Early postictal electroencephalography and correlation with clinical findings in children with febrile seizures / 소아과

PURPOSE: Electroencephalography (EEG) is frequently ordered for patients with febrile seizures despite its unclear diagnostic value. We evaluated the prevalence of abnormal EEGs, the association between clinical findings and abnormal EEGs, and the predictive value of EEG for the recurrence of febrile seizures. METHODS: Data were collected on 230 children who were treated for febrile seizures at Kyung Hee University Medical Center from 2005 to 2009. EEGs were recorded after 1-2 days of hospitalization when children became afebrile. EEG patterns were categorized as normal, epileptiform, or nonspecific relative to abnormalities. The patients' medical records were reviewed, and telephone interviews with the families of the children were conducted to inquire about seizure recurrence. The relationships between clinical variables, including seizure recurrence, and EEG abnormalities were evaluated. RESULTS: Of the 131 children included, 103 had simple and 28 had complex febrile seizures. EEG abnormalities were found in 41 children (31%). EEG abnormalities were more common in children with complex than simple febrile seizures (43% vs. 28%), but the difference was not statistically significant. Logistical regression analysis showed that having multiple seizures in a 24-hour period was significantly predictive of abnormal EEG (odds ratio, 2.98; 95% confidence interval, 1.0 to 88; P=0.048). The frequency of recurrence did not differ significantly in the normal (31%) and abnormal (23%) EEG groups. CONCLUSION: Multiple seizures within 24 hours were predictive of abnormal EEG in children with febrile seizures. Abnormal EEG was not predictive of febrile seizure recurrence.

An Extremely Macrosomia Born Weighted 6.14 kg: Case Report and Review of the Literatures

Infants, born with a birth weight above 4.0 kg, are categorized as high birth weight infant (HBWI). The term HBWI is often used in similar context with macrosomia. Macrosomia is associated with many complications, and is considered to be a high risk group that requires an intensive care in most cases. This report is presenting an extreme macrosomia born at a gestational age of 38+5 weeks, with a body weight of 6.14 kg. The infant was born by a cesarean section from a mother with diabetes, and was admitted into an intensive care unit with tachypnea, which had occurred soon after birth. There were other complications, such as hypoglycemia, hypocalcemia, secondary atrial septal defect, patent ductus arteriosus, pulmonary hypertestion, and etc. With conservative management, the symptoms improved over a 10 day course and the patient was discharged from the hospital. To this day, the child has not presented with further health problems during the 6 months of follow up period. We reviewed the frequency and trend of the births of HBWI, through the raw data from the Statistics Korea on births between 2000 and 2010. With additional analysis of the cases of macrosomia, through the years of 1964 to 2011, we were able to find 7 reports, including this current case of infants born with a body weight above 6.0 kg. This case was the fifth heaviest infant among these 7 cases. We are reporting this case with the hope that it may contribute to the future care of high risk infants in a neonatal intensive care unit.