Acute necrotizing encephalopathy is a rare type of acute encephalopathy characterized by multi-focal brain lesions and associated severe neurological findings and various organ dysfunctions may accompany it. Patients with acute necrotizing encephalopathy of childhood diagnosed by pediatric neurology and pediatric intensive care at Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital between 2007 and 2020 were included in this study. Nine patients (six females, three males) with a mean age of 4.05±1.94 years (age range 1-6.5) were included in this study. The interval range between fever and encephalopathy in patients was 1-4 days. Influenza A (3H1N1, one untyped) was detected in four patients, influenza B in three patients, and no cause was found in two patients. Major clinical findings other than febrile encephalopathy in all patients were a hemodynamic shock in seven patients, seizures in six patients, vomiting in five patients, dystonia in three patients, and flaccid paralysis in the upper extremity in one patient. Despite all our treatment approaches, including plasmapheresis, moderate to severe neurological sequelae was observed in all of our patients, who survived even with significant radiological improvement. Three patients for whom we could not perform plasmapheresis died. Our study revealed that thalamic involvement increased as the interval shortened, and brainstem involvement increased in patients over four years of age. The presence of persistent vomiting accompanying encephalopathy during the parainfectious period and plasmapheresis treatment being a treatment option that could prevent mortality were cautionary for our study.
28 March 2023 in Turkish Journal of Child and Adolescent Mental Health
Permanent junctional reciprocating tachycardia (PJRT) is most often observed in infants and children and can lead to incessant tachycardia. PJRT is usually refractory to medical treatment. Tachycardia may infrequently occur in the fetus in which case fetal tachycardia transplacental treatment should be started immediately. Term delivery is recommended for fetuses with tachycardia in the absence of significant clinical compromise to avoid complications of preterm birth. Herein, a 36-week preterm neonate presented with PJRT. He had tachycardia in the fetal period and was treated with digoxin, amiodaron, and esmolol therapy after birth without undergoing the catheter ablation procedure.
Malnutrition is common in children with cerebral palsy (CP) due to feeding difficulties, altered body composition, and functional limitations, making an ac
A specific learning disorder (SLD) is a neurodevelopmental disorder in which academic skills, such as reading, writing, and mathematics ability, are below the expected range. This study was conducted to determine the relationship between spike-wave index and SLD in children. We recruited 110 child psychiatry outpatients (38 girls, 72 boys) with SLDs for this study between January 2015 and March 2018. The mean ± standard deviation patient age was 9.17 ± 1.87 years. Electroencephalography (EEG) findings were abnormal in 20.9% of children. We found that children with expressive language delay and who were born prematurely had a significantly higher risk of spike-wave index. Attention deficit/hyperactivity disorder was present in 55.5% of children with SLD. This comorbidity was significantly higher in children with a history of prenatal smoking exposure or premature birth. The EEG findings were particularly important in cases of SLD in children who were born prematurely and had expressive language delay. The spike-wave index is a potential marker of SLD and can be easily and noninvasively detected by EEG.