ABSTRACT
Mild encephalitis/ encephalopathy with a reversible splenial lesion (MERS)in the corpus callosum is a clinical - radiological syndrome with typical imaging characteristics,which can be divided into 2 types (MERS Ⅰand MERS Ⅱ)according to the affected parts. The main cause is infection in children. Patients can be presented with symptoms that are common for acute mild encephalitis or encephalopathy such as disturbance of consciousness,hea-dache,vomiting,seizure. Brain magnetic resonance imaging(MRI)indicates lesions in the splenium of the corpus callo-sum. The symptoms and brain MRI lesions disappear almost within 1 month,and the prognosis is usually good. Early recognition is necessary and excessive treatment should be avoided.
ABSTRACT
Objective To investigate the early diagnostic and the prognostic value of amplitude integrated e-lectroencephalography(aEEG)in neonates with hypoxic - ischemic encephalopathy( HIE). Methods The medical data subjects were admitted to the Department of Neonatology,Children's Hospital of Hebei Province from January 2012 to December 2013. Ninety term infants with HIE were divided into 3 groups(mild,moderate and severe),and they were investigated respectively by aEEG monitoring within 12 hours after birth,and all of the infants accepted cranial magnetic resonance imaging(MRI)on 3 to 7 days after birth. The outcomes by MRI were divided into 3 groups(mildly abnor-mal,moderately abnormal and severely abnormal). The findings of aEEG monitoring were divided into 3 groups(nor-mal,mildly abnormal and severely abnormal),the correlation between the findings of aEEG and the severity of HIE was analyzed. The correlation between the results of aEEG and severity of MRI were analyzed. Behavior evaluation of infants with HIE were applied by Neonatal Behavioral Neurological Assessment(NBNA)score on 7 d,14 d,28 d after birth and prognostic evaluation of children with HIE was conducted based on Children's Development Center of China infants intelligence development test at 12 months of age. Results (1)Among 90 term infants with HIE,44 cases(48. 9% ) had mild HIE,29 cases(32. 2% )moderate and 17 cases(18. 9% )severe HIE;49 cases(54. 4% )had mildly ab-normal MRI,23 cases(25. 6% )moderately abnormal MRI and 18 cases(20. 0% )severely abnormal MRI;43 cases (47. 8% )had normal aEEG,25 cases(27. 8% )mildly abnormal and 22 cases(24. 4% )severely abnormal aEEG. (2)The findings of aEEG classification were correlated with the severity of HIE(r = 0. 970 7,P ﹤ 0. 001). The findings of aEEG classification were correlated with the severity of MRI(r = 0. 933 5,P ﹤ 0. 001).(3)NBNA score with severe-ly abnormal aEEG was obviously lower than that with the mildly abnormal aEEG. NBNA score on 7 d after birth:(14. 1 ± 4. 2)scores vs(32. 2 ± 2. 3)scores,on 14 d after birth:(17. 8 ± 5. 6)scores vs(33. 4 ± 2. 1)scores,on 28 d after birth:(18. 9 ± 8. 4)scores vs(34. 6 ± 2. 6)scores,and the difference was statistically significant(all P ﹤0. 05).(4)The infants with HIE were followed at 12 months of age. The development quotient mental development in-dex(MDI)and psychomotor development index(PDI)with severely abnormal aEEG were obviously lower than that with the mildly abnormal aEEG[MDI(65. 1 ± 4. 1)scores vs(89. 1 ± 6. 7)scores,PDI(67. 5 ± 10. 1)scores vs(90. 7 ± 8. 3)scores],the difference was statistically significant(all P ﹤ 0. 05). Conclusion It is indicated that aEEG can early evaluate the severity of HIE and help predict its neurological outcome.
ABSTRACT
Objective To investigate the correlation between eigenvalues(λ∥ andλ⊥)of sciatic nerve and limb function in a rabbit model of acute nerve traction inj ury for finding the role ofλ∥ andλ⊥ on diagnosis of nerve inj uries.Methods The right sciatic nerves of 32 Newland rabbits were selected to be performed as traction injury,and then left sciatic nerves were treated as control for the sham operation side.MRI DTI scan was performed before and after the operation on 1 day ,3 day,and 1 week,2,3,4,6 and 8 weeks respectively.Theλ∥ andλ⊥ of inj ured sciatic nerves and sham operated nerves were measured,meanwhile functional exami-nations were evaluated,and then analyzing the correlation betweenλ⊥ of inj ured sciatic nerves and the score of inj ured limb function in the periods of 3 days to 8 weeks;finally different portions of sciatic nerve were removed for histological examinations.Results Theλ⊥ of inj ured sciatic nerves in the proximal portion was slightly increased at 3 days and recovered to the normal at 2 weeks.Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were slightly raised at 1 day,reached to its maximum value at 3 days,and then decreased gradually after 1 week and dropped to the pre-operation level after 4 weeks.Theλ⊥ of inj ured sciatic nerves in the proximal portions was significantly higher than that of the sham-operated nerves from 1 day to 1 week(F=7.275,P=0.000). Theλ⊥ of inj ured sciatic nerves in the traction portion and distal portion were significantly higher than that of the sham-operated nerves from 1 day to 3 weeks(F=5.851,F=3.794,P=0.001,P=0.000).However,there was no significantly difference between theλ∥ of inj ured nerves in each portion and sham-operated nerves .The negative correlation between theλ⊥ of inj ured sciatic nerves in the distal portion and the score of the nerve function in the injured limb was found (r=-0.938,r=-0.897,P<0.01).Conclu-sion Theλ⊥ of inj ured nerves in the traction portion and distal portion could monitor the process of degeneration and regeneration of sciatic nerve in traction inj ury,while theλ∥ plays no obvious role in diagnosis of nerve inj uries.