An Adolescent Case of Recurrent Episodes of Ophthalmoplegic Migraine / 대한소아신경학회지

Ophthalmoplegic migraine (OM) is a poorly understood neurological syndrome characterized by recurrent headaches with paresis of the ocular cranial nerves. The third cranial nerve is most commonly affected; the fourth and sixth nerve less so. The etiology, pathophysiology, and definitive treatment of OM remain unclear. We here report a 12-year-old girl who presented with recurrent OM attacks. This adolescent patient demonstrated contrast-enhanced oculomotor nerves on magnetic resonance imaging during OM episodes and marked responses to steroid treatment. The findings in our present study emphasize the difficulty of OM diagnosis, even with new International Headache Society criteria, because patients rarely fulfill all of the relevant characteristics at the same time.

Neuropsychiatric Manifestations of Childhood Systemic Lupus Erythematosus / 대한소아신경학회지

PURPOSE: Systemic lupus erythromatosus (SLE) is an autoimmune disease which involves multiple organs, including the central nervous system. Neuropsychiatric (NP) involvement is one of the major causes of morbidity and mortality in children with SLE. The aim of this study was to evaluate neuropsychiatric manifestations and to find the clinical factors associated with the development of NP manifestation in children with SLE (NPSLE). METHODS: We retrospectively reviewed the medical records of 51 patients diagnosed with SLE at Asan Medical Center Children's hospital between April 1998 and January 2011. Clinical factors between patients with NP manifestations and patients without NP manifestations were compared. RESULTS: NPSLE developed in 41.2% (21/51) of the patients with SLE. The mean age of onset was 13.0 (8-19) years. Twelve patients (57.1%) developed NP manifestations within 1 month after the diagnosis of SLE. NP manifestations included seizures (47.6%), headaches (42.9%), movement disorders (9.5%), peripheral neuropathy/AIDP (9.5%), stroke/TIA (9.5%), psychosis (4.8%). As comparing clinical factors, hematological profile and immunologic profile between patients with NP manifestations and patients without NP manifestations, there were no significant differences between the two groups. CONCLUSION: NP symptoms are common in children with SLE, especially within 1 month after the diagnosis of SLE. However, there were no clinical factors or laboratory profiles that may predict the development of NPSLE. Therefore, careful monitoring of NP manifestations may be important in children with newly-diagnosed SLE and prompt immunomodulatory treatment should be considered.