scholarly journals Clinical and EEG features, treatment, and outcome of hot water epilepsy in pediatric patients

2020 ◽  
pp. 21-24
Author(s):  
Sevgi ÇIRAKLI ◽  
Ayşe Kaçar BAYRAM ◽  
Aslıhan DEMİR ◽  
Mehmet CANPOLAT ◽  
Sefer KUMANDAS ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Background Activity ◽  
The Body ◽  
Hot Water ◽  
Reflex Epilepsy ◽  
Impaired Consciousness ◽  
Focal Seizures ◽  
Interictal Eeg ◽  
Eeg Features

Background: Hot water epilepsy is a type of reflex epilepsy which generally occurs with pouring water on the body during bath. Objective: The aim of this study is to evaluate the clinical and electrophysiological features, treatment, and outcome of the pediatric patients with diagnosis of hot water epilepsy. Methods: Patients were followed and treated at Erciyes University, between January 2010 and January 2016. Results: There were 15 patients total, included 9 (60%) boys and 6 (40%) girls. The average age at diagnosis was 30 months (range: 13-60 months). The follow-up period was 16 months (range: 12-48 months). Seven patients (46.6%) had focal seizures with impaired consciousness, four (26.7%) had focal seizure and four (26.7%) had focal starting and generalized tonic-clonic continuing seizures. Seven patients (46.6%) had abnormal interictal EEG findings, ranged from unilateral slowing of the background activity to bilateral sharp wave. Intermittent clobazam treatment (0.8-1.2 mg/kg) was given to 13 patients (86.7%). Other epileptic treatments were used in 5 (33.3%) patients. Three patients (20.0%) developed nonreflex seizures during followup period. Conclusions: Intermittent clobazam prophylaxis prior to hot water bath, as well as changing bathing habits can be effective in pediatric patients with hot water epilepsy.

scholarly journals Ruxolitinib Might Be an Effective Hormone Reduction and Replacement Drug in Children With Secondary Hemophagocytic Lymphohistiocytosis 

2020 ◽  
Author(s):  
Ying Chi ◽  
Rong Liu ◽  
Zhixuan Zhou ◽  
Xiaodong Shi ◽  
Yuchuan Ding ◽  
...  
Keyword(s):  
Body Temperature ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Conventional Treatment ◽  
Pediatric Patients ◽  
Neuropsychiatric Symptoms ◽  
The Body ◽  
Control Group ◽  
Control Group Group ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Abstract Background: To analyze the effects of ruxolitinib on children with secondary hemophagocytic lymphohistiocytosis (HLH).Methods: Eleven pediatric patients diagnosed with HLH and treated with ruxolitinib (ruxolitinib group: group R) between November 2017 and August 2018 were retrospectively analyzed. Eleven age-matched pediatric patients with HLH undergoing conventional treatment (control group: group C) were also analyzed.Results: In group R, three patients who did not respond to conventional treatment (dexamethasone and etoposide) were treated with Ruxolitinib and their temperature decreased to normal levels. Four patients had normal temperature after conventional treatment, but they had severe organ involvement, including obvious yellowing of the skin, increased liver enzyme levels and neuropsychiatric symptoms, and they were all ameliorated with ruxolitinib treatment. Four patients were relieved with ruxolitinib therapy alone. In group C, the body temperature of eleven patients all decreased to normal levels after conventional treatment. The body temperature of group R patients decreased to normal levels more rapidly than that of group C patients. The hormone dosage in group R was significantly lower than that in group C. Both groups were followed up for 2–2.5 years. No obvious adverse drug reactions of ruxolitinib were observed during treatment and follow-up.Conclusion: Ruxolitinib might be an effective drug in controlling body temperature and reducing inflammation indicators. It might be a potential replacement for hormone therapy for HLH treatment in children, thereby reducing or avoiding hormone-related adverse reactions.

scholarly journals Temporal Onset Focal Seizures Induced by Intermittent Photic Stimulation

2021 ◽  
Vol 12 ◽  
Author(s):  
Yue Niu ◽  
Pan Gong ◽  
Xianru Jiao ◽  
Haipo Yang ◽  
Zhixian Yang
Keyword(s):  
Photic Stimulation ◽  
Pediatric Epilepsy ◽  
Temporal Area ◽  
Focal Seizures ◽  
Left Posterior ◽  
Intermittent Photic Stimulation ◽  
Interictal Eeg ◽  
Interictal Discharges ◽  
Electroencephalogram Eeg

