Nervous system assessment with evoked potential tests in pediatric bone marrow transplant patients.
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Adolescent↗
Biomedical subjects
W D Shields
Publications and source records attributed to W D Shields.
Myoclonic, atonic, and absence seizures following institution of carbamazepine therapy in children.
Five children, aged 3 to 11 years, treated with carbamazepine for epilepsy, had an acute aberrant reaction characterized by the onset of myoclonic, atypical absence and/or atonic (minor motor) seizures within a few days. When the carbamazepine was discontinued, two of the children returned to their former state very quickly, two had the minor motor seizures resolve in 3 and 6 months, and one had the seizures persist. The child in whom the seizures persisted was later found to have ceroid lipofuscinosis. The other children are doing well on other anticonvulsants.
Carbamazepine↗
Torticollis in three children with syringomyelia and spinal cord tumor.
There are numerous well-known causes of acquired torticollis. However, an extensive review of the literature reveals only a rare, brief remark that associates torticollis with syringomyelia. We present three children found to have syringomyelia and spinal cord tumor, with torticollis as an early finding in each.
Astrocytoma↗
Serum CK-BB isoenzyme in preterm infants with periventricular hemorrhage.
Periventricular hemorrhage in the preterm infant kills or injuries thousands annually. Because of the relatively recent emergencies of PVH as a major problem, the pathophysiology of this disorder is not yet known. This study was performed to examine the relationship between brain origin creatine kinase and the occurrence of PVH, both prior to the time of the hemorrhage and after. Twenty-six preterm infants were studied. Serum CK-BB levels were obtained at birth, if possible, and twice daily thereafter for four to seven days. The PVH was proven by either CT scan or autopsy. Infants with PVH had significantly higher average serum levels of CK-BB when compared to infants without, both immediately after birth and during the follow-up period.
Brain↗
Effects of dipropylacetate on brain development.
Dipropylacetate (DPA: valproic acid) is a new anticonvulsant reported to be effective in many types of seizures including those that occur early in life. This study describes the effects of chronic administration of DPA upon a developing organism. Four-day-old rat pups were injected daily with either 75 mg/kg DPA, 200 mg/kg DPA, or vehicle until day 18. Administration of DPA resulted in decreased body and organ weights, with the greatest reductions in the 200 mg/kg group. To control caloric intake, and additional experiment was conducted. Animals were injected with either vehicle or 200 mg/kg DPA. Each animal was implanted with a chronic intragastric cannula and fed through the cannula. The results of this experiment indicated that body and organ weights were the same for both vehicle and drug groups, except for brain. The animals receiving DPA had significant deficits of 12% in total brain weight and 22% in weight of the cerebellum. The data suggest that chronic administration of DPA early in life may have adverse consequences on brain growth.
Animals↗
A prospective double-blind study of side effects associated with the administration of amantadine for influenza A virus prophylaxis.
During a study of efficacy of amantadine prophylaxis of influenza A virus infection in young adults, gross and subtle side effects were monitored. Eighty-eight students were randomly selected to receive either amantadine or placebo for four weeks or both in a sequential crossover design of two weeks each. Side effects (i.e., dizziness, nervousness, and insomnia) occurred in 33% of those receiving amantadine and in 10% of those receiving placebo (P less than 0.005). Although side effects were well tolerated by most subjects, six volunteers discontinued amantadine because of marked complaints. Cessation of side effects occurred in more than half of those continuing amantadine. Sixteen students receiving amantadine had decreased performance on sustained attention tasks as compared with ones receiving placebo (P less than 0.05). Gross and subtle side effects of amantadine observed in this study on currently recommended dosage are higher than previously reported, which may be an important factor in consideration of mass prophylaxis.
Adolescent↗
Acute necrotizing ulcerative gingivitis. A study of some of the contributing factors and their validity in an Army population.
A study of some of the possible contributing factors in ANUG were evaluated by a comparison of ANUG patients with a random patient sample. This paper supports the role of stress and smoking in the pathogenesis of ANUG.
