Pediatric neurology
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Pediatric neurology · Oct 2004
Review Case ReportsPediatric tick paralysis: discussion of two cases and literature review.
This report describes two cases of tick paralysis in children diagnosed within a 3-month period (May-July 2002) in rural South Carolina. Differing presenting symptoms consisted of acute onset of ataxia in one patient and acute ascending paralysis in the other. ⋯ The diagnosis of tick paralysis must be considered in any patient, particularly children, who present with either acute ataxia or acute ascending paralysis. As in any clinical encounter, careful history and thorough general and neurologic examinations must be performed to exclude the possibility of tick attachment.
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Pediatric neurology · Sep 2004
Comparative StudyGastric emptying in children with cerebral palsy and gastroesophageal reflux.
Gastric emptying time is considered a factor in the increased frequency of gastroesophageal reflux in children with cerebral palsy. It is unknown if emptying time influences the severity of reflux. In this study, 76 cerebral palsy patients with reflux indicative symptoms were investigated by 24-hour pH monitoring. ⋯ In conclusion, reflux (moderate or severe) is common in children with cerebral palsy, frequently leading to complications but no delayed emptying time. The patients described in this report had no delayed emptying time. There was also no relationship between emptying time and severity of reflux.
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Pediatric neurology · Sep 2004
Comparative StudyMagnetic resonance imaging in 122 children with spastic cerebral palsy.
The interrelationship between magnetic resonance imaging findings, types of cerebral palsy, and gestation was studied. We analyzed the magnetic resonance imaging of brain in 122 children with spastic cerebral palsy. Forty-three patients had spastic hemiplegia, 61 had spastic diplegia, and 18 had spastic tetraplegia. ⋯ Term-type brain injuries (term-type border-zone infarct, basal ganglia-thalamic lesion, subcortical leukomalacia, and multicystic encephalomalacia) were observed only in patients born at or near term. We conclude that magnetic resonance imaging findings for patients with spastic cerebral palsy were closely related to types of cerebral palsy and gestation at birth. Magnetic resonance imaging in patients with perinatal brain injury may reflect pathologic changes and is useful in understanding and evaluating cerebral palsy.
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This study asked what incites the development of a new daily persistent headache in children. A total of 175 children with chronic daily headache were prospectively identified and observed by the author. Of these patients, 40 (23%) with a new daily persistent headache were identified. ⋯ Four patients were initially identified as having idiopathic intracranial hypertension, yet their chronic headache persisted despite the normalization of their intracranial pressure. Similar findings were observed in episodic migraine patients who abruptly developed the onset of chronic migraine. In conclusion, the onset of new daily persistent headache in childhood is typically associated with a physiologic stress such as an infection, head trauma, or post-surgery.