The study aimed to review the clinical, radiological, and pathological findings and electroencephalogram (EEG) of pediatric epilepsy patients with temporal onset focal seizures induced by intermittent photic stimulation (IPS). Four patients with temporal onset photosensitivity focal seizures were analyzed. Three (75%) of the four patients were female. The average age of seizure-onset was 4.4 years. The interictal EEG showed both generalized and focal spike and waves in one patient and focal or multifocal spike and waves alone in three patients. Photoparoxysmal response (PPR) was evoked in all patients and showed generalized discharges (patients 2–4), both generalized and posterior discharges (patient 1). Both generalized and focal discharges could coexist in interictal discharges and PPR. The sensitive frequencies of PPR and photoconvulsive response (PCR) were 12–30 and 10–16 Hz, respectively, which were close to the occipital rhythm. In all patients, the onset of PCR was recorded, namely, the left anterior and mesial temporal lobe (TL), the left posterior TL, and the whole left TL, which showed two forms: the seizure of two patients was the onset of slow waves in the temporal area without spreading generalized discharges (patients 1 and 4), and the other one was fast rhythmic activities in the temporal area, spreading to the occipital area or gradually evolving into the generalized discharges (patients 2 and 3). During follow-up, except for patient 3 who had occasional seizures, the seizures of the remaining patients were under control. Temporal onset focal seizures could be induced by IPS. Temporal onset photosensitivity seizures were mostly easy to control with antiseizure drugs.

Complex clavicle fractures in children: Kids are not little adults

Trauma ◽  
2017 ◽  
Vol 21 (1) ◽  
pp. 35-39
Author(s):  
Hayk Stepanyan ◽  
William Hennrikus ◽  
Derek Flynn ◽  
David Gendelberg
Keyword(s):  
Pediatric Patients ◽  
Adult Population ◽  
Clavicle Fracture ◽  
The Body ◽  
Bony Union ◽  
Dash Score ◽  
Non Union ◽  
Fractures In Children ◽  
Clavicle Fractures

Background The clavicle is the most commonly fractured bone in the body and accounts for 10–15% of all pediatric fractures. Adult patients with complete midshaft clavicle fractures often undergo surgical management. Pediatric patients have a thicker periosteum, more robust blood supply and a greater healing potential. Controversy exists as to whether to treat adolescents with surgery similar to adults versus with a sling as children are treated. Some orthopaedic surgeons are now operating on adolescent clavicle fractures. Objective The objective of the study was to evaluate the outcomes of displaced midshaft clavicle fractures in adolescent who were treated conservatively with a sling. Methods We performed a retrospective chart review of 25 pediatric patients aged 12–16 with complete midshaft clavicle fracture. The outcomes of the study were bony union and functional outcomes such as pain, problems with ADL measured by the modified Disability of Arm, Shoulder, and Hand (DASH) score. Results All patients in our cohort had excellent outcomes at follow-up visits with no complaints of pain or limitations of activities of daily living. Mean follow-up time was 12 months. All patients had perfect modified DASH score of 18. Injury radiographs demonstrated an average of 13 mm shortening initially and 8 mm shortening in final follow-up. Average fracture angulation at final follow-up was 15°. Normal clavicle angulation at the mid shaft is 8°. All clavicles healed completely with no case of malunion or non-union reported. Conclusion Clavicle fractures are common. Although operative treatment of clavicle fractures in the adult population is gaining popularity due to issues in adults with non-union and malunion, the adolescent population is different. The adolescent clavicle fracture demonstrates robust healing and remodeling and complete return to full function. We therefore recommend that adolescent patients aged 12–16 with complete clavicle fracture be treated conservatively with a sling.

Hot Water Epilepsy

2019 ◽  
Vol 08 (04) ◽  
pp. 100-102
Author(s):  
Alcy R. Torres ◽  
Marleny Aquino-Cabrera ◽  
Mugdha Mohanty
Keyword(s):  
Common Type ◽  
Effective Therapy ◽  
Hot Water ◽  
Review Of The Literature ◽  
Reflex Epilepsy ◽  
Focal Seizures ◽  
Triggering Factor ◽  
Impaired Awareness ◽  
Clonic Seizures ◽  
Higher Temperature

AbstractHot water epilepsy (HWE) is a type of reflex epilepsy in which seizures are precipitated by pouring water at a higher temperature during bathing onto the head or body. The etiology is still not known and is presumably both genetic and environmental. Focal seizures with impaired awareness are the most common seizure types and generalized tonic-clonic seizures are the second common type of seizures. The diagnosis is clinical. Interictal electroencephalography and neuroimaging are usually normal. Treatment consists of avoidance of the triggering factor. However, in cases where this option is not effective, antiepileptics can be used. Clobazam appears to be the most effective therapy, particularly for pure HWE. This is an up-to-date review of the literature.

scholarly journals Ruxolitinib treatment permits lower cumulative glucocorticoid dosing in children with secondary hemophagocytic lymphohistiocytosis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ying Chi ◽  
Rong Liu ◽  
Zhi-xuan Zhou ◽  
Xiao-dong Shi ◽  
Yu-chuan Ding ◽  
...  
Keyword(s):  
Body Temperature ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Conventional Treatment ◽  
Pediatric Patients ◽  
Neuropsychiatric Symptoms ◽  
The Body ◽  
Control Group ◽  
Control Group Group ◽  
Secondary Hemophagocytic Lymphohistiocytosis

