Intellectual impairment among epileptic children correlation with age of onset and duration of epilepsy

Intellectual impairment among epileptic children has been a subject of study throughout the modern era of epileptology. Early age of onset and long duration of epilepsy have been implicated as possible contributors. To test for this hyposis, 45 epileptic children and 20 normal controls of the same age group [6-16 years] were studied using Wechsler Intelligence Scale for Children Revised [WISC-R]. Correlations between intellectual impairment and age of onset and duration of epilepsy were done. The results showed that epileptic children have significantly lower IQ than controls. Moreover, those with earlier seizure onset and longer seizure duration have significantly lower IQ. In conclusion, the earlier the age of onset and the longer the duration of epilepsy, the more the intellectual impairment

Cognitive dysfunction in epileptic children in correlation to seizure type, frequency and egg changes

This work was conducted on 46 epileptic children with EEG recording to study the problem of intellectual impairment in epileptic children. The intellectual functions [verbal IQ [VIQ], performance IQ [PIQ] and general IQ [GIQ]] were assessed using Wechsler intelligence scale for children revised [WISC-R]. The results showed a statistical significant difference between patients and controls as regard intellectual functions with higher IQ scores of the control group. There was an insignificant difference between patients with different seizure type, however children with generalized tonic clonic seizures had lower IQ scores than those with absence or complex partial seizures. It was concluded that epileptic seizure itself had a detrimental effect on intellectual functions rather than other risk factors, thus intractable epilepsy strongly deteriorated intellectual functions. Partial versus generalized seizures and normal interictal EEG were good predictor of normal intellectual functions in epileptic children

Comparison of H-reflex latency with conventional motor nerve conduction study in diagnosis of diabetic neuropathy

Distal polyneuropathy is the most common neurologic complication of diabetes mellitus. Prolongation of H-reflex latency could be demonstrated at time when convential motor nerve conduction study may not show an abnormality. The aim of this work was to compare motor conduction study with H-reflex latency in diagnosis of diabetic neuropathy. This study was carried out on 44 patients with diabetes mellitus of both type 1 and type 2, they were 26 males with mean age 47.5 years and 18 females with mean age 43.4 years. A control group of 10 healthy subjects were chosen, six were males and 4 were females, the two groups were matched together as regard the age and sex. The patients and control groups were subjected to thorough clinical evaluation and electrophysiological testing for distal latency of the median and lateral popliteal nerves and their motor nerve conduction velocity as well as the H-reflex latency. Correlations between H-reflex and other variables including motor conduction velocity and type of diabetes were done. The results were: 30 cases showed peripheral sensory affection while 14 patients showed no symptoms of sensory affection, 27 patients showed motor manifestations, 6 patients showed cranial nerve affection and 5 patients showed manifestations of autonomic dysfunctions. The electrophysiological tests showed highly significant difference between control and patients groups regarding median nerve distal latency, median and lateral popliteal nerves motor conduction velocity and very highly significant difference between control and patients groups in H-reflex latency. Comparing H-reflex latency with motor nerve conduction velocity revealed significant superiority of H-reflex latency on motor conduction velocity in both clinical and subclinical cases of diabetic neuropathy. We concluded that H-reflex latency is of great diagnostic value in diabetic neuropathy. Furthermore, it is more sensitive than conventional motor nerve conduction study

Evaluation of cerebral blood flow during laparoscopic cholecystectomy using transcranial doppler ultrasonography

Laparoscopic procedures are common nowadays. They have many advantages, however, they carry special risks in certain cases due to the associated cardiac and pulmonary dysfunction as well as CO2 retention. The aim of this work is to evaluate the effect of one of these procedures; namely laparoscopic cholecystectomy; on cerebral blood flow [CBP] using transcranial Doppler [TCD] ultrasonography to determine the right middle cerebral artery velocity [MCAV] which is proved to correlate well with CBF. Sixteen patients classified as American Society of Anaesthesiologists [ASA] physical status I, and II were included in the study. Their heart rate [HR], mean arterial pressure [MAP], end-tidal carbon dioxide concentration [PETCO2], arterial carbon dioxide tension [PaCO2], and MCAV were recorded before CO2 insufflation, then 10, 20, 30 and 40 minutes after insufflation, and again 10 minutes after peritoneal deflation. Significant increase [P<0.01] in MCAV in all the recorded values was found. This increase was attributed mainly to the accompanying rise in PaCO2. The present study concluded that CBF was increased significantly in laparoscopic procedures utilizing C02 as the insufflation gas. ft is recommended to avoid pneumoperitonium or to use it with extreme caution in patients with suspected or documented intracranial injuries due to the potential for significant increase in intracranial pressure [ICP] and alterations in cerebral perfusion pressure [CPP]

Brain abscess in children with congenital heart diseases

45 children with congenital heart diseases, who followed regularly in the pediatric outpatient clinic, examined thoroughly to detect any neurological complications, particularly brain abscess. These children divided into two groups I-cyanotic congenital heart disease group; 24 patients [19 males and 5 females] with mean age of 5.3 years. II-Acyanotic congenital heart disease group; 21 patients [12 males and 9 females] with mean age of 5.6 years. We detected brain abscess in two patients in the cyanotic group with the incidence of 8.3% and no cases in the Acyanotic group. We concluded that in children with cyanotic congenital heart disease we have to suspect brain abscess if these children developed focal neurological deficits or seizures with deterioration in the level of consciousness and they have to be fully examined and investigated