Type I diabetes mellitus in a child presenting with epilepsy partialis continua.

Epilepsy partialis continua is an uncommon, localisation-related, seizure characterised by simple partial motor seizures with repetitive clonic jerks. A case of type I diabetes mellitus in a child who had presented with epilepsy partialis continua is presented. Antiglutamic acid decarboxylase 65 antibodies were found in his serum. Seizures were eventually controlled by anti-epileptic drugs, insulin and IV gamma.

Non-resolving pneumonia in a young boy--beware of foreign body aspiration.

A 4 1/2-year-old boy presented with recurrent cough and cold of 2 years duration. Chest x-ray revealed collapse consolidation of right lower lobe. Rigid bronchoscopy was done and the nozzle of a pen was extracted from right main bronchus. The radiological improvement took three months after extraction of the foreign body. Undetected foreign body aspiration is one of the causes of nonresolving pneumonia in children.

A case of opsoclonus-myoclonus-ataxia with neuroblastoma.

A 2 year old boy presented with features of opsoclonus, myoclonus and ataxia. Routine investigations of blood, urine, x-ray chest, bone scan, EEG and MRI of brain, were normal. Urine for VMA was negative. A right suprarenal mass was detected at MRI of abdomen. The mass was resected completely and was found histologically to be of differentiating type of neuroblastoma. The child was treated initially with prednisolone for 6 weeks along with sodium valproate. He is still on sodium valproate for his neurological symptoms. His symptoms still persist though they have decreased in intensity.

Febrile convulsion--an overview.

Febrile convulsion is the most frequently occurring epilepsy syndrome, experienced in infants/children between 6 months and 5 years of age associated with fever >38 degrees C. Children having first or second degree relative with history of febrile convulsion, neonatal nursery stay of more than 30 days, developmental delay or attendance at day care centre are at increased risk of developing febrile convulsion. Single febrile convulsion does not increase the risk of epilepsy and there is no causal relationship between febrile convulsion and subsequent epilepsy. It has been recognised that there is significant genetic component for susceptibility to febrile seizures. To make the diagnosis of febrile convulsion, meningitis, encephalitis, serious electrolyte imbalance and other acute neurologic illnesses are to be excluded. While managing acute attack the steps to be taken are--airway management, a semi-prone position to avoid aspiration, monitoring vital signs and other supportive care. Diazepam or lorazepam is the drug to be used. There is no reason to expect phenobarbitone administered at the time of fever to be effective in prevention of febrile convulsion. The parents should be counselled about the benign nature of the convulsion. Although the febrile convulsion a frightening event, still it is a benign condition.