Pediatric neurology
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This study was designed to determine whether the observed reactive electroencephalographic patterns in comatose children were associated with a better outcome. All electroencephalograms performed in comatose children aged 2 months to 18 years during the period 1996-2003 were retrospectively analyzed and classified according to modified Young's classification. Reactivity to painful/auditory stimuli and passive eye closure (at least two modalities) was checked in all electroencephalograms. ⋯ Outcome was better in children with reactive electroencephalographic patterns (Fisher exact test; P = 0.023). Comatose children with reactive electroencephalographic patterns have better clinical outcome in terms of morbidity and mortality. A careful assessment of electroencephalographic reactive patterns in all comatose children is required for better understanding of the clinical outcome.
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Pediatric neurology · Nov 2005
Case ReportsIntrathecal baclofen overdose followed by withdrawal: clinical and EEG features.
Intrathecal baclofen therapy is increasingly used to alleviate medically intractable spasticity in children with cerebral palsy, spinal cord injuries, and generalized dystonia. Complications like overdose or withdrawal can occur and could be the result of pump malfunction (device-related) or refilling and programming mistakes (human errors). This report describes a case, with emphasis on electroencephalographic changes, of a 12-year old male on long-term intrathecal baclofen therapy who had sequential occurrence of both acute inadvertent baclofen overdose followed by withdrawal symptoms. ⋯ During withdrawal, mild generalized slowing during wakefulness was observed along with the appearance of high-amplitude, sharply contoured delta activity resembling frontal intermittent rhythmic delta activity in sleep. To our knowledge, this temporal profile of electroencephalographic features during baclofen intoxication followed by withdrawal has not been described before in pediatric patients. It is important for treating physicians to recognize the evolution of this electroencephalographic pattern in order to avoid misinterpretation of diagnosis and prognosis.