Vehicular entrapment and heat stroke in three children: is it a form of child neglect?

The medical records of three children who were entrapped inside vehicles are reviewed and their outcome following the incidents were assessed in this report. The children developed heat stroke following the incidents and survived after several days in coma but with severe cognitive functions impairment. Two of the children were left with hyperactivity and attention deficit, while the third had active epilepsy. Vehicular entrapment heat stroke is one of the preventable brain injuries in children. Several children get entrapped in cars or other vehicles yearly and survivors are left with significant brain damage. The usual cause for brain damage is heat stroke the lesson learned was to never leave children unattended in cars. Therefore, it is essential to double check that doors are locked when leaving children unattended near vehicles

Clinical characteristics of childhood Guillain-Barr‚ syndrome

To find the incidence, clinical pattern and outcome of Guillain-Barre syndrome in the Sultanate of Oman in children less than 15 years of age. All children under fifteen years with acute flaccid paralysis were admitted to identify the underlying cause. The diagnosis of Gullain Barre syndrome was made by clinical criteria, cerebrospinal fluid findings and nerve conduction studies. Intravenous immunoglobulins were given to all and two needed plasmapharesis. Sixty-one children were diagnosed as Guillan-Barr‚ syndrome and constituted 20% of cases of acute flaccid paralysis. Males 39 [63.9%] outnumbered females [36.1%].The annual incidence below 15 years was 0.45/100,000. Cranial nerves were involved in 31 [50.8%] children. Albumino-cytological dissociation in cerebrospinal fluid was seen in 42/45[93.3%] cases. Acute relapse was seen in six [9.8%] cases. Eleven children [18.3%] needed ventilation. Complete recovery was seen in 45 to 310 days [mean 69.1 days]. Three children [4.9%] were left with minimal residual deficit. There was no mortality. Guillain Barre syndrome is a serious disease, although recovery is the rule in children. The disease is associated with very low mortality and long term morbidity. Immunoglobulins have reduced the duration of hospital stay and the total time needed for recovery

Transient opsoclonus-myoclonus syndrome secondary to neuroblastoma

We report a 2 1/2-year-old girl who presented with acute history of fluctuating level of consciousness in the form of drowsiness, extreme irritability, and involuntary abnormal movements in the form of shaking of the whole body. She was treated with acyclovir empirically, contemplating Herpes simplex virus encephalitis. Overtime she improved substantially. The opsoclonus, myoclonus, and ataxia disappeared without treatment. However, 6 weeks later she presented again with classic opsoclonus-myoclonus syndrome. The investigations revealed neuroblastoma. This case illustrates that transient opsoclonus-myoclonus may occur with neuroblastoma and should not be assumed to be due to viral cause. Thus, a thorough search for occult neuroblastoma should be initiated even if opsoclonus-myoclonus resolves spontaneously

Corpus callosum agenesis

The objectives are to analyse corpus callosum agenesis in children with various neurological problems in a hospital set-up, and to study the neurological and systemic abnormalities associated with this condition. The children with various neurological problems who underwent computerized tomography brain from January 1993 to December 1997, and were found to have corpus callosum agenesis, formed the subjects of this study. These children were examined for any syndromic association, congenital infections or metabolic defects. Out of 2164 children who underwent computerized tomography brain, 22 had corpus callosum agenesis [1%]. Most cases were not syndromic and 64% were males. Epileptic disorders were noted in about one third of cases. Corpus callosum agenesis is an important anomaly in children with neurodevelopment handicaps, usually detected by neuroradiology