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Objective:To analyze the characteristics of electroencephalogram (EEG) and clinical manifestations of children with moyamoya disease (MMD), and to explore the value of EEG in the clinical diagnosis of childhood MMD.Methods:Twelve children indicated as cerebrovascular diseases by EEG and later diagnosed with MMD by head magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to June 2019 were enrolled in this study.Their EEG and clinical data were retrospectively analyzed.Results:Nine cases were male and 3 cases were female, with the onset age of 3.0-8.7 years old.Ten cases were taken to the hospital because of paroxysmal limb weakness on one side or both sides, 1 case was because of paroxysmal fall, and 1 case was because of paroxysmal posture abnormalities.EEG background activities of 12 cases were normal.Interictal EEG was normal in 8 cases, borderline in 1 case, and abnormal in 3 cases (1 case had many slow waves in bilateral anterior head, and its number significantly increased during the awakening period; 1 case had a great many irregular delta slow waves on bilateral prefrontal cortex, showing significant aggravation during the awakening period; 1 case had many multifocal delta slow waves especially in the right frontopolar region). The hyperventilation (HV) induction test was abnormal, and rebuild-up of slow waves was noted in 4 cases.The focal delta slow waves (especially in the anterior head) developed to diffuse slow waves after stopping HV for 0.5 to 1.0 minutes, and lasted for 5 to 9 minutes after relief of symptoms.The delayed disappearance of asymmetric focal slow waves was noted in 8 cases.Focal slow waves (especially in anterior head) developed to diffuse slow waves at 1.5 to 2.0 minutes after HV initiation, and lasted for 5 to 10 minutes in total.Among them, 1 case pre-sented no obvious accompanying symptoms during HV, while 11 cases showed transient ischemic symptoms that were basically consistent with the chief complaint.The duration of symptoms was much shorter than the appearance of slow waves in EEG.Besides, brain MRI of 3 cases suggested local malacia lesions or abnormal signals, especially in parietal and basal ganglia areas.The high signal shadow was observed in the sulcus of bilateral cerebral hemispheres on the fluid attenuating inversion recovery sequence of one case.All of 12 cases were proved to MMD by head MRA.Conclusions:Clinical symptoms of children with MMD are paroxysmal limb weakness.Rebuild-up of slow waves or the delayed disappea-rance of focal slow waves is highly suggestive of MMD.These 2 kinds of abnormal EEG patterns sustain over long periods of time.Focal slow waves (especially in anterior head) develop to diffuse slow waves, and lastly decrease to focal slow waves in anterior head.
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Objective To investigate the characteristics of ictal and interictal electroencephalogram (EEG) and clinical manifestation in children with startle epilepsy. Methods The age of onset, inducing factors, the types of attacks, EEG features, cognitive function, treatment and prognosis were retrospectively analyzed in 8 cases of children with startle epilepsy from June 6, 2012 to March 2016. Results In 8 cases, 3 cases were male and 5 were female. The onset age was from 2.3 to 8.1 years old. The forms of onset were varied from generalized (tonic, myoclonic, atonic) to partial seizures (the asymmetry of posture rigidity, spasm). The most common ictal EEG finding was a diffuse electrodecremental pattern (5 cases), and the interictal EEG showed a large number of multifocal, generalized spines, slow waves and multiple spinous waves. There was one case with no history of brain injury while the other 7 cases had a history of brain injury. There were 7 cases with imaging abnormality, and the lesions of the frontal, parietal and temporal regions were indicated with a partial cerebral softening and brain atrophy. In 7 cases, all children had abnormal mental and motor development, and 1 case had normal cognitive function. The 7 cases with shock epilepsy showed no obvious response to the treatment of multiple antiepileptic drugs, and 1 case had no clinical onset after 2 months of treatment with VPA. Conclusions Startle epilepsy is mostly symptomatic, and few are non-symptomatic. The former had history of brain structure abnormalities, certain degree of motor retardation and mental disability, and no clinical response to antiepileptic drug therapy. The latter had basically normal cognitive function, and antiepileptic drug VPA treatment is effective. The degree of interictal epileptic was not an indicator of cognitive impairment and prognosis in children with startle epilepsy.
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Objective To explore the prognostic factors in Guillain Barre syndrome (GBS) in children. Methods A total of 125 children with GBS were included and grouped according to their independent walking at two and six months after discharge, and their clinical data were analyzed. Results In 125 children (74 males, 51 females) the average age was 84.49±25.32 months, and 41 were under 6 years old. 102 children had a history of prodromal infections. 32 children had cranial nerve involvement and 35 had autonomic nerve involvement. 12 children need assisted respiration. At 2 and 6 months after discharge, when compared with children who could walk independently, the rates of functional score > 3, cranial nerve involvement, and neuroelectrophysiology as denervation potential were higher in children who could not walk independently, and the differences were statistically significant (P all<0.05). Conclusions The factors that affect the short-term prognosis are denervation potential in neuroelectrophysiology, cranial nerve involvement, and functional score > 3. Early identification of uniqueness in patients and subsequent development of targeted rehabilitation training should be carried out to improve the prognosis.
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Objective To evaluate the efficiency of long-term video electro-encephalography(VEEG) monitoring in neonatal seizure.Methods The medical records of 36 neonates recruited and performed with long-term VEEG in the neonatal intensive care units in hospital from Jun.2011 to Jun.2012 were collected.The medical records included age,gender,diagnosis,VEEG background,epileptiform activity,epileptic seizures (electrographic seizures,electroclinical seizures or both),and nonepilepic events.Informations on prognosis and therapy was also obtained.Results Among the 36 neonates,the neonates with normal,or mildly,moderately,and severely abnormal VEEG were 3 (8.3％),9 (25.0％),16 (44.4％) and 8 (22.2％) neonates,respectively.Children with normal electro-encephalography (EEG) developed normally.The percentage with developmental delay in children with mildly,moderately,and severely abnormal EEG were 1 1.1％,37.5％ and 62.5％,respectively and abnormal VEEG was significantly associated with developmental delay(x2 =13.8,P =0.003).Among these 36 neonates,21 cases had neonatal seizures (58.3％),including 14 (66.7％) cases with epileptic seizures and 6(28.6％) cases with nonepileptic seizures and 1 case with both.In addition,13 (61.9％) cases out of 21 cases with neonatal seizures developed abnormally (including developmental delay and death),and there was no significant association between neonatal seizure and development (x2 =0.206,P =0.65).Conclusions Neonatal seizure is very common,but electroclinical dissociation is an outstanding feature of neonatal seizures.Long-term VEEG monitoring is a valuable tool and may aid in the early identification and management of patients who are more likely to develop epilepsy.