Pediatric neurology
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Pediatric neurology · Oct 2010
Case ReportsAnti-NMDA receptor encephalitis with atypical brain changes on MRI.
A young girl with antibodies to the N-methyl-D-aspartate receptor presented with a clinical syndrome suggestive of dyskinetic encephalitis lethargica with neuropsychiatric features at presentation, movement disorder, mutism, sleep disorder, and seizures. Persistent lesions in the white matter and pons were observed in magnetic resonance imaging of the brain, findings that have not been described previously in N-methyl-D-aspartate receptor antibody encephalitis.
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Pediatric neurology · Oct 2010
Nerve root enhancement on spinal MRI in pediatric Guillain-Barré syndrome.
Guillain-Barré syndrome diagnosis is based on clinical presentation and supportive diagnostic testing. In its early stage, no single, reliable diagnostic test is available. However, a finding of nerve root enhancement on spinal magnetic resonance imaging may be useful. ⋯ Patterns of enhancement were variable, but involved the thoracolumbar nerve roots in all patients. Enhancement of nerve roots with gadolinium on initial spinal magnetic resonance imaging was frequently present in these children with Guillain-Barré syndrome. Spinal magnetic resonance imaging is a sensitive diagnostic test and should be considered an additional diagnostic tool in select cases.
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Pediatric neurology · Oct 2010
Concussion or mild traumatic brain injury: parents appreciate the nuances of nosology.
We explored whether parents of our pediatric patients valued the diagnostic terms "concussion," "minor traumatic brain injury," and "mild traumatic brain injury" as equivalent or nonequivalent. 1734 of 2304 parents attending a regional pediatric emergency department completed a brief questionnaire assessing the equivalence or nonequivalence of the diagnostic terms "concussion," "minor traumatic brain injury," and "mild traumatic brain injury" in a pairwise fashion. Many parents viewed these diagnostic terms as equivalent, when assessed side by side. ⋯ As a group, parents reported that concussion or mild/minor traumatic brain injuries are valued equivalently. However, many parents considered them different, with concussion reflecting a "better" (or less "worse") outcome.
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Pediatric neurology · Oct 2010
Case ReportsPediatric neuro-Behçet's disease responsive to adalimumab.
Neurologic manifestations of Behçet's disease (neuro-Behçet's disease) are uncommon, but may cause patients significant morbidity and mortality. Neuro-Behçet's disease is chronic and may be refractory to treatment. We report on a 12-year-old girl with neuro-Behçet's disease that responded to standard doses of subcutaneous adalimumab.
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Pediatric neurology · Sep 2010
Restricted diffusion in the corpus callosum in hypoxic-ischemic encephalopathy.
Restricted diffusion within the splenium of the corpus callosum was described in various conditions, but is not a prominent finding in magnetic resonance imaging after neonatal hypoxic-ischemic encephalopathy. Perinatal characteristics were reviewed in 42 term neonates with hypoxic-ischemic encephalopathy treated with selective head cooling. Neonatal images of 34 infants were reviewed. ⋯ The positive predictive value of changes in the splenium of the corpus callosum regarding poor outcomes or death was 90%. Changes in the splenium of the corpus callosum were also associated with lower birth weights, larger base deficits in cord arterial gas, and more severe encephalopathy during enrollment in selective head cooling. Restricted diffusion within the splenium of the corpus callosum of term infants with hypoxic-ischemic encephalopathy is often associated with extensive brain injury, and in these circumstances appears to be an early neuroradiologic marker of adverse neurologic outcomes.