Papilledema and abducens nerve palsy associated with vitamin B12 deficiency

Papilledema is defined as optic disc swelling that is secondary to elevated intracranial pressure. Vision is usually well preserved with this condition. The optic discs appear blurred in papilledema. Elevation in intracranial pressure is due to variety of reasons of which intracranial hemorrhageis the most common. We present a case in which our patient developed papilledema due to vitamin B12 deficiency. Lateral rectus muscle palsy occurs due to abducens nerve palsy. The lateral rectus muscle is responsible for lateral movement of the eyeball, specificallyabduction. Its palsy results in sudden onset of horizontal double vision, which is worse when the patient looks to the affected side. There is also limited outward movement of the affected eye. Abducens nerve palsy can occur due to ischemia injury, stroke, infection, brain tumour, elevated intracranial pressure, or inflammation of the nerve. In our patient the abducens nerve palsy was due to homocysteinemia secondary to dietary vitamin B12 deficiency. Homocysteine is a potent atherosclerotic risk factor and can cause ischemic nerve palsy, as seen in our patient.

Professor Antonio Branco Lefèvre: the forefather of child neurology in Brazil / Professor Antonio Branco Lefèvre o pai da neurologia infantil no Brasil

OBJECTIVE: To report on the life and works of Prof. Antonio Branco Lefèvre and the relevance that led him to be considered the Forefather of Child Neurology in Brazil. METHOD: The method utilized was the historical documents research; bibliographical. RESULTS: Antonio Branco Lefèvre (1916-1981) was born in São Paulo city; graduated in 1941 from the São Paulo Medical School. The date - 1950 - can be considered when Child Neurology took shape for a fully specialty, when Lefèvre presented his two internationally acclaimed thesis. Lefèvre was recognized as he founder of Child Neurology in Brazil since the early years of his brilliant academic activities. In 1967 achieved the title of professor in the Child Neurology Clinic. His numerous trainees and Residents - from -1950 to 1981 - held today key positions in Brazilian Child Neurology. CONCLUSION: The extension and importance of the Child Neurology School of which he is the legitimate founder is recognized.

OBJETIVO: Relatar a vida e obra do Prof. Antonio Branco Lefèvre e a relevância que leva a ser denominado o Pai da Neurologia Infantil no Brasil. MÉTODO: Pesquisa de documentos históricos e bibliográfica. RESULTADOS: Antonio Branco Lefèvre (1916-1981) nascido em São Paulo; formou-se na Faculdade de Medicina de São Paulo em 1941. A data de 1950 pode ser considerada quando a Neurologia Infantil tornou-se uma especialidade completa quando Lefèvre defendeu suas duas teses aclamadas internacionalmente. Lefévre foi reconhecido como o Pai da Neurologia Infantil no Brasil desde os primeiros anos de sua carreira acadêmica brilhante. Em 1967 atingiu o título de Professor de Neurologia Clínica Infantil. Seus numerosos estagiários e Residentes - de 1950 a 1981 - têm hoje posições de destaque na Neurologia Infantil brasileira. CONCLUSÃO: É reconhecida a extensão e a relevância da escola de Neurologia Infantil da qual Lefèvre é o legítimo fundador.

An Assessment of Statistical Methods in the Journal of Korean Child Neurology Society, 1993-2003 / 대한소아신경학회지

PURPOSE: A clinical trial cannot be adequately interpreted without information about the methods used in the design of the study and the analysis of the results. We would like to evaluate trends in statistical methods and describe the frequency with which various statistical techniques are reported in the Journal of Korean Child Neurology Society. METHODS: We reviewed 288 original articles published in the Journal of Korean Child Neurology Society from 1993 to 2003 to assess the statistical methods. RESULTS: The number of cross-sectional study was 232(80.6%) articles and that of animal study was 45(15.6%) articles but Cohort study was only eleven(3.8%) articles. One hundred twenty seven(44.1%) articles used no statistical methods or descriptive statistics only, frequency of which decreased yearly and 84 articles(29.2%) used T-test, frequency of which increased yearly. Seventy two(25%) articles used contigency tables and twenty three(8.0%) articles used ANOVA. Orphan P where no statistical methods had been specified and only the P value given was presented in 19 articles(6.6%) which decreased yearly. CONCLUSION: These results suggest that medical articles published in the Journal of Korean Child Neurology Society, 1993-2003, were short of their expected quality and the validity of statistical methods used appears to be seriously compromised in this period and has much to be done to improved the current situation. It is concluded that a basic training in biostatistical methods, more consultation of medical investigators with statistician or other experts, careful review by someone in biostatistics or research design before accepting a manuscript are needed.