Abstract Background This study aimed to analyze the effects of ruxolitinib on children with secondary hemophagocytic lymphohistiocytosis (HLH). Methods Eleven pediatric patients diagnosed with HLH and treated with ruxolitinib (ruxolitinib group: group R) between November 2017 and August 2018 were retrospectively analyzed. Eleven age-matched pediatric patients with HLH undergoing conventional treatment (control group: group C) during the same period were also analyzed. Results In group R, three patients who did not respond to methylprednisolone (MP) pulse and intravenous immunoglobulin (IVIG) therapies were treated with Ruxolitinib and their temperature decreased to normal levels. Four patients had normal temperature after conventional treatment (dexamethasone and etoposide, with or without cyclosporine A), but they had severe organ involvement, including obvious yellowing of the skin, increased liver enzyme levels and neuropsychiatric symptoms, and they were all ameliorated with ruxolitinib treatment. Four patients were relieved with ruxolitinib therapy alone. In group C, the body temperatures of eleven patients decreased to normal levels after conventional treatment. The body temperature of group R patients decreased to normal levels more rapidly than that of group C patients. The glucocorticoid dosage in group R was significantly lower than that in group C. Both groups were followed-up for 2–2.5 years. No obvious adverse drug reactions to ruxolitinib were observed during treatment and follow-up. Conclusion Ruxolitinib might be an effective drug in controlling body temperature and reducing inflammation indicators. It might be a potential replacement for glucocorticoid therapy for HLH treatment in children, thereby reducing or avoiding glucocorticoid-related adverse reactions.

CARBOHYDRATE PRODUCT FOR THERAPEUTIC AND PROPHYLACTIC PURPOSES

2020 ◽  
pp. 89-94
Author(s):  
Khvorova L.S. ◽  
Byzov V.A.
Keyword(s):  
Antioxidant Activity ◽  
Uric Acid ◽  
Phenolic Compounds ◽  
Mental Stress ◽  
The Body ◽  
Hot Water ◽  
Preventive Effect ◽  
Activity Inhibition ◽  
Medicinal Properties ◽  
Simple Carbohydrates

The article is devoted to the creation of a carbohydrate product with rosehip extract in the form of sweets (glucose Fudge) with a therapeutic and preventive effect aimed at restoring the body of people exposed to intense physical and mental stress and the effects of damaging environmental factors. As carbohydrates in the recipe, simple carbohydrates (glucose) and complex carbohydrates in the form of starch molasses containing (maltose, tri - Tetra - sugars, dextrins) are used. Glucose in the formulation is the main energy ingredient, sweetener and structure-forming component that gives the product a solid consistency due to crystallization. The medicinal effect of the product is provided by rosehip extract. Numerous published studies have established its vitamin, immunostimulating and antioxidant activity, inhibition of uric acid formation and obesity, which are associated with flavonoids, other phenolic compounds, and vitamins. The list of medicinal properties of rosehip extract shows the feasibility of using it in additional nutrition of people in order to prevent diseases. For the formulation of our sweets, the extraction of crushed rosehip fruits was carried out three times with hot water at a temperature of 65-700C, followed by concentration of the extract under vacuum to 25-30% SV. The resulting extract-concentrate was introduced into the formulation in a dosage of 5.5% SV per 100 g of SV glucose Fudge, which provided the necessary dosage for the product when used from 3 (for children) to 10 sweets a day (for adults) for the prevention of colds.

Long-term outcomes of lumbar microdiscectomy in the pediatric population: a large single-institution case series

2019 ◽  
Vol 24 (5) ◽  
pp. 549-557
Author(s):  
Malia McAvoy ◽  
Heather J. McCrea ◽  
Vamsidhar Chavakula ◽  
Hoon Choi ◽  
Wenya Linda Bi ◽  
...  
Keyword(s):  
Conservative Management ◽  
Functional Outcomes ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Case Series ◽  
Csf Leak ◽  
Single Institution ◽  
The Mean

