Journal of child neurology
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The neurologic outcomes at school age in children who underwent neonatal extracorporeal membrane oxygenation for noncardiac indications in a single institution surviving till the age of 5 years was determined by standardized neurologic assessment. Of 42 newborns undergoing extracorporeal membrane oxygenation, 24 underwent neurologic assessment by a single neurologist at 5 years of age. In all, 12 (50%) had a normal neurologic outcome. ⋯ The number of peri-extracorporeal membrane oxygenation complications experienced by a child was associated with later epilepsy. Although invasive and implemented in critically ill infants, half of newborns undergoing extracorporeal membrane oxygenation will have a normal neurologic outcome at school age. Preexisting factors, rather than factors related to the extracorporeal membrane oxygenation itself, appear to be greater determinants of later neurologic outcomes.
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Delirium in children has received little attention from researchers until very recently, despite being a frequently encountered clinical problem, particularly in the context of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). In this article, we report 3 cases of severe hyperactive delirium occurring in children with advanced HIV/AIDS in the context of probable underlying HIV encephalopathy and complex drug-drug interactions. We also present a hypothesis in relation to HIV-associated delirium as a potential neuropsychiatric manifestation of the immune reconstitution inflammatory syndrome in children commenced on highly active antiretroviral therapy.
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A 7-year-old female patient with a new diagnosis of ornithine transcarbamylase deficiency was treated for hyperammonemia with a standard protocol. Several days later, she developed ataxia, dysmetria, and dysarthria. ⋯ Classically described as a consequence of hyponatremia treatment, osmotic demyelination syndrome has rarely been associated with other entities. This case suggests a potentially serious complication of the standard therapy for hyperammonemia in patients with ornithine transcarbamylase deficiency.