Paraneoplastic neurological disorders in children with benign ovarian tumors.

Aim: Paraneoplastic neurological diseases (PND) are rare, but potentially treatable disorders. Paraneoplastic encephalitis is rapidly emerging as an important but likely under-recognized condition in children. The aim of this study was to assess the prevalence and spectrum of PND in children with benign ovary tumor and the long-term outcome.

Tc-99m HMPAO brain SPECT imaging in children with acute cerebellar ataxia.

Purpose: We prospectively evaluated consecutive cases of acute cerebellar ataxia in children to identify brain perfusion SPECT features associated with acute cerebellar ataxia and to correlate the brain SPECT findings to clinical severity and prognosis.

Results: Among the 10 consecutive children with acute cerebellar ataxia, 7 had abnormal Tc-99m HMPAO brain SPECT findings (4 cerebellar hypoperfusion, 5 unilateral cortical and/or subcortical hypoperfusion, and 1 unilateral cortical hyperperfusion), in contrast to no abnormalities disclosed by CT or MR imagings. Furthermore, the extent of brain perfusion SPECT abnormalities correlated significantly with the clinical severity and the recovery time of cerebellar ataxia.

Long-term neuroplasticity effects of febrile seizures in the developing brain.

Febrile seizures (FS) are the most common seizure disorder in childhood, occurring in 2%-5% of children. Regarding the large number of children with FS, it is important to delineate whether early-life FS alters long-term neuroplasticity, especially the neurocognitive function and subsequent temporal lobe epilepsy (TLE). Recent epidemiological studies reassure that most FS do not adversely affect global intelligence and hippocampal function, such as memory.

Neonatal adrenoleukodystrophy presenting with seizure at birth: a case report and review of the literature.

Neonatal seizures are critical conditions because they are usually related to significant illnesses that require a specific therapy. Antepartum and peripartum seizures are very rare, and represent signs of prenatal-onset neurologic dysfunction. A review of the literature revealed that the main etiologies include severe brain malformations, multiple anomalies, and metabolic encephalopathy.

Diagnostic approach to recurrent bacterial meningitis in children.

Recurrence of bacterial meningitis in children is not only potentially life-threatening, but also involves or induces psychological trauma to the patients through repeated hospitalization and multiple invasive investigations if the underlying cause remains undetected. Bacteria migration, along congenital or acquired pathways from the skull or spinal dural defects, gains entrance into the central nervous system (CNS) and should be taken into consideration when children face recurrent bacterial meningitis, however, symptoms and signs of cerebrospinal fluid (CSF) rhinorrhea or otorrhea are rare in such patients. Without evidence of CSF leakage, a cranial symptom/sign or coccygeal cutaneous stigmata may suggest the approximate lesion site, diagnosis and detection remains difficult.

Seizures complicating infantile and childhood bacterial meningitis.

In this study, 116 patients, at least 1 month of age but younger than 5 years, were identified with culture-proven bacterial meningitis. A comparison was made between the clinical data of the patients with and without seizures during hospitalization. Seizures during acute bacterial meningitis accounted for 47% (55/116) of the episodes.

Bacterial meningitis in infants: the epidemiology, clinical features, and prognostic factors.

This 16-year (1986-2001) retrospective study enrolled 80 infantile patients (aged, 30-365 days old) with culture-proven bacterial meningitis. The most prevalent pathogens were Salmonellaspecies, Streptococcus (S.) agalactiae, Escherichia (E.

A clinical and electrophysiologic survey of childhood Guillain-Barré syndrome.

In this 16-year (1986-2001) retrospective study, 23 childhood patients were identified with Guillain-Barré syndrome. According to clinical and electrophysiologic findings, 18 patients manifested acute inflammatory demyelinating polyradiculoneuropathy, 2 had Miller Fisher syndrome, 1 had axonal forms, and 2 were unclassified. Seasonal preponderance was evident in 39% of patients with Guillain-Barré syndrome, developing the disease in the winter (November to January) with upper respiratory infection the most frequent preceding event.

Neonatal bacterial meningitis in southern Taiwan.

To determine the epidemiologic trends, prognostic factors, and therapeutic results of neonatal bacterial meningitis, 60 neonatal patients with culture-proven neonatal bacterial meningitis were enrolled in this study. To compare changes over time, the appearance of disease among the patients was divided into two equal periods (1986-1993 and 1994-2001). Group B streptococci were the most common causative pathogens, accounting for approximately 32% of the episodes.

Vocal cord paralysis after transcatheter coil embolization of patent ductus arteriosus.

Background: In patients with patent ductus arteriosus (PDA) after Gianturco coil embolization, vocal cord paralysis (VCP) had not been previously described. This study investigates the risk factors of coil embolization associated with VCP.

Methods: We reviewed the medical records of all patients who had undergone transcatheter closure of PDA with a Gianturco coil between March 1998 and May 2001, and 75 patients (age range, 6 months to 55 years; mean age, 5.

Echocardiographic guidance for transcatheter coil occlusion of patent ductus arteriosus in the catheterization laboratory.

The objective of this study was to investigate the feasibility of transthoracic echocardiography as a guide to monitor the completeness of patent ductus arteriosus (PDA) occlusion immediately after coil implantation. In all, 52 patients who underwent Gianturco coil implantation for PDA occlusion were evaluated by transthoracic echocardiography within 15 minutes after the first coil implantation in the catheterization laboratory. According to Doppler echocardiographic findings, these patients were classified into 3 groups: group 1, complete occlusion without residual shunt; group 2, a residual PDA diameter < 1 mm and no continuous waveforms detected; and group 3, a residual PDA diameter >or= 1 mm or continuous waveforms.

Periodic lateralized epileptiform discharges of pediatric patients in Taiwan.

Periodic lateralized epileptiform discharges are special electroencephalographic abnormalities present in adults with stroke, brain tumor, intracranial hemorrhage, or other rare etiologies. Few reports focused on the etiologies in pediatric patients. We retrospectively reviewed 8002 of our pediatric electroencephalographic records for the past 12 years and listed all associated illness and their outcomes.

Tuberculous meningitis in infancy.

The lack of specific symptoms and signs in patients with tuberculous meningitis makes early diagnosis difficult. To our knowledge, there has been no report in the literature focusing on tuberculous meningitis patients younger than 1 year of age. In this report, we reviewed the clinical features and laboratory findings of seven infants with tuberculous meningitis encountered during a 15-year period.

Oral wooden stick injury complicated by meningitis and brain abscess.

Meningitis is rarely seen following oral injury. We describe a 3-year-old boy developing meningitis and brain abscess following a penetrating oral wooden stick injury. There was no cerebrospinal fluid rhinorrhea noted.

Transcranial ultrasound diagnosis of intracranial lesions in children with headaches.

The diagnostic value of transcranial ultrasound for intracranial lesions in children with headaches was evaluated. From January 1995 to December 1998, 444 children with headaches for more than 2 weeks visited our Pediatric Neurologic and Neurosurgical Outpatient Clinics. A 2-MHz-sector sonographic transducer was used to perform transcranial ultrasound.