Optimizing anticonvulsant administration for children before anesthesia: a quality improvement project.

Objective: Children with epilepsy are at increased risk of missing scheduled anticonvulsants during the home-to-hospital transition, including when being admitted for procedures requiring anesthesia. This may contribute to breakthrough seizures because of lowered anticonvulsant levels. We conducted an interdisciplinary quality improvement project with a specific aim to increase the percentage of children receiving their anticonvulsants as scheduled before procedures requiring anesthesia.

Emergency department use of computed tomography in children with epilepsy and breakthrough seizure activity.

Children with epilepsy are frequently evaluated in the emergency department for breakthrough seizure activity. This population is at risk for undergoing repeated computed tomography (CT) scans. The long-term health risks associated with CT scans has been the subject of multiple articles in recent years.

Childhood autoimmune neurologic diseases of the central nervous system.

An autoimmune mechanism for ADEM and MS can be supported by the similar patterns of pathologic changes seen in both diseases with the animal model EAE induced by inoculating animals with nervous tissue and the occurrence of ADEM in patients exposed to nervous tissue during vaccination. Whereas there are no universally agreed-upon criteria for the diagnosis of ADEM, a combination of prodromal illness or preceding vaccination, MRI signs of demyelination, and an acute presentation of neurologic symptoms are the triad most commonly looked for in making the diagnosis of ADEM. An ever-increasing number of infections and vaccinations (nonspecific URIs being most common) has been associated with ADEM.