Journal of child neurology
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A previously healthy 2-year-old girl was admitted with generalized convulsive status epilepticus. She was in a stupor and could respond only to painful stimuli. She also had severe metabolic acidosis. ⋯ She was discharged from the hospital on the twelfth day of admission. At the fourth month of follow-up, she was seizure free. Because of this case, we would like to re-emphasize that acute isoniazid poisoning should also be considered in a child with unexplained status epilepticus.
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Clinical Trial
Eight-year study of childhood status epilepticus: midazolam infusion in management and outcome.
Sixty-eight children 2 months to 14 years of age were admitted with status epilepticus to Sultan Qaboos University Hospital from November 1993 to December 2001. Thirty-eight children (55.9%) had refractory status epilepticus and 30 (44.1%) had established status epilepticus. The children with refractory status epilepticus had received intravenous or per rectal diazepam and intravenous phenytoin/phenobarbital (either or both) before continuous infusion of midazolam was given. ⋯ No metabolic derangements or compromise of vital functions was noted on midazolam infusion. All children made a complete recovery. There was one death related to meningoencephalitis.
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Metabolic disorders constitute an important cause of neurologic disease, including infantile epilepsy. The inability to characterize seizures and epilepsy syndromes precisely in infants impedes the recognition of features suggestive of specific underlying metabolic and neurodegenerative etiologies. Classification systems using simple descriptions of ictal behaviors can be reliably applied and may aid in the recognition of these disorders. ⋯ Occasionally, there are distinctive electroencephalographic patterns that may suggest a specific metabolic disease. Earlier recognition of metabolic disorders may be accomplished by careful study of clinical and electrographic characteristics. There are important treatment considerations associated with these disorders.
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Case Reports
Calcium carbonate consumption during pregnancy: an unusual cause of neonatal hypocalcemia.
The occurrence of hypocalcemia in a term infant after the first few days of life is known to result from excessive dietary phosphate, hypomagnesemia, neonatal hypoparathyroidism, hypovitaminosis D, and maternal hyperparathyroidism. Less well recognized is the possibility that maternal ingestion of antacids may cause late neonatal hypocalcemia. Our observations suggest that taking large doses of calcium carbonate during pregnancy may be a potential cause of neonatal hypocalcemia.
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Case Reports
Cervicothoracic extradural arachnoid cyst: possible association with obstetric brachial plexus palsy.
The association of cervicothoracic extradural arachnoid cysts and obstetric brachial plexus palsy has not previously been reported. We report two patients with this association. ⋯ The second patient is a 3-year-old girl with bilateral brachial plexus palsy and spastic paraparesis who had magnetic resonance imaging at 3 days of age that showed intraspinal cord injury and a cervicothoracic extradural arachnoid cyst compressing the spinal cord. We believe that the association of cervicothoracic epidural arachnoid cysts and obstetric brachial plexus palsy in these patients was causal and recommend that the possibility of a cervicothoracic epidural arachnoid cyst be considered in patients with brachial plexus palsy and evidence of spinal cord injury.