OBJECTIVEFew studies describe long-term functional outcomes of pediatric patients who have undergone lumbar microdiscectomy (LMD) because of the rarity of pediatric disc herniation and the short follow-up periods. The authors analyzed risk factors, clinical presentation, complications, and functional outcomes of a single-institution series of LMD patients over a 19-year period.METHODSA retrospective case series was conducted of pediatric LMD patients at a large pediatric academic hospital from 1998 to 2017. The authors examined premorbid risk factors, clinical presentation, physical examination findings, type and duration of conservative management, indications for surgical intervention, complications, and postoperative outcomes.RESULTSOver the 19-year study period, 199 patients underwent LMD at the authors’ institution. The mean age at presentation was 16.0 years (range 12–18 years), and 55.8% were female. Of these patients, 70.9% participated in competitive sports, and among those who did not play sports, 65.0% had a body mass index greater than 25 kg/m2. Prior to surgery, conservative management had failed in 98.0% of the patients. Only 3 patients (1.5%) presented with cauda equina syndrome requiring emergent microdiscectomy. Complications included 4 cases of postoperative CSF leak (2.0%), 1 case of a noted intraoperative CSF leak, and 3 cases of wound infection (1.5%). At the first postoperative follow-up appointment, minimal or no pain was reported by 93.3% of patients. The mean time to return to sports was 9.8 weeks. During a mean follow-up duration of 8.2 years, 72.9% of patients did not present again after routine postoperative appointments. The total risk of reoperation was a rate of 7.5% (3.5% of patients underwent reoperation for the same level; 4.5% underwent adjacent-level decompression, and one patient [0.5%] ultimately underwent a fusion).CONCLUSIONSMicrodiscectomy is a safe and effective treatment for long-term relief of pain and return to daily activities among pediatric patients with symptomatic lumbar disc disease in whom conservative management has failed.

Long-term stability of fusiform dilatation of the internal carotid artery following surgery adjacent to the circle of Willis: report of 2 cases

2020 ◽  
pp. 1-4
Author(s):  
Madeline B. Karsten ◽  
R. Michael Scott
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Arachnoid Cyst ◽  
Pediatric Patients ◽  
Internal Carotid ◽  
Imaging Finding ◽  
Neurological Status ◽  
Suprasellar Region

Fusiform dilatation of the internal carotid artery (FDCA) is a known postoperative imaging finding after craniopharyngioma resection. FDCA has also been reported following surgery for other lesions in the suprasellar region in pediatric patients and is thought to be due to trauma to the internal carotid artery (ICA) wall during tumor dissection. Here, the authors report 2 cases of pediatric patients with FDCA. Case 1 is a patient in whom FDCA was visualized on follow-up scans after total resection of a craniopharyngioma; this patient’s subsequent scans and neurological status remained stable throughout a 20-year follow-up period. In case 2, FDCA appeared after resection and fenestration of a giant arachnoid cyst in a 3-year-old child, with 6 years of stable subsequent follow-up, an imaging finding that to the authors’ knowledge has not previously been reported following surgery for arachnoid cyst fenestration. These cases demonstrate that surgery involving dissection adjacent to the carotid artery wall in pediatric patients may lead to the development of FDCA. On very long-term follow-up, this imaging finding rarely changes and virtually all patients remain asymptomatic. Neurointerventional treatment of FDCA in the absence of symptoms or significant late enlargement of the arterial ectasia does not appear to be indicated.

Effects of background substraction on differential kidney function measured by static scintigraphy with DMSA and dynamic scintigraphy with MAG 3

2008 ◽  
Vol 47 (01) ◽  
pp. 43-47 ◽  
Author(s):  
A. Smokvina ◽  
S. Grbac Ivanković ◽  
V. Licul ◽  
N. Girotto
Keyword(s):  
Kidney Function ◽  
Background Subtraction ◽  
Background Activity ◽  
Ratio Method ◽  
Uptake Ratio ◽  
Kidney Size ◽  
Significant Difference ◽  
Laboratory Changes ◽  
Dynamic Scintigraphy

SummaryThe aim of this study was to assess the influence of background subtraction (BS) on estimation of differential kidney function (DF) on the static scintigraphy with 99mTc dimercaptosuccinic acid (DMSA) and dynamic scintigraphy with 99mTc mercaptoacetyltriglicine (MAG3) and to establish possible differences between DF values estimated with these methods. Patients, methods: Patients (n = 106) were selected among those scheduled to static and dynamic scintigraphies within 3 months, with no interim clinical and laboratory changes, regardless the kidney pathology. DF was estimated according to the uptake ratio method. Four background regions of interest (ROIs) were applied, identical for both studies, and DF values were recalculated after BS. The corrected values were compared to the values before correction, separately for DMSA and MAG3, and between the studies. The results showed that ROIs used introduce variable results for the same patients, predominantly when noncorrected DF values were <45%. There were no significant differences between DF values (corrected and noncorrected) obtained from static and dynamic scintigraphy in all groups of patients. Since numerous reasons can bring to the errors in DF estimation when BS is used, the conclusions are that it would probably be more accurate to avoid BS, particularly when DF values are compared in a patient follow-up, and when kidney function is normal. BS should be used, but always in the same way, only when there is a significant difference in kidney size, or when DF is <25%, since background activity is then considerable. MAG3 and DMSA can be equally used for DF estimation and their results compared in patient follow-up.

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