Pediatric neurology
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Pediatric neurology · Feb 2014
Comparative Study Observational StudyManagement of pediatric migraine in a tertiary care versus community based emergency department: an observational pilot study.
Because of a lack of guidelines for the management of pediatric migraine in the emergency department setting, marked variations in treatment protocols exist between institutions. We aimed to characterize differences in management strategies for pediatric migraine treatment between a community-based and a tertiary care emergency department. ⋯ Low rates of intravenous combination therapy, antidopaminergic agent, and serotonin agonist use were noted across both hospital settings. Community-based physicians used opiates and obtained neuro-imaging more than those in the academic setting. Standardization of care in the emergency setting coupled with reliable acute care plans that are based on evidenced-based guidelines can allow for better control of episodic migraine and reduce emergency department visits.
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Pediatric neurology · Feb 2014
Electrophysiological characteristics of the pediatric femoral nerve and their use in clinical diagnosis.
To explore the electrophysiological characteristics of the pediatric femoral nerve at different ages. ⋯ The development of pediatric femoral nerve mainly began after 1 years old and continued to 14 years old. The proximal latency and compound muscle action potential amplitude of the pediatric femoral nerve have clinical value. Detection of the femoral nerve is important in the diagnosis of lower limb monoplegia, especially for acute flaccid paralysis associated with nonpolio enterovirus infection.
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Pediatric neurology · Feb 2014
Outcomes of greater occipital nerve injections in pediatric patients with chronic primary headache disorders.
Chronic migraine is common in pediatrics and generally disabling. In adults, infiltration of the area around the greater occipital nerve can provide short- to medium-term benefit in some patients. This study reports the efficacy of greater occipital nerve infiltrations in pediatric patients with chronic primary headache disorders. ⋯ Greater occipital nerve injections benefitted 53% of pediatric patients with chronic primary headache disorders. Efficacy appeared greater in chronic migraine than NDPH. Given the benign side effect profile, a greater occipital nerve infiltration seems appropriate before more aggressive approaches.
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Pediatric neurology · Jan 2014
Neurofibromatosis type 1 associated with moyamoya syndrome in children.
Vascular abnormalities in neurofibromatosis type 1 may arise anywhere in the cardiovascular system, and cerebrovascular involvement is the predominant feature of moyamoya syndrome. Because neurofibromatosis type 1 is a neurocutaneous disorder and routine follow-up with cranial MRI is not standard practice in asymptomatic children, accurate epidemiologic data are lacking. On follow-up, clinical and radiologic progression is often found in patients with moyamoya syndrome. ⋯ The association between moyamoya syndrome and neurofibromatosis type 1 is rare, but it poses a potential risk of clinicoradiologic progression. Targeted monitoring of children with neurofibromatosis type 1 ensures an early diagnosis of moyamoya syndrome.
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Pediatric neurology · Jan 2014
Case ReportsIdentification of a novel de novo p.Phe932Ile KCNT1 mutation in a patient with leukoencephalopathy and severe epilepsy.
More than half of patients with genetic leukoencephalopathies remain without a specific diagnosis; this is particularly true in individuals with a likely primary neuronal etiology, such as those in which abnormal white matter occurs in combination with severe epilepsy. ⋯ Severely delayed myelination was anecdotally reported in previous patients with KCNT1 mutations. This case reinforces that KCNT1 sequencing should be included in an investigation of patients with severely delayed myelination and epilepsy.