[Brain tumors in nursing infants]. / Tumores cerebrales en lactantes.

The purpose of this study was to determine the anatomical-pathological distribution of brain tumors in children under two years of age and their clinical characteristics (age, sex, time span from the start of symptoms or signs to the time the tumor was diagnosed, main clinical manifestations, evolution and prognosis). From 1981 to 1989, 16 children with brain tumors, under two years of age, were studied. The tumors arose in 13 patients during first year of life and during the second, in the remaining three. In 50% of the patients, the tumors were supratentorial. The histological diagnosis was made in all cases, finding the ependymoma the most frequent tumor, followed by the astrocytoma and other tumors: teratoma, choroid plexi papilloma. The increase in size was within the cephalic perimeter, with a risen fontanelle, irritability, vomiting and convulsive episodes, as main clinical manifestations. In 15 of the patients a partial or total resection of the tumor was performed, 6 were given radiotherapy and 2 chemotherapy. The prognosis correlated with the greatest surgical risk, the anatomical-pathological characteristics and the lateness in its diagnosis. We emphasize the greater morbi-mortality rate with respect to other pediatric ages.

[Usefulness of clobazam in the treatment of refractory epilepsy in children]. / Utilidad del clobazam en el tratamiento de la epilepsia refractaria en niños.

Below is report on our experience using a relatively new benzodiazepine as treatment for refractory epilepsy in 30 children. All of the patients had a severely fixed encephalopathy; 17 presented mixed epilepsy, 9 had Lennox-Gastaut syndrome and 4 others, West Syndrome. The seizures were totally controlled in 20% of the children; in a proportion superior to 75%, seizures were decreased in 46% of the patients. There were positive results in 6% of the cases and side-effects were seen in 13%. The usefulness of the clobazam as a co-adjuvant medication in the control of refractory epileptic seizures was demonstrated since the number of seizures decreased from 15 to 3 per day.

[Acute hemiplegia in childhood and alternating hemiconvulsions secondary to Moya-Moya disease. Report of a case associated with Down's syndrome]. / Hemiplejía aguda de la infancia y hemiconvulsiones alternantes secundarias a enfermedad de Moya-Moya. Reporte de un caso asociado a síndrome de Down.

Moya-Moya disease has been associated to a number of disease entities including Down syndrome. Initial clinical manifestations in our patient were alternating lateralizing seizures with sudden onset hemiparesis. Ct scan demonstrated several infarcts in different stages of evolution, in the territory of left middle cerebral artery. Single digital subtraction angiography showed bilateral occlusion, predominantly on the left side of the supraclinoid portion of the interna carotid arteries with formation of collateral circulation in the diencephalic territory. The association of Moya-Moya disease and Down syndrome is not fortuitous and it is probably due to a congenital vascular dysplasia. It should be suspected in children with trisomy 21 (with or without congenital heart disease) who presents with alternating hemiplegia and convulsions or acute hemiplegia.