Epilepsy among children in Greenland.

INTRODUCTION: Epilepsy has been considered to be more frequent in Greenland than in Denmark, where the prevalence among children is 0.40%. STUDY DESIGN: Evaluation of the prevalence, diagnosis and treatment of epilepsy among children in Greenland aged 0-15 years. METHODS: During autumn 2000, 13 out of 18 hospitals in Greenland were visited. The population of children in the areas visited was 11,965 of a total of 15,226 in Greenland. All children with the diagnosis of epilepsy were referred for evaluation and the diagnosis was confirmed. When possible, informed consent was obtained to collect data from medical records. RESULTS: 43 children (18 boys) had the diagnosis of epilepsy. For 38 (15 boys) further data were obtained. Mean age was 8.5 years (3-14) for boys and 7.9 years (2-14) for girls. The age at diagnosis was 4.9 years (1-11) for boys and 4.2 years (0-10) for girls. The prevalence of epilepsy was 0.34%. In 31 cases an electroencephalograph (EEG) recording was done, comprising sleep recordings in 26 cases. Medication was according to recommendations in Denmark. CONCLUSION: The prevalence of epilepsy in children and the medical treatment of epilepsy among children in Greenland is the same as in Denmark.

Persisting pain after cholecystectomy. A prospective investigation.

A prospective survey of the short-term outcome after cholecystectomy was carried out under circumstances in which the study itself did not influence preoperative decision making or surgical procedures. Of 122 consecutive patients, 115 were evaluable. In all cases gallstones were verified preoperatively either by oral cholecystography or by ultrasonography. Follow-up study was 6-12 months postoperatively. Ninety-one patients (79.1%) reported satisfactory outcome in terms of complete relief of preoperative symptoms. Age, sex, preoperative pain characteristics, history of disease, type of surgery, histology, and complications did not predict the surgical outcome. A test for psychic vulnerability was included among preoperative data items. Psychic vulnerability was significantly associated with persisting pain irrespective of the above-mentioned factors. This suggests that psychologic factors influence the outcome after cholecystectomy with regard to pain relief.

Epstein-Barr virus infection and serological profile in Greenland Eskimo children.

The Epstein-Barr virus (EBV)-specific antibody profile of 101 Greenland Eskimo children was determined. The proportion of children with serological evidence of recent or past primary EBV infections rose from 22% at 6 months of age to 79% at 24 months of age. All but 2 of 49 children more than 4 years of age proved seropositive. The geometric mean titre (GMT) of antibodies to the viral capsid antigen (VCA) was highest during the first 3 years of life and declined sharply to a lower, nearly constant level in older children. The GMT of antibodies to the nuclear antigen (EBNA), rose slowly during the first 4 years of life to its persistent level. None of the children had a history of illnesses comparable to infectious mononucleosis. The results have shown that in this population with an enhanced risk of nasopharyngeal carcinoma, primary EBV infection occurs at a very early age.

X-linked congenital adrenal hypoplasia. A study of five generations of a Greenlandic Family.

In a Greenlandic family comprising 171 descendants in 5 generations, 11 boys had died with a clinical picture of adrenocortical insufficiency within three weeks of birth. Three treated male patients, who survived, were closely studied. The adrenal glands could not be identified by computed tomography. The clinical picture and biochemical studies were consistent with congenital adrenal hypoplasia. The pedigree indicates X-linked recessive inheritance. The pubertal development was delayed in two patients aged 14 years. LHRH stimulation yielded a significant rise in LH and FSH in at least one of the patients, adrenal androgen values were very low. A family instruction programme has been set up.