ABSTRACT
The classification of epilepsy includes a group of generalized idiopathic epilepsies that are triggered by a specific mode of activation, known as reflex epilepsies. Photosensitive epilepsy is the most common type. Some patients with photosensitive epilepsy use this sensitivity to induce seizures or epileptiform discharges on the electroencephalogram. In some patients, psychopharmacological treatment, for instance with selective serotonin reuptake inhibitors and neuroleptics, has demonstrated benefit insofar as self-induction of seizures is concerned. However, so far as we know, there are no documented cases of treatment with methylphenidate in patients with this type of seizure. Our purpose is to report the case of an 8-year-old girl with attention-deficit hyperactivity disorder (ADHD) and self-induced photosensitive epilepsy whose behavior in general, and self-inducing behavior in particular, improved dramatically following treatment with methylphenidate.
Subject(s)
Central Nervous System Stimulants/therapeutic use , Epilepsy, Reflex/drug therapy , Methylphenidate/therapeutic use , Attention Deficit Disorder with Hyperactivity/complications , Attention Deficit Disorder with Hyperactivity/drug therapy , Child , Epilepsy, Reflex/complications , Female , HumansABSTRACT
Meralgia paresthetica is a mononeuropathy affecting the lateral femoral cutaneous nerve that is extremely rare in children. Two adolescent females, aged 11 and 13 years, presented due to tingling and pain on the side of the thigh of 2 to 3 weeks duration. The general examination revealed mild obesity; the neurological examination of both patients is normal except for pain, hypo- or hyperesthesia on the side of the quadriceps. An electromyogram was performed in the first case that reveals decreased conduction velocity of the affected lateral femoral cutaneous nerve. The younger child was treated successfully with diet and topiramate; the second patient's symptoms disappeared after initiating conservative measures. Meralgia paresthetica is probably underdiagnosed in the pediatric population. First-line treatment should be conservative, but topiramate may be useful for the treatment of meralgia paresthetica, although broader studies are needed to evaluate its true effectiveness in this pathological condition.
Subject(s)
Femoral Neuropathy/therapy , Obesity/therapy , Adolescent , Anti-Obesity Agents/therapeutic use , Child , Female , Femoral Neuropathy/diagnosis , Femoral Neuropathy/physiopathology , Follow-Up Studies , Fructose/analogs & derivatives , Fructose/therapeutic use , Humans , Muscle, Skeletal/physiopathology , Neural Conduction , Obesity/diagnosis , Obesity/drug therapy , Obesity/physiopathology , Pain/diagnosis , Pain/physiopathology , Pain Management , Topiramate , Treatment OutcomeABSTRACT
The authors report the case of a pair of siblings with 3-methylglutaconic aciduria type 4 manifesting as Leigh syndrome. Disease progression was monitored from birth until the present. Both patients fulfilled the diagnostic criteria for Leigh syndrome along with increased urinary excretion of 3-methylglutaconic acid and 3-methylglutaric acid (biochemical markers of methylglutaric acid) in several determinations. No mitochondrial respiratory chain defects in muscle biopsy were detected. Although mitochondrial abnormalities are the most common known cause of Leigh syndrome, there have been several reports of links with nonmitochondrial metabolic disorders. Descriptions of 3-methylglutaric acid type 4 associated with Leigh syndrome are rare.
