ABSTRACT
In this study, we report 11 patients with intractable childhood epilepsy that improved following acute viral infection. The patients were 8 boys and 3 girls. Six of the 11 children were diagnosed as West syndrome (5 of the symptomatic type and 1 of the cryptogenic type). The remaining 5 children were myoclonic seizures. The patients became seizure free within 6 days following acute viral infections without an exchange or addition of antiepileptic drugs (AEDs). The types of acute viral infections were Exanthema subitum (Roseola infantum) in 5 patients, Rotavirus gastroenteritis in 2 patients, Measles infection in 2 patients, Herpetic stomatitis in 1 patient and Common cold in the remaining patient. Salaam seizures and/or tonic spasms disappeared within 6 days after the onset of viral infections, and hypsarrhythmia evolved to localized spikes on electroencephalography (EEG) in the patients with West syndrome. Epileptic seizures disappeared rapidly and EEG gradually normalized or improved in patients with myoclonic seizures. Four patients became seizure free for 5 years to 20 years. In 6 patients, seizures relapsed within 14 days to 1 month after the disappearance of seizures. One child remained seizure free for 12 months after viral infection. Common factors in 4 children who were continuously seizure free include (1) normal or almost normal findings of brain CT/MRI, (2) normal development prior to the onset of epileptic seizures, and (3) a short time interval between the onset of seizures and the acute viral infection. We propose several hypotheses including an immunological effect for the improvement of intractable childhood epilepsy following acute viral infection. Further study may provide important information concerning the mechanism of seizure control and the applicable to treatment for intractable childhood epilepsy.
Subject(s)
Epilepsies, Myoclonic/drug therapy , Epilepsies, Myoclonic/etiology , Spasms, Infantile/drug therapy , Spasms, Infantile/etiology , Virus Diseases/complications , Acute Disease , Child, Preschool , Electroencephalography , Epilepsies, Myoclonic/physiopathology , Female , Humans , Infant , Magnetic Resonance Imaging , Male , Spasms, Infantile/physiopathology , Virus Diseases/virologyABSTRACT
To evaluate auditory spatial cognitive function, age correlations for event-related potentials (ERPs) in response to auditory stimuli with a Doppler effect were studied in normal children. A sound with a Doppler effect is perceived as a moving audio image. A total of 99 normal subjects (age range, 4-21 years) were tested. In the task-relevant oddball paradigm, P300 and key-press reaction time were elicited using auditory stimuli (1000 Hz fixed and enlarged tones with a Doppler effect). From the age of 4 years, the P300 latency for the enlarged tone with a Doppler effect shortened more rapidly with age than did the P300 latency for tone-pips, and the latencies for the different conditions became similar towards the late teens. The P300 of auditory stimuli with a Doppler effect may be used to evaluate auditory spatial cognitive function in children.
Subject(s)
Event-Related Potentials, P300/physiology , Evoked Potentials, Auditory/physiology , Sound Localization/physiology , Acoustic Stimulation , Adolescent , Adolescent Development , Adult , Age Factors , Child , Child Development , Child, Preschool , Doppler Effect , Electroencephalography , Female , Humans , Male , Reaction Time , Regression AnalysisABSTRACT
We report a case of severe rhabdomyolysis associated with Salmonella encephalopathy. A 3-year-old girl was admitted to our hospital because of status convulsives and unconsciousness. She was diagnosed as having Salmonella encephalopathy with rhabdmyolysis, and was treated by mild hypothermia and mechanical ventilation. Five days later she developed anuria with increased serum levels of myoglobin, CK and creatinine. And the diagnosis of acute renal failure was made. Peritoneal dialysis was begun from 6 days after admission. Hyperinfusion, the usual therapy of rhabdomyolysis, was not performed. She survived showing gradual improvement of renal function and consciousness. In a case of rhabdomyolysis complicating a neurologic disorder, a well-known poor prognostic factor, priority should be given to brain protection rather than to symptomatic treatment of rhabdomyolysis.
Subject(s)
Brain Diseases/microbiology , Rhabdomyolysis/etiology , Salmonella Infections/complications , Acute Kidney Injury/etiology , Acute Kidney Injury/therapy , Brain Diseases/complications , Brain Edema/complications , Child, Preschool , Female , Humans , PrognosisABSTRACT
BACKGROUND: For evaluation of spatial cognitive function, we studied the brain evoked potentials (EP) of 3-D auditory stimuli in regard to the change of latencies in normal subjects aged 1-21 years and compared them with patients who have mental retardation (MR). METHODS: A total of 144 normal subjects and 67 patients with MR were tested. The EP were elicited by 1000 Hz fixed and enlarged tones with Doppler effect randomly presented. No specific task was imposed in relation to the auditory stimuli. Electroencephalograms were recorded at the Fpz, Fz, Cz, Pz and Oz scalp locations (10-20 system), referenced to linked earlobes. The 64 responses of EP were averaged. The EP were measured from the difference in waveform by subtracting the EP of the fixed tone stimuli from that of the enlarged tone stimuli. RESULTS: The waveforms of EP consisted of the components P0, N1, P1, N2 and P2. These components (P0, N1, P1, N2 and P2) in the EP gradually shortened with increasing age in children. About 30% of patients with MR showed more prolonged latencies than normal subjects. CONCLUSION: These results suggest that these components indicated auditory kinetic evoked potentials. This developmental change could be related to maturational phenomena regarding spatial cognitive function. The EP of 3-D auditory stimuli may be used in children to evaluate the development of spatial cognitive function.
