[Periodic breathing with periodic oxygen variation in infancy]. / Periodische Atmung mit periodischen Sauerstoffschwankungen im Säuglingsalter.

Oxycardiorespirographies, recording arterial oxygen saturation (SaO2), breathing movements, heart rate and ECG with a mean recording time of 22.3 hours, were performed on 85 preterm (mean postconceptional age: 38 weeks) and 81 term infants (mean postconceptional age 42.4 weeks). 83% of the preterm infants showed periodic breathing (PB), in 97% of them this was accompanied by periodic variations of arterial oxygen saturation (PVO). Periodic breathing occurred in 61% of the term infants, 84% of them showed PVO during periodic breathing. The mean variation of oxygen saturation was between 92.8 and 96.8% (+/- 1.7) for preterm and between 92.9 and 96.0% (+/- 2.2) for term infants. In some infants the peak to peak amplitude of the SaO2 cycles was up to 22%, sometimes a further fall of SaO2 occurred. There was a strong correlation of the PVO both at the beginning and end of the episode as well as with the PB-cycle periodicity itself. The fall of the oxygen saturation occurred 3.1 to 7.8 s after the beginning of the first apnea of an episode of periodic breathing, the minimum SaO2 was reached approximately 4.2 to 8.6 s later. This periodic rapid fall of SaO2 from a high oxygenation level cannot be explained by the apneas of a rather short duration during periodic breathing. It is discussed that PVO during periodic breathing may be caused by an ideopathic right to left shunting across fetal circulation pathways which occurs intermittently and periodically. This mechanism could-via patterns of reaction exhibited during the fetal and neonatal time period-lead to acute hypoxemia, as found in apparently life threatening events (ALTE) and as postulated in sudden infant death (SID).

[Herpes encephalitis in infancy]. / Herpes-Enzephalitis im Säuglingsalter.

Since antiviral chemotherapy is available herpes encephalitis has become of great importance among viral affections of the central nervous system. Five young infants are presented with special problems of this disease and its diagnostic possibilities especially serological and imaging methods (CT scan, nuclear magnetic resonance tomography, ultrasonography of the brain) as well as electroencephalography. Clinical symptoms are very important since all those methods are not sufficient for early diagnosis and prompt onset of antiviral chemotherapy. Herpes encephalitis should be considered after apparent febrile seizures with focal symptoms as well as increasing disturbance of consciousness as manifestation of acute encephalopathy.

[New aspects of differential vertigo diagnosis in childhood]. / Neue Aspekte zur Differentialdiagnose des kindlichen Schwindels.

Eight cases of vertigo in childhood are reported. Four of them suffered from benign paroxysmal vertigo, and the other four from atypical migraine. History of a head injury and attacks of vertigo lasting only a few seconds are typical of benign paroxysmal vertigo. These children are older than 4 years and the vertigo is of peripheral origin. Vertigo due to atypical migraine is frequent in young children up to 4 years of age, shows a longer duration of vertigo (more than 1 min) and is of central origin.