[Factors related to the short term remission of tics in children with Tourette syndrome].

Introduction: Tourette syndrome shows a fluctuating evolution, often masked by its comorbidity.

Objective: To study the clinical factors predicting the initial remission of tics in children with Tourette syndrome. Patients and methods.

Episodic spontaneous hypothermia: a periodic childhood syndrome.

Episodic spontaneous hypothermia is an infrequent disorder, with unknown pathogenic mechanisms. A systemic cause or underlying brain lesion has not been found for the disease. We report four new patients, 3-9 years old, with episodic hypothermia lower than 35 degrees C, marked facial pallor, and absent shivering.

[Disturbances of neuroblast migration and amniocentesis. An under diagnosed problem?].

Introduction: Performing amniocentesis between the fourth and sixth months of gestation is a widespread practice. However, it can entail serious consequences, apart from the loss of the foetus, such as injuries to the developing central nervous system.

Case Reports: Over the past few years we have dealt with four patients who were carriers of a focal disturbance of neuroblast migration, which could have its origins in amniocentesis.

[Neurological complications of non neurological disorders: from protagonism to comorbidity].

Introduction: The development of scientific advances, constantly opening new frontiers of knowledge, leads to increasing complexity and specialization.

Development: The conflict between the never ending medical specialization and the opposite tendency, which is based mostly on economic grounds, prevents the acquisition of new knowledge across different disorders and diseases. Considering the brain as a complex adaptative system, it follows that in order to understand its pathogenic mechanisms and to design new therapies, the study of the interrelation of all parts concerned must be undertaken.

[Sudden death in epilepsy: clinical experience].

Introduction: The disconcerting experience of sudden unexpected death in epilepsy (SUDEP) obliges the clinician to consider the differential diagnosis and study the mechanisms by which it may be prevented.

Clinical Case: A 13 year old patient with idiopathic generalized epilepsy and a history of febrile convulsions, both also described in the family history, who suddenly died at his home from no apparent cause. The legal autopsy findings were normal.

[Benign myoclonic epilepsy in infant].

Objective: To review the concept of benign myoclonic epilepsy of infancy in the literature as compared with our series of patients.

Patients And Methods: We review the literature and describe seven personal patients, three males and four females, diagnosed with benign myoclonic epilepsy of infancy according to Dravet's criteria.

Results: Six of the seven patients were followed along 6 26 years, three of whom showed an unfavourable evolution of their intellectual and behavioral development.

[The efficacy of lamotrigine in refractory infantile epilepsy].

Introduction: The new antiepileptic drugs should also be evaluated outside clinical trials.

Objective: To study the efficacy of treatment with lamotrigine in everyday neuropaediatric clinical practice.

Patients And Methods: We made a longitudinal study of all patients treated with lamotrigine in a hospital outpatients department.

Multilocular hydrocephalus: ultrasound studies of origin and development.

Multilocular hydrocephalus is a complication of neonatal hydrocephalus. Its main feature is the presence of multiple cysts inside the ventricles, which requires a specific therapeutic approach. The case of a preterm infant with intracranial hemorrhage grade II-III and central nervous system infection is reported.

[Sudden unexpected and unexplained death in epilepsy].

Introduction: Sudden unexpected death in epilepsy (SUDEP) is a rare and disconcerting event, scarcely reported in our country.

Development: The definition proposed at the last meeting of experts, in 1997, excludes all cases with a known cause of death, except for the seizure itself or the antecedent of epilepsy. The cause-effect relationship between epileptic seizure and sudden death has not been definitely proved but relies heavily on the following facts: 1.

[Opercular epileptic syndrome: an unusual form of benign partial epilepsy in childhood].

Introduction: Functional opercular syndrome in childhood is an exceptional form of presentation of benign partial epilepsy with centro-temporal rolandic spikes (BECRS).

Clinical Cases: We studied the evolution of four patients, three of them followed for more than 15 years. Two were siblings, and their father suffered from BECRS with permanent language problems (verbal dyspraxia) and difficulty of protunding his tongue in adulthood.

[Long-term follow-up of childhood epilepsy treated with vigabatrin outside of clinical trials].

Introduction: Experimental conditions are not mirrored by clinical practice.

Objective: To study the efficacy of vigabatrin in the usual conditions of everyday clinical practice.

Patients And Methods: Retrospective review of all epileptic patients treated with vigabatrin in a neuropediatric outpatient clinic.

