Hormonal changes in epileptic children with primary generalized tonic-clonic seizures

We studied the hormonal changes in 24 epileptic children with primary generalized tonic-clonic seizures. Their ages ranged between 3 and 16 years with a mean of 9.08 +/- 4.05 years, 13 were males and 11 were females. Electroencephalographic studies showed high voltage slow waves pattern in 17 patients while computed tomography of brain was normal in all cases. As regards the acute changes following an attack, we found significant elevation of both prolactin and ACTH levels after 20 minutes, 1, 2, and 3 hours of seizure compared with baseline level [after 24 hours]. The increase in plasma ACTH level was accompanied with significant elevation in plasma cortisol level after 1, 2 and 3 hours of the seizure onset. Plasma TSH level after 1 and 2 hours were significantly higher than the baseline value. Early postictal significant elevation of growth hormone levels was observed after 20 minutes and 1 hour. Concerning chronic hormonal changes, we found that the baseline levels of prolactin, ACTH and cortisol in epileptic children with generalized tonic-clonic seizures were significantly higher than the levels recorded in healthy children while no significant differences could be detected as regards TSH and growth hormone. We suggest conducting other studies in pediatric age to assess the role of neurotransmitters in producing the variable hormonal changes following the onset of seizures

therapeutic efficacy of intravenous immunoglobulin compared to plasmapheresis in pediatric guillain-barre syndrome

Between January 1st 1996 and end of February 1997, 31 children with severe Guillain-Barre syndrome were included in this study to evaluate whether treatment with intravenous immunoglobulin [IVIg] is as effective as plasma exchange [PE] in improving the clinical course of the disease. Analysis of data have shown that there were no significant differences between the treatment groups as regards the mean disability grade improvement after 4 weeks of therapy or the mean time needed to improve by 1 functional grade or the mean time needed to unaided walking. The mean duration of ventilatory support needed by the patients during the course of the disease was significantly less in IVIg group. By the end of 24 weeks of follow up 18.75% and 20% of patients treated with IVIg and PE respectively were still unable to walk independently and none of the patients died. On grounds of equal therapeutic efficacy, greater convenience especially in children and similar cost, IVIg may be preferable to PE for treatment of pediatric Guillain-Barre syndrome provided that the disease is severe, the duration of neuropathy is less than 14 days and the child is not known to have allergic reactions to immunoglobulin