Acute Disease↗
Fibromuscular dysplasia as a cause of stroke in infancy and childhood.
Two children had abrupt onset of hemiplegia due to childhood fibromuscular dysplasia (FMD). Although FMD is a recognized cause of strokes in adults, the disorder has not, to our knowledge, been reported previously in children. Our report reviews the pathology and diagnosis of FMD and discusses the complexities of its treatment.
Cerebrovascular Disorders↗
Cerebellar hemorrhage in the premature infant.
Lesions of the central nervous system were reviewed in 144 premature neonates without anomalies or infections coming to autopsy from the Intermountain Regional Neonatal Intensive Care Unit. Twelve neonates were found to have had cerebellar hemorrhages. Eleven of the 12 with cerebellar hemorrhage also had germinal plate hemorrhages at postmortem examination. Some hemorrhages destroyed one or both cerebellar hemispheres. Three of 19 (16%) infants between 20 to 24 weeks' gestation, six of 26 (25%) infants between 26 to 28 weeks' gestation, two of 24 (8%) infants between 28 to 30 weeks' gestation, and one of 19 (5%) infants between 20 to 32 weeks' gestation had cerebellar hemorrhage. No premature neonate after 32 weeks' gestation had cerebellar hemorrhage. It is probable that trauma does not play a role in the pathogenesis of the cerebellar hemorrhage.
Birth Injuries↗
A danger of haloperidol therapy in children.
Attention is directed to the potential danger of therapy with haloperidol in children. Its value in reducing the excessive movements of Sydenham chorea must be weighed against the usual tendency of this disorder to remit spontaneously and the occasional tendency of the drug to cause castastropic adverse reaction
Child, Preschool↗
Occipitofrontal head circumference--an accurate measure of intracranial volume.
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Brain↗
Neurosurgical treatment of refractory status epilepticus.
Refractory status epilepticus (RSE) is defined as status epilepticus that continues despite aggressive treatment. A 9.8-year-old boy with a past history of daily left focal motor seizures was transferred to University of California at Los Angeles (UCLA) Hospital in pentobarbital coma after 4 days in RSE. The RSE was treated with very high doses of all appropriate antiepileptic drugs (AEDs), alone and in combination. The pentobarbital was titrated to burst suppression on EEG, but whenever pentobarbital was decreased, the seizures recurred. An ictal positron tomography scan of glucose metabolism demonstrated a right frontal area of hypermetabolism corresponding to an epileptic focus on EEG and magnetic resonance lesion. Eight days after the boy was admitted to UCLA, the right frontal focus was surgically removed, with immediate control of the status epilepticus. Whereas before onset of RSE, he had daily focal seizures, the boy has been seizure-free postoperatively for greater than 1 year. Operative treatment should be considered in patients with RSE in whom a focus of seizure onset can be demonstrated and who are reasonably considered surgical candidates.
Child↗
Surgery for intractable infantile spasms: neuroimaging perspectives.
Twenty-three infants and children underwent cortical resection (n = 15) or hemispherectomy (n = 8) for intractable infantile spasms. Infantile spasms were present at the time of surgery in 17 of the 23 patients; in six, spasms had evolved to other seizure types during surgical evaluation. Children with a remote history of infantile spasms were excluded from this study. Focal or hemispheric lesions were identified by magnetic resonance imaging in seven children; an additional two showed focal atrophy without a discrete lesion. Positron emission tomography (PET) showed lateralized or localized abnormalities of cerebral glucose utilization in all patients; in 14, PET was the only neuroimaging modality to identify the epileptogenic cortex. When this occurred, neuropathological examination of resected brain tissue typically showed malformative and dysplastic cortical lesions. Focal interictal and/or ictal electrographic abnormalities were present in all patients, and corresponded well with localization from neuroimaging. None of the patients were subjected to chronic invasive electrographic monitoring with intracranial electrodes. At follow-up (range 4-67 months; mean 28.3 months), 15 children were seizure-free, three had 90% seizure control, one had 75% seizure control, and four failed to benefit from surgery with respect to seizure frequency.
Brain↗