Effects of valproic acid, carbamazepine, and phenobarbitone on the fatty acid composition of erythrocyte membranes in children.

Purpose: To investigate a possible relation between antiepileptic drugs (AEDs) and the fatty acid composition of membranes.

Methods: Fatty acid (FA) composition of erythrocytes was studied in children with epilepsy receiving AED monotherapy. Children taking valproate (VPA, n = 28), carbamazepine (CBZ, n = 17), or phenobarbitone (PB, n = 14) were compared with healthy controls (n = 25).

Topiramate enhances the risk of valproate-associated side effects in three children.

Purpose: We present three children with severe therapy-refractory epilepsy who tolerated valproate (VPA) well in various combinations with other antiepileptic drugs (AEDs) but developed typical VPA side effects in combination with topiramate (TPM).

Methods: The clinical symptoms began with apathy in all three children; two of them also had hypothermia. Furthermore all children had elevated blood ammonia levels, one child in combination with increased liver transaminases and one with thrombocytopenia.

[Long-term follow-up MRI in children with craniocerebral trauma].

Purpose: A prospective study was initiated for the correlation of the findings in the initial cranial CT with the long-term follow-up MRI in children with severe head injury. Another aim was the evaluation of frequency and location of lesions, found only in MRI.

Methods: 70 children with severe head injury and initially performed pathological CCT were followed up (mean time 3 years) by MRI.

Long-term follow up of children with head injuries-classified as "good recovery" using the Glasgow Outcome Scale: neurological, neuropsychological and magnetic resonance imaging results.

Unlabelled: The primary issues addressed in this study were: (1) determination of the significance of the classification "good outcome" utilizing the Glasgow Outcome Scale (GOS) in children at least 1 year after brain injury; (2) detection of residual lesions of brain parenchyma in these children upon follow up MRI scans; and (3) detection of relationships between neuropsychological test performance and MRI results. Selection criteria included children 6-15 years of age at the time of testing who received an initial CT scan at the time of their head injury and who had been injured at least 12 months prior to the follow up test. Only children who did not demonstrate neurological disability at the time of follow up examination were selected.

How reliable is the predictive value of SEP (somatosensory evoked potentials) patterns in severe brain damage with special regard to the bilateral loss of cortical responses?

Objective: In patients sustaining severe brain damage (SBD), prediction of later outcome is often very difficult, in particular under conditions of therapeutic management like relaxation and intravenous phenobarbital. Somatosensory evoked potentials (SEP) correlated best with later prognosis and expected neurological deficit. In detail, the primary bilateral loss of cortical responses (BLCR) is regarded to be a reliable marker for poor prognosis.

[Not Available].

We report on a strikingly frequent referral of former preterm babies with respiratory syncytial virus (RSV) infection and subsequent ARDS in our hospital during the winter 1994/95 with regard to the clinical course under application of alternative treatment modalities. Treatment modalities like inhalational ribavirin, use of bronchodilators and instillation of surfactant had been tried without success. All children (age: 1-43 months) were ventilated for 6.

MRI of encephalitis in children: comparison of CT and MRI in the acute stage with long-term follow-up.

We examined 14 children aged 28 days to 12.7 years with encephalitis by CT or MRI. Of the patients examined by CT 58% had a normal first scan, whereas all MRI investigations demonstrated abnormalities.

Prognosis and outcome of neonates treated either with veno-arterial (VA) or veno-venous (VV) ECMO.

A comparison was done between neonates requiring veno-arterial (VA) ECMO (too small jugular vein, inability to insert a 12 Fr double lumen catheter or cardio-circulatory instability) and neonates treated with veno-venous (VV) ECMO in the same period of time. From 1991-1995 ECMO was done in 48 neonates after failure of maximum conventional treatments, NO-inhalation and HFOV. 30/48 babies were treated with VV-ECMO, with a switch to VA-ECMO later on in 3 of them.

Neonatal stroke involving the middle cerebral artery in term infants: clinical presentation, EEG and imaging studies, and outcome.

Six children with neonatal cerebral infarction of the middle cerebral artery are reported. Seizures or respiratory distress were the initial symptoms. In some cases abnormal findings appeared earlier on EEG than on ultrasound.

Magnetic resonance angiography in 140 neuropediatric patients.

Three-dimensional magnetic resonance angiography (MRA) is a noninvasive technique that images the intracranial arterial vasculature without contrast agents. The suitability of MRA was evaluated for routine use and all children were prospectively studied with conventional MR imaging and time off flight MRA (FISP3D). All MR studies were performed on a 1.

