Hypoxic-ischemic encephalopathy (HIE) remains a leading cause of neonatal brain injury, often resulting in long-term neurodevelopmental impairment. Therapeutic hypothermia (TH) is currently the only evidence-based treatment for HIE. This review summarizes volumetric magnetic resonance imaging (MRI) findings in children with HIE treated with TH. Across multiple studies, the hippocampus, thalamus, cerebellum, and basal ganglia consistently exhibit reduced volumes compared to healthy controls, though the statistical significance of these differences varies. Hippocampal volume reductions are observed in the neonatal period and later childhood, and are associated with poorer memory and cognitive outcomes. Thalamic and basal ganglia volumes are lower from the neonatal period through later childhood. Reduced thalamic volume is associated with impairments in cognitive and motor function. Cerebellar volume findings are inconsistent. Interpretation of volumetric differences remains challenging due to methodological heterogeneity across studies. Future studies are needed to validate volumetric biomarkers and establish normative data, facilitating the integration of volumetric MRI into early diagnostic and therapeutic stra­tegies for children with HIE.

Introduction and aim. Nowadays, almost 4% of people in the world suffer from depressive disorders, and the forecasts of further increase in incidence are alarming. The disease is debilitating and can lead to suicide, and available treatments are still imperfect. The aim of the study was to review the literature and present the potential role of the gut microbiota in the development of depression and to consider the use of prebiotics and probiotics as one of the therapeutic options in this disease. Material and methods. Review of articles published on PubMed since 2015. Analysis of the literature. The available reports point to a relationship between disturbances in the composition of the intestinal flora and the development of depressive disorders. In addition, more and more studies indicate the benefits of the influence on mood and clinical improvement, observed when using psychobiotics as an adjuvant treatment of depression, as well as monotherapy. Conclusion. Further research is needed in this area, especially in humans, to gain a deeper understanding of the role of the gut microbiota in depression and the promising use of psychobiotics for its treatment.

The SARS-CoV-2 virus that causes COVID-19 disease is still evolving and, despite the end of the acute phase of the pandemic, still poses a risk to public health. One of the very rare complications, occurring in less than 1% of children, is multisystem inflammatory syndrome in children (MISC). Due to the risk of thromboembolic complications as well as cardiac problems, MISC carries a number of life-threatening complications. We report a case of a 16-year-old boy who was hospitalized due to general weakness, fever, conjunctivitis, vomiting and diarrhoea. In view of the mother’s positive result of the SARS-CoV-2 test, the teenager underwent numerous laboratory tests. Taking into account the critical condition of the patient, anticoagulant and antipyretic treatment, steroids and IVIG were added. During hospitalisation, alarming symptoms occurred, including dysarthria, drooping corner of the mouth and muscle weakness on the right side. The magnetic resonance imaging showed changes characteristic of ischemic stroke. Further studies are needed to assess possible thrombotic complications in children after SARS-CoV-2 infection, and specialists should be more vigilant in paediatric patients presenting with such symptoms.

Introduction Leukodystrophies involve a diverse group of rare hereditary disorders mostly affecting the white matter of the central nervous system, which straddleses nerves and glial cells. Unfortunately, these conditions are often undervalued by doctors from various specialties. The aim of the article was to present the most common leukodystrophies occurring in children Material and methods A review of the most common leukodystrophies based on the available literature. We conducted a systematic literature review. We searched the PubMed and Google Scholar databases from 1997 to 2023. Conclusions Leukodystrophies are rare genetic diseases that often present with non-specific symptoms, which can pose diagnostic challenges. Ocular abnormalities and psychomotor delay in the early stages of life should raise suspicion. A combination of symptoms may suggest a pyramidal-extrapyramidal form of cerebral palsy. Therefore, it is crucial to include a head MRI examination in the diagnostic workup and carefully evaluate the findings, as subtle imaging changes can indicate the presence of leukodystrophies. Currently, no causal treatment for leukodystrophies has been developed. Hence, further research is needed to enable the introduction of gene therapies.

Introduction and aim. Paroxysmal non-epileptic events (PNEEs) are neurological conditions that include behavioral changes or disturbances of consciousness. The aim of the article is to compare individual paroxysmal non-epileptic events disorders, to indicate differences in their clinical picture and to discuss their differential diagnosis. Material and methods. A review of the most common non-epileptic paroxysmal events is presented based on the available literature of PubMed and Google Scholar databases from 2000 to 2023. Analysis of the literature. Depending on the age of the child, the nature and type of seizures are variable. Unfortunately, epilepsy is currently overdiagnosed, which results in the inclusion of antiepileptic drugs without the need to use them. This may be related to the immaturity of the central nervous system, malfunctioning of other organs or have a psychogenic background. In most cases, they do not require pharmacological treatment. Conclusion. Paroxysmal non-epileptic events, due to the diverse and uncharacteristic clinical picture, pose a major diagnostic challenge. Because of the current overdiagnosis of epilepsy they should always bear in mind differential diagnosis. This is important because of the differences in the treatment of these disorders.

Wstęp: Ostre zapalenie wyrostka robaczkowego jest najczęstszą ostrą chorobą jamy brzusznej u dzieci wymagającą leczenia chirurgicznego. Charakteryzuje się ostrym bólem brzucha, wymiotami oraz gorączką. W ostatnim czasie zapalenie wyrostka robaczkowego u dzieci łączone jest z wieloukładową chorobą zakaźną związaną z zakażeniem SARS-Cov-2. Opis przypadku: 15- letni chłopiec został przyjęty do szpitala z powodu dolegliwości bólowych. W badaniach laboratoryjnych stwierdzono wysoką leukocytozę oraz neutrofilię. Rozpoznano zgorzelinowe, perforowane zapalenie wyrostka robaczkowego z naciekiem kątnicy. Wykonano laparoskopową appendektomię. Dwa dni później w badaniu fizykalnym obecny był obustronnie dodatni objaw Goldflama. Podejrzewano kamicę moczową. W badaniu RTG nie stwierdzono cieni wapiennych w rzucie nerek i dróg moczowych, w prawej jamie opłucnowej stwierdzono obecność płynu. Następnie dołączyła gorączka oraz duszność. Założono drenaż opłucnowy i ewakuowano około 500ml płynu przesiękowego. Otrzymano również dodatni wynik testu PCR na obecność SARS-CoV-2. W kolejnych dniach ewakuowano ponownie około 500ml płynu z jamy opłucnowej. W badaniach laboratoryjnych obserwowano wzrost wskaźników zapalnych. Zmieniono antybiotykoterapię oraz włączono leczenie przeciwzakrzepowe. W badaniach ultrasonograficznych zdiagnozowano ropień w operowanej okolicy, który po kilku dniach uległ samoistnej inwolucji. Chłopiec przestał gorączkować, parametry zapalne stopniowo zmniejszały się. Pacjent również nie zgłaszał dolegliwości ze strony układu oddechowego. Wnioski: Analizując powyższy przypadek kliniczny można stwierdzić, że infekcja COVID-19 wpłynęła na przedłużenie hospitalizacji chłopca i mogła przyczynić się do nasilenia powikłań po appendektomii. Należy wziąć pod uwagę wystąpienie wieloukładowego zespołu zapalnego związanego z COVID-19. Warto rozważyć przeprowadzenie testów w kierunku SARS-CoV-2 u dzieci, które mają ciężkie objawy ze strony układu pokarmowego.