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Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) complicated with "top of the basilar" syndrome (TOBS) in children. Method The clinical data of MPP complicated with TOBS in a child were retrospectively analyzed, and the related literature was reviewed. Results A 6-year-old girl developed fever and inflexible movement in unilateral limb, and serum Mycoplasma pneumoniae antibody increased gradually. Lung CT showed a large area of inflammatory consolidation. Brain magnetic resonance imaging (MRI) showed multiple cerebral infarctions. After the symptomatic treatment of anti-infection, anticoagulation, thrombolysis and intracranial pressure reduction, the girl's condition continued to worsen and she presented with coma, cough weakness, dysphagia, facial nerve paralysis and bilateral pupillary inequality. Although the vital signs of the child were stable, she could not take care of herself and was still recovering. Conclusion MPP is often accompanied by hypercoagulative state and autoimmune abnormalities, and the prognosis of patients combined with TOBS is poor.
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Objective To evaluate the clinical curative effect of Salvia miltiorrhiza Ligustrazine combined with Butylphthalide in cerebral infarction of children. Methods Sixty-two children with acute cerebral infarction were randomly divided into treatment group (33 patients) and control group (29 patients). The patients in two groups received the same basic treatment. The control group used Salvia Ligustrazine injection, and the treatment group used Salvia Ligustrazine injection combined with Butylphthalide. The total efficiency, the degree of recovery of muscle strength and the scores of nerve defect 2 weeks after treatment were compared. Results The total efficiency in treatment group was 87.9%(29/33), in control group was 75.9%(22/29), and there was significant difference (P<0.05). Two weeks after treatment, the muscle strength scores in treatment group was (4.00 ± 0.47) scores , in control group was (3.59 ± 0.98) scores, and there was significant difference (P<0.05). Two weeks after treatment, the scores of nerve defect in treatment group was (5.42 ± 2.18) scores, in control group was (6.86 ± 2.23) scores, and there was significant difference (P<0.05). Conclusions Salvia Ligustrazine combined with Butylphthalide in treatment of cerebral infarction of children has obvious effect, and it is worthy of spreading.
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Objective To explore the clinical manifestation, diagnosis and prognosis of Leigh syndrome in children. Method Clinical data from 4 cases of Leigh syndrome conifrmed by genetic testing were retrospectively analyzed. The related literature were reviewed. Results In 4 cases, 3 were boys and one was a girl, 3 cases were onset in infant and one case was in school age. The main manifestations were mental retardation, low muscle tone, convulsions, feeding dififculties, drooping eyelids, extraocular muscle paralysis and nystagmus, irritation, activity intolerance etc. The brain magnetic resonance imaging (MRI) revealed symmetry long T1, T2 abnormal signal in brainstem, bilateral globus pallidus, thalamus, cerebellar dentate nuclei, and periaqueductal, 3 cases involved midbrain, one case involved thalamus, and one case involved cerebellar dentate nuclei;2 cases had encephalatrophy. Electromyography was normal in all cases. The levels of lactate in blood and cerebrospinal lfuid were increased. Mitochondrial DNA (mtDNA) detection found the mutation of mtDNA 8993 T>G in one case, and the mutation of mtDNA 9176 T>C in another 3 cases. The case onset in school age died of respiratory failure one month later, and another 3 cases were still in follow up, there were mental retardation, but no signiifcant setback. Conclusion The clinical manifestations of Leigh syndrome in children are diverse. The diagnosis is based on the typical clinical manifestations and MRI, blood and/or cerebrospinal lfuid lactate levels. The genetic testing is the golden standard for diagnosis.