Severe hepatotoxicity during valproate therapy: an update and report of eight new fatalities.

Since our last report on valproate (VPA)-related hepatotoxicity in 1988, 8 other children have died of VPA-associated liver failure in Germany and Switzerland. We compared the clinical course of these children with that of 6 children with a reversible outcome of severe hepatotoxicity related to VPA. Thirty-five percent of patients with fatal liver failure were normally developed, 23.

Childhood progressive spinal muscular atrophy with facioscapulo-humeral predominance, sensory and autonomic involvement and optic atrophy.

A female child of healthy parents developed rotary nystagmus at the age of 15 months. Ophthalmoscopy disclosed incomplete optic atrophy. Blood tests, EEG and CT scans were normal.

[High frequency oscillatory ventilation of infants with severe respiratory disorders: possibilities, risks and limits].

By pediatricians the high frequency oscillatory ventilation (HFOV) is used almost only in the neonatal period. We report on the administration of HFOV in infants with pulmonary insufficiency after failure of conventional ventilatory support. 6 infants (aged 2-7 months, all former preterm babies) were referred to our hospital due to severe pneumonia after unsuccessful conservative management.

GM-2 gangliosidosis (Sandhoff's disease): two year follow-up by MRI.

Two children with GM-2 gangliosidosis type 0 (Sandhoff's disease) followed up by MRI at 1.5 Tesla for 1.8 years are reported.

Results of parenchymal and angiographic magnetic resonance imaging and neuropsychological testing of children after stroke as neonates.

We describe the long-term follow up of infants after neonatal stroke of the middle cerebral artery (MCA). Stroke was diagnosed by CT scan in eight full-term neonates. Three dimensional (volume) magnetic resonance angiography (MRA) is a noninvasive technique that images the arterial vessels without contrast agents.

[Hemimegalencephaly. Therapy with hemispherectomy].

Hemimegalencephaly is associated with a poor clinical course characterized by intractable seizures and severe encephalopathy. We present a case report of a girl with hemimegalencephaly. At the age of 9 month hemispherectomy was undertaken to preserve function of the other hemisphere.

Neurological findings in newborn infants after extracorporeal membrane oxygenation, with special reference to the EEG.

Seventeen newborn infants were treated with extracorporeal membrane oxygenation (ECMO). Two died shortly after the start of ECMO due to the underlying disease, two died later in the course due to a lack of recovery of lung function and two others died weeks after ECMO from renal damage and a cardiac defect. Of the survivors, nine are developing normally (aged between one and four years) and two are severely disabled because of infarctions of the left hemisphere, acquired before and after ECMO.

[Unusual symptoms in brain tumors in childhood].

Headache, nausea, ataxia and diplopia are leading symptoms of brain tumors in children. We report of 3 children with unusual symptoms and findings. Patient 1 complained of occasional headaches.

Psychiatric disturbances in children with hamartomas: a neglected somatopsychic issue. A case report.

To date, in publications on hamartomas, precocious puberty and laughing seizures have been discussed, but behavioural and cognitive abnormalities have been neglected. Therefore, we report a 14-year-old girl with a proven hamartoma, in which abnormalities of behaviour and cognition played an important role within the somatopsychic complex. In our patient, urinary incontinence during the seizures and psychiatric symptoms, such as eating disorder with obesity, school phobia, antisocial behaviour, withdrawal and cognitive problems (e.

[Risk of recurrent seizures after the first afebrile grand mal seizure in childhood].

A cohort of 74 children three months to 16 years-old who presented with a first unprovoked seizure were followed for five years to assess the risk of recurrence. Children with febrile convulsions, immediate posttraumatic seizures, meningitis and encephalitis were not included. The risk of recurrence was 68% for a second seizure.

[Precocious puberty and laugh attacks].

A 7 year old girl presented with precocious puberty and ictal laughter. Brief, repetitive, stereotyped attacks of laughter were the first manifestation of the epileptic syndrome. Stages of puberty were noted as B III-IV and PH II according to Tanner.

[Intrathecal production of neopterin in meningitis in childhood].

A major activator of antigen presenting cells (APC) is gamma interferon a product of activated T-lymphocytes. CNS is not well studied and represents a unique system with respect to the immune reactions. Neopterin is an indirect marker of gamma interferon deliberation and may give some new information on the role of APC in CNS.