Acute disseminated encephalomyelitis ssociated with enteroviral infection

Acute disseminated encephalomyelitis [ADEM] is an acute demyelinating infection of the CNS that is characterized by multifocal white matter involvement often following an infection and vaccination. A 16-year-old child receiving risperidone for 7 years for the treatment of attention-deficit/hyperactivity disorder was hospitalized with complaints of double-vision during the past month and weakness on his right side, ataxia, and vomiting over the past 3 days. The child was diagnosed with ADEM after clinical, laboratory, and cranial MRI was conducted. Following an initial 3-day therapy with pulsed methylprednisolone, the child showed obvious clinical improvement. The treatment was continued with prednisolone and significant improvement was achieved. Enterovirus was detected in the results of the viral examination of the CSF. This child was found to be an interesting case having been diagnosed with ADEM associated with enteroviral infection, because of the rarity of few case reports in the literature

Topiramate as a long-term therapy in children with refractory epilepsy

To evaluate the long-term efficacy, safety, and retention rate of topiramate [TPM] in childhood refractory epilepsies. This study was designed as a single-center, retrospective study. Children with refractory epilepsy who has been followed in Behcet Uz Children's Hospital, Izmir, Turkey, between 2003 and 2007 were included in the study. The study population consisted of 43 boys [60.6%], and 28 girls [39.4%] aged between 2-18 years. Mean age was 8.83 [SD: 3.77] and mean duration of epilepsy was 3.89 [SD: 1.51] years. There were 41 children [57.7%] with mental retardation. Twenty-seven children had generalized epilepsy, and 44 children had localization-related epilepsy. Fifty-one children [71.8%] showed a good response to initial treatment. The retention at a mean of 32 months was 31 out of 71 children [43.6%], and approximately 18 children [25.3%] were seizure free. A loss of efficacy in long-term use occurred in 17 [33.3%] of initial responders. Adverse events were seen in 20 children [28.1%]. There were no significant differences between the groups who continued and discontinued TPM treatment in long-term use. As a result, it was determined that the drug was more effective and well tolerated in localization-related epilepsies, on long-term follow up