Diagnostic and therapeutic studies in herpes simplex encephalitis [HSE]

Twenty children [aged 1:4 years] with suspected HSE are studied. Main clinical presentations were fever, focal seizures altered state of consciousness and focal neurologic deficits. C.S.F. examination was normal in three cases and abnormal in 17 [85%]; with pleocytosis, increased protein concentration and excess R.B.Cs. Serologic studies revealed elevation of antiherpes antibodies in C.S.F. in 4 cases [20%] and in serum in 7 cases [35%]. CT. examination was normal in 15 patients, and abnormal in 5 cases [25%] showing reduced enhancement [hypodense area] in temporal lobe [s]. E.E.G. was abnormal in all patients, it revealed Periodic Lateralized Epileptiform Distharge [P.L.E.D] in 17 cases and other patterns denoting encephalopathy and periodic epileptiform activity in the rest. All patients received specific antiviral antiherpes drug [Acyclovir], in a 10 days course. Complete recovery occur in 12 cases, 6 patients survived with some residue and 2 patients dieded. Validity of newer tools of investigations is discussed

Misuse of antiepileptic drugs in breath holding spell

Breath holding spells are not uncommon problems in pediatric practice and are frequently misdiagnosed as epilepsy. Fifty patients suffering from breath holding spells [37 cyanotic, 11 pallid and 2 mixed] misdiagnosed as epileptics, all to them receiving antiepileptic medications, were carefully studied. Proper management of cases was undertaken and withdrawal of antiepileptic drugs was carried out. All patients recovered in less than three months. Follow up for three months further, showed no recurrence of the attacks. Some cases have abnormal EEC patterns and in few of them, the abnormalities persisted, even when all attacks have stopped. Breath holding spells must be excluded before diagnosing epilepsy and embarking on antiepileptic medications. Exclusion and management as epilepsy will subject the patients to undeeded side effects of toxicity of antiepileptic medications, beside the occurrence of moral and behavioral disturbances as a result of neglect upbringing

Misuse of antiepileptic drugs in breath holding spell

Breath holding spells are not uncommon problems in pediatric practice and are frequently misdiagnosed as epilepsy. Fifty patients suffering from breath holding spells [37 cyanotic, 11 pallid and 2 mixed] misdiagnosed as epileptics, all to them receiving antiepileptic medications, were carefully studied. Proper management of cases was undertaken and withdrawal of antiepileptic drugs was carried out. All patients recovered in less than three months. Follow up for three months further, showed no recurrence of the attacks. Some cases have abnormal EEC patterns and in few of them, the abnormalities persisted, even when all attacks have stopped. Breath holding spells must be excluded before diagnosing epilepsy and embarking on antiepileptic medications. Exclusion and management as epilepsy will subject the patients to undeeded side effects of toxicity of antiepileptic medications, beside the occurrence of moral and behavioral disturbances as a result of neglect upbringing