid therapy is critical to prevent permanent sequelae.

The Factors associated with Oliguria after Indomethacin Administration in Preterm Infants with Patent Ductus Arteriosus

PURPOSE: Oliguria is an occasionally encountering phenomenon after indomethacin administration for the treatment of patent ductus arteriosus. This study was conducted to determine factors contributing to oliguria after indomethacin administration. METHODS: Sixty five infants with patent ductus arteriosus who had been administrated indomethacin in our NICU were enrolled in this study. The patients were divided into two groups; Oliguria group as a study group (n=17), and non-oliguria group as a control group (n=48). The oliguria was defined when urine output is more than or equal to 1.5 mL/kg/hr before indomethacin administration and less than 1.5 mL/kg/hr after indomethacin administration. Patients in oliguria group also included those urine output markedly decreased after indomethacin administration from pre-indomethacin urine output of less than 1.5 mL/kg/hr. Factors including intrauterine age, birth weight, sex, apgar score, respiratory distress syndrome, surfactant instillation, weight loss, ductal size, intraventricular hemorrhage, phototherapy, mechanical ventilation, oxygen therapy, dopamine injection, aminoglycoside injection, serum BUN, creatinine, sodium, potassium, glucose, platelet, hemoglobin, blood pressure were compared between oliguria group with non-oliguria group. RESULTS: Statistically significant factors contributing to oliguria after indomethacin administration included ductal size, gestational age and birth weight (P<0.05). The incidence of oliguria after indomethacin administration increased with increased gestational age, birth weight and ductal size. CONCLUSION: The ductal size, gestational age and birth weight prior to indomethacin administration are important factors contributing to oliguria after indomethacin administration.