Cerebral palsy in Jordan: clinical and neuroimaging characteristics

To evaluate the diagnostic findings of neuroimaging in patients with cerebral palsy and if there is any specific finding correlated to certain types of Cerebral Palsy. Case records of 158 patients diagnosed to have cerebral palsy attending the pediatric neurology and neurodevelopmental clinics at King Hussein Medical Center and King Abdullah University Hospital over 2 years period, 2006 and 2007, were studied retrospectively with reference to their clinical characteristics and their correlation to the neuroimaging [MRI and CT scan] findings. A total of 158 cases with cerebral palsy were included in the study, 84 [53%] males, 74 [47%] females, 41 [26%] preterm and 117 [74%] full- term babies. Spastic cerebral palsy was seen in 112[70.8%] with spastic quadriplegia being the commonest seen in 63[40%]. Hypotonic ataxic type present in 22[14%], dyskinetic 15[9.4%] and mixed cerebral palsy in 9[5.6%]. Abnormal neuroimaging findings were seen on MRI in 125[79%], while in CT scan in 113[71%]. Specific neuroimaging findings were seen suggesting brain asphyxia in 40[25%], congenital brain anomaly in 22[14%], intracranial hemorrhage in 10[6%], vascular and infectious causes in 29[18.5%], unknown/Isolated brain atrophy in 26[16.5%], and periventricular leukomalacia in 31[20%]. The most common single etiology identified was birth asphyxia 40[25%], and the second is periventricular leukomalacia which was identified in 31 patients [20%]. Nonspecific brain atrophy was considered as nonspecific finding, that was found most often in patients with dyskinetic CP 5/15[33%], and in patients with spastic quadriplegia 15/63[24%] as compared to other groups. The principle contribution of imaging is to the understanding of etiology and pathogenesis, including ruling in or out conditions that may have implicated a genetic counseling, such as malformations. MRI is a more sensitive test than CT in detecting brain abnormalities

Effectiveness of ultrasonography in children after urinary tract infection

To determine the effectiveness of ultrasonography in identification of reflux nephropathy in children after urinary tract infection. A prospective study carried out at pediatric and radiology department at Prince Au Ben Al-Hussein Hospital. Rena] ultrasonography was performed in 135 children, by an experienced radiologist after first attack of urinary tract infection, Age between 2 to 10 years, 70 males and 65 females. The overall size of each kidney was estimated and length was measured in all patients. Voiding cystourethrography and scintigraphy [DMSA scan] were done in all patients. Scinligraphy [dimercaptosuccinic acid labelled with technetium-99rn] was used as a method of reference. From 270 kidney examined, 31 were scarred and 239 were normal according to scintigraphy. When we used DMSA scan as the method of reference with scarring as diagnostic criterion, only 9 of 31 were correctly classified as abnormal at ultrasonography, [sensitivity 29% and specificity 78%]. When scarring or reduced renal size or both were used as diagnostic criterion, 14 were correctly classified as abnormal at US, [sensitivity 68% and specificity 45%]. Ultrasonography is not a reliable tool for diagnosing reflux nephropathy and should not be used as the only imaging study in children with urinary tract infection

Waardenburg syndrome. A case report and review of literature

Waardenburg syndrome is an autosomal dominantly inherited disorder with variable penetrance affecting 3% of all deaf children[1]. Genetic studies revealed a mutation in the PAX3 geneon the 2Q35 region. The major characteristic features are: Dystopia canthorum; Synophrys; Broad nasal root; Depigmentation of hair, skin or both with white forelock; Heterochromic or hypochromic irides and congenital deafness. Genetic heterogenicity has led to classification of affected families as type I with dystopia canthorum, or type II, without dystopia canthorum disease. This article reviews the literature and describes a case of Waardenburg syndrome type I in a twelve month old male child