Differences in Mean Platelet Volume and Platelet Count between Children with Simple and Complex Febrile Seizures.

OBJECTIVE: The aim of our study was to find the relationship of MPV (Mean Platelet Volume) levels and platelet counts as markers of inflammation between simple and complex febrile seizures. MATERIALS & METHODS: In this retrospective comparative study, we investigated the recordings of 356 children between 5 months and 6 yr with diagnosis of simple and complex febrile seizure (SFS&CFS) in Amircola's Children's Hospital, Babol University of Medical Sciences, Babol, Iran between Mar 2011 and Dec 2015. RESULTS: Mean age was similar in two groups. The MPV of the CFS group (8.32±0.48fl) was lower than that of the SFS group (8.58±0.34fl) but this difference was not significant statistically. The platelet count of the CFS group (315.03×103 ±117.17×103) was higher than that of SFS group (291.82×103 ± 87.49×103) but there was no significant statistical difference. CONCLUSION: We did not find significant differences between two groups. Therefore, further studies about this idea should be performed.

Prognosis of Guillain-Barré Syndrome in Children.

OBJECTIVE: Guillain-Barre Syndrome (GBS) is an acute polyradiculoneuropathy characterized by progressive motor weakness of limbs and areflexia. In this study, our aim was to evaluate the clinical pattern and prognosis of children with Guillain-Barre syndrome. MATERIALS & METHODS: This cross-sectional study was conducted in the Pediatric Neurology Unit of Amirkola Children's Hospital, Babol, Iran during the period of 5 years from October 2008 to September 2013. We assessed the clinical features, results of electrodiagnostic tests, functional status, treatment and outcome of 17 children diagnosed with GBS. RESULTS: Of 17 (male to female ratio = 1.6:1) children studied, all had motor weakness, 4 children (23.5 %) and cranial nerve palsies. Respiratory paralysis was found in one child requiring assisted ventilation. Antecedent illness preceding GBS was recorded in 7 (41.2%) children. The GBS subtype distribution as per electrodiagnostic studies was as follows: acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 12 (70.6%) acute motor axonal neuropathy (AMAN) in 3 (17.6%), acute motor sensory axonal neuropathy (AMSAN) in 2 (11.8%). IVIG constituted the treatment given in all of the patients. Complete recovery was observed in 16 children and the remaining one child was dependent to wheelchair. CONCLUSION: GBS in children is not poor prognostic disorder and our recommendation is administration of IVIG as soon as possible after clinical diagnosis. Except for one child who remained wheelchair bound, there was no mortality or morbidity in long-term observation. Besides, strong limitation of our study was the low number of subjects.

Acute necrotizing encephalopathy of childhood; a case report.

Acute necrotizing encephalopathy of childhood (ANEC) is a disease characterized by respiratory or gastrointestinal infection and high fever accompanying with rapid alteration of consciousness and seizures. This disease is nearly exclusively seen in East Asian infants and children who had previously been completely healthy. Serial magnetic resonance imaging examinations have demonstrated symmetric lesions involving the thalami, brainstem, cerebellum, and white matter in this disease. The condition accompanies a poor prognosis with high morbidity and mortality rates. A 22-month-old toddler with ANEC hospitalized in Amirkola Children Hospital is being reviewed.

Zinc status in febrile seizure: a case-control study.

OBJECTIVE: Febrile seizure is the most common type of seizure in children. Their incidence is 2-5%. There are different hypotheses about relationship between neurotransmitters and trace elements (such as zinc) and febrile seizure. Zinc, as a major element of some enzymes, plays an important role in the central nervous system (CNS) and can affect some inhibitory mechanisms of CNS. The aim of the present study was to determine whether there were any changes in serum zinc level in children with febrile seizure in comparison with febrile children without seizure. MATERIALS & METHODS: This case-control study was performed on 100 patients aged 6 months to 6 years. This study was conducted between January and August 2012, on 50 children with febrile seizures (case) and 50 febrile children without seizures (control), that were referred to Amirkola Children Hospital (a referral hospital in the north of Iran). Two groups were matched for age and sex. The serum zinc levels in the both groups were determined by atomic absorption spectrophotometry method. RESULTS: The mean serum zinc level was 0.585±0.166 mg/L and 0.704±0.179 mg/L in the case group and the control group, respectively (p=0.001). The mean serum zinc level was significantly lower in the febrile seizure group compared to the control groups. CONCLUSION: Our findings revealed that serum zinc level was significantly lower in children with simple febrile seizure in comparison with febrile children without seizure. It can emphasize the hypothesis that there is a relation between serum zinc level and febrile seizure in children.

Debilitating progressive encephalitis in a patient with BTK deficiency.

X-linked agammaglobulinemia (XLA), also known as Bruton's tyrosine kinase (BTK) deficiency, is a primary antibody deficiency, characterized by low number of B cells, agammaglobulinemia and increased susceptibility to a variety of infections. Herein, we report a case of XLA with confirmed BTK mutation that developed neurological deficits. While we could not detect any responsible microorganism in spite of comprehensive workup, brain magnetic resonance imaging revealed moderate brain atrophy. The diagnosis of progressive encephalitis was made for this patient. Patients with XLA have a higher chance of encephalitis compared with other primary antibody deficiencies. Given the violent nature of encephalitis, it is a concern among XLA patients.

Acute generalized weakness in patients referred to Amirkola Children's Hospital from 2005 to 2010.

BACKGROUND: Diseases that cause acute flaccid paralysis (AFP) often progress rapidly, thus may cause life threatening complications, therefore, their diagnosis and cure are important. This study was carried out to investigate the causes of acute generalized weakness in children referred to Amirkola Children's Hospital, in Babol, Iran. METHODS: In this case series, the epidemiological causes of the disease and clinical features of 15 cases with acute generalized weakness from April 2005 to September 2010 were evaluated. The data were collected and analyzed. RESULTS: The mean age of cases was 4.7±3.5 years. The male/female ratio was 2. Twenty cases had Guillain-Barre syndrome, two with myositis and one with periodic hyperkalemic paralysis. CONCLUSION: Guillain-Barre syndrome is the most common cause of AFP in children admitted due to acute generalized weakness in Amirkola Children's Hospital.