[Neuropediatric clinical practice in a tertiary hospital of Basque Country].

Introduction: In our country, studies on the neuropediatric practice are scarce, in spite of their importance for planning of spending and resources, and definition of quality criteria.

Objective: To study the clinical workload of the main neuropediatric clinical problems.

Methods: Prospective, longitudinal, descriptive study of doctor-patient encounters, according to diagnosis, in the Child Neurology Division of a tertiaty hospital.

[About protocols, regulations and guidelines in clinical practice. Spanish Society of Pediatric Neurology].

Objective: In order to increase the awareness and perception of guidelines as a helpful tool in clinical practice, a description of its main features, foundations and social context is provided.

Development: Protocols, algorithms and guidelines are defined as instruments to improve patient care without interfering with the clinician's criteria regarding a particular patient. They are supported by the Evidence Based Medicine, and its development follows precise rules.

[Telephone consultation in child neurology practice: quantification and contents].

Introduction: The workload of telephone consultations has been scarcely studied except at the Emergency Units, in spite of the considerable amount of time consumed by the task in normal practice.

Objective: To asses the workload of telephone consultations in a Neuropediatric Unit, during normal working hours.

Methods: A prospective analysis of all calls received during a year, at the out-patient hospital-based neuropediatric clinic.

Resolution of MRI abnormalities of the oculomotor nerve in childhood ophthalmoplegic migraine.

Ophthalmoplegic migraine is an uncommon disorder, usually starting in older childhood. Its physiopathology remains obscure and diagnosis is reliant on clinical grounds and exclusion of other disorders. We report four cases of childhood ophthalmoplegic migraine, one of them starting in infancy.

[Profile of the patient who drops out of neuropediatric follow-up].

Introduction: Patients who drop out of programmed follow-up cause adverse effects to both themselves and the running of the medical.

Objective: To obtain information which would permit us to modify guidelines for medical care in cases with particular diagnoses, so as to avoid interrupting follow-up.

Patients And Methods: We selected all the patients who attended during 1995, and on 31 December 1995 had not been discharged or died.

[Etiology of epilepsy in adolescents].

Objective: To review the etiology of epilepsies in adolescent patients treated at the Child Neurology Clinic, during the years 1995-1997.

Patients And Methods: All 13 years old patients, or older, were selected and considered adolescents.

Results And Conclusions: A total of 863 patients with epileptic seizures were reviewed.

[Intraparenchymal hematomas: specific features in children].

Introduction: Intraparenchymatous haemorrhages are rare in infancy, but their effects may be very harmful. The aetiology, clinical characteristics and prognosis regarding life and function are different from those in adults.

Objective: We decided to analyze the characteristics of this pathology in children and compare them with those in adults.

[Therapeutic failure, treatment and non-treatment of childhood epilepsy].

Introduction: The classification of epileptic syndromes defines the prognosis and offers some orientation about treatment in childhood epilepsy.

Objective: To study the medical therapy according to epileptic syndromes in the everyday practice of a hospital based outpatient neuropediatric clinic.

Methods: Survey of the database using an algorithm to define therapeutic failure, treatment and spontaneous evolution, according to syndrome and drug, of all epileptic patients attended at the clinic during 1966.

[Brain lesions of perinatal and late prenatal origin in a neuropediatric context].

Introduction: The obstetric and neonatal technological advances have changed the frequency and syndromic classification of perinatal brain lesions.

Objective: To study all prevalent patients during 1996, with perinatal or late intrauterine brain lesions, in the outpatient neuropediatric clinic at our hospital.

Methods: Selection of patients according to neuroimaging findings, and/or neurological sequela with documented perinatal antecedent.

[Frontal lobe epilepsy in infancy: is there a benign partial frontal lobe epilepsy?].

Introduction: Only the organic and cryptogenic forms of frontal lobe epilepsy have been admitted by the ILAE, but according to several reports in the literature, it probably exists also an idiopathic form, at present not well recognized.

Objective: To study the differences between the organic and the cryptogenic forms of frontal epilepsy in our patients, that might indicate the presence of idiopathic cases within the presumed cryptogenic group.

Material And Methods: All patients diagnosed of frontal lobe epilepsy, EEG registered, at the neuropediatric clinic of our hospital during 1993-1996, were selected: 30 patients under 14 years of age that were classified as organic (10 cases) or cryptogenic (20 cases) according to CT or MRI findings.