European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
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Eur. J. Paediatr. Neurol. · Nov 2011
Morphometry and diffusion MR imaging years after childhood traumatic brain injury.
Our goal was to detect possible unrecognized injury in cerebral white matter (WM) in adult survivors of traumatic brain injury (TBI) during childhood, who showed no detectable axonal injury or chronic contusion on late conventional MRI. ⋯ Our results indicate that persistent focal long-term volume reduction and underlying WM structural changes may occur after TBI during childhood and that their effects extend into adulthood. Normal late conventional MR findings after childhood TBI do not rule out non-apparent axonal injury.
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Eur. J. Paediatr. Neurol. · Nov 2011
The incidence of traumatic brain injury in young people in the catchment area of the University Hospital Rotterdam, The Netherlands.
Traumatic brain injury (TBI) is in the developed countries the most common cause of death and disability in childhood. ⋯ The ratio for mild, moderate and severe traumatic brain injury in children and young people was 33.7-1.8-1.In the mild TBI group almost 17% of the patients reported sequelae. The finding that 42% of them had a normal brain CT scan at admission underwrites the necessity of careful follow up of children and young people with mild TBI.
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Primary out-of-hospital cardiac arrest in childhood is rare but survival is a little better for children than for adults, although the prognosis for infants is very poor. Hypoxic-ischaemic encephalopathy after in-hospital cardiac arrest in children undergoing complicated treatment for previously untreatable conditions is now a common problem and is probably increasing. An additional ischaemic insult worsens the prognosis for other encephalopathies, such as that occurring after accidental or non-accidental head injury. ⋯ EEG and initial pH were the best predictors of outcome in this study. Seizures affected one third and were associated with deterioration and worse outcome. The advent of extracorporeal membrane oxygenation (ECMO) and the positive results of hypothermia trials in neonates and adults have rekindled interest in timely management of this important group of patients.
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Eur. J. Paediatr. Neurol. · Jul 2011
Case ReportsAcute leukoencephalopathy after buprenorphine intoxication in a 2-year-old child.
Leukoencephalopathies have been reported after heroin inhalation or ingestion, and buprenorphine injection, but the physiopathology remains unclear. We report here the first case of leukoencephalopathy caused by buprenorphine ingestion in a 2-year-old child who was admitted for coma and fever. ⋯ A brain MRI found bilateral and symmetric white matter damages in the cerebral hemispheres and the cerebellum. Rapid recovery and positive toxicology screen for buprenorphine on day 4 confirmed the diagnosis of acute intoxication.
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Eur. J. Paediatr. Neurol. · May 2011
ReviewGenetic heterogeneity and pathophysiological mechanisms in congenital myasthenic syndromes.
Congenital myasthenic syndromes (CMS) are a rare heterogeneous group of inherited neuromuscular disorders associated with distinctive clinical, electrophysiological, ultrastructural and genetic abnormalities. These genetic defects either impair neuromuscular transmission directly or result in secondary impairments, which eventually compromise the safety margin of neuromuscular transmission. In this report we will explore the significant progress made in understanding the molecular pathogenesis of CMS, which is important for both patients and clinicians in terms of reaching a definite diagnosis and selecting the most appropriate treatment.