Rahul Sinha, Dharmesh Soneji, Gautam Kamila, Sonali Singh, A. Upadhyay
Purpose: The present study investigated the clinical profile of children with primary headache at a tertiary care center in North India. Methods: A retrospective observational study was conducted between January 2021 and October 2022. In total, 100 children 5 to 18 years of age who attended the pediatric outpatient department or the emergency department with primary headache were included. Children with secondary causes of headache were excluded. Results: This study included 100 children (40 boys, 60 girls), and the female-to-male ratio was 1.5:1. The patients ranged in age from 5 to 18 years (mean±standard deviation, 10.1±2.8). Mi-graine headaches were most commonly reported (60%) followed by tension-type headache (28%) and others (12%). The throbbing type of pain was most common (43%), followed by the tightening type in 32%. The pain location was bilateral frontal in 47% of patients, followed by bitemporal in 20% and occipital in 17%. Most of the children (87%) had a headache duration of 2 to 4 hours. The common precipitating factors were skipped meals (25%), bright light (18%), lack of sleep (16%), and schoolwork (15%). A family history was present in around 62%. Around 70% of children required prophylactic medications (flunarizine and propranolol). Long screen time (2 to 4 hours/day) and a family history of headache were significantly associated with primary headache ( P <0.05). Conclusion: The present study highlights that migraine is most common cause of primary head-ache in children, and every effort should be made for the early detection and management of headaches among children.
{"title":"Clinical Profile of Children with Primary Headache at a Tertiary Care Center in North India: A Retrospective Study","authors":"Rahul Sinha, Dharmesh Soneji, Gautam Kamila, Sonali Singh, A. Upadhyay","doi":"10.26815/acn.2023.00017","DOIUrl":"https://doi.org/10.26815/acn.2023.00017","url":null,"abstract":"Purpose: The present study investigated the clinical profile of children with primary headache at a tertiary care center in North India. Methods: A retrospective observational study was conducted between January 2021 and October 2022. In total, 100 children 5 to 18 years of age who attended the pediatric outpatient department or the emergency department with primary headache were included. Children with secondary causes of headache were excluded. Results: This study included 100 children (40 boys, 60 girls), and the female-to-male ratio was 1.5:1. The patients ranged in age from 5 to 18 years (mean±standard deviation, 10.1±2.8). Mi-graine headaches were most commonly reported (60%) followed by tension-type headache (28%) and others (12%). The throbbing type of pain was most common (43%), followed by the tightening type in 32%. The pain location was bilateral frontal in 47% of patients, followed by bitemporal in 20% and occipital in 17%. Most of the children (87%) had a headache duration of 2 to 4 hours. The common precipitating factors were skipped meals (25%), bright light (18%), lack of sleep (16%), and schoolwork (15%). A family history was present in around 62%. Around 70% of children required prophylactic medications (flunarizine and propranolol). Long screen time (2 to 4 hours/day) and a family history of headache were significantly associated with primary headache ( P <0.05). Conclusion: The present study highlights that migraine is most common cause of primary head-ache in children, and every effort should be made for the early detection and management of headaches among children.","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48847318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yoo Jung Lee, Eun Hye Yang, Yoon Hee Jo, Soo-Han Choi, H. W. Yoo, Ha Young Cho, M. Kwak, S. J. Park, Kyung-Hee Park, Young Mi Kim
{"title":"Clinical Usefulness of a Multiplex Molecular Panel for Central Nervous System Infection: An 11-Month Experience at a Tertiary Center in Korea","authors":"Yoo Jung Lee, Eun Hye Yang, Yoon Hee Jo, Soo-Han Choi, H. W. Yoo, Ha Young Cho, M. Kwak, S. J. Park, Kyung-Hee Park, Young Mi Kim","doi":"10.26815/acn.2022.00388","DOIUrl":"https://doi.org/10.26815/acn.2022.00388","url":null,"abstract":"","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43366694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Gaspar, C. Melo, Jacinta Fonseca, R. Sousa, M. Sampaio
{"title":"Early Successful Treatment in a Child with Febrile Infection-Related Epilepsy Syndrome","authors":"N. Gaspar, C. Melo, Jacinta Fonseca, R. Sousa, M. Sampaio","doi":"10.26815/acn.2022.00423","DOIUrl":"https://doi.org/10.26815/acn.2022.00423","url":null,"abstract":"","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46916670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhamad Azamin Anuar, Sharifah Aishah Alsagoff, A. R. Mohamed, S. Murugesu
{"title":"Epilepsy of Infancy with Migrating Focal Seizures in a Patient with Nonketotic Hyperglycinemia","authors":"Muhamad Azamin Anuar, Sharifah Aishah Alsagoff, A. R. Mohamed, S. Murugesu","doi":"10.26815/acn.2022.00346","DOIUrl":"https://doi.org/10.26815/acn.2022.00346","url":null,"abstract":"","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45802580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hui Jin Shin, A. Ko, S. H. Kim, Joon Soo Lee, H. Kim, Hoon-Chul Kang
{"title":"Efficacy and Safety of Lamotrigine Adjunctive Therapy in Lennox-Gastaut Syndrome","authors":"Hui Jin Shin, A. Ko, S. H. Kim, Joon Soo Lee, H. Kim, Hoon-Chul Kang","doi":"10.26815/acn.2022.00437","DOIUrl":"https://doi.org/10.26815/acn.2022.00437","url":null,"abstract":"","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42152212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tan, W. Cher, S. Chong, A. Ang, S. Ganapathy, D. Chan, R. M. K. Tan
Purpose: Strokes are challenging to diagnose in pediatric emergency departments (EDs) as level of suspicion is low and atypical presentations are common. We analyzed clinical features, epidemiology and factors of delayed identification in arterial ischemic strokes (AIS) and hemorrhagic strokes (HS). Methods: Single-centre retrospective cohort study of children aged between 29 days and 18 years old diagnosed with stroke between July 2016 to June 2021. Results: Among 36 children, 11 (30.5%) had AIS, 25 (69.4%) had HS. Median age for AIS was 9 years (interquartile range [IQR], 2 to 9) and HS 9 years (IQR, 1 to 11.5) ( P =0.715). Focal neurological deficit was seen in 72.7% of AIS and 20% of HS ( P =0.006). Only 18.2% of AIS and 52.0% of HS presented within 6 hours of symptoms. Median time from symptom onset to ED presentation was 24 hours (IQR, 12 to 28) for AIS and 7 hours (IQR, 1.8 to 48) for HS ( P =0.595). Most (85.6%) arrived by own transport. Median time from presentation to neuroimaging was 7 hours (IQR, 0.9 to 7) for AIS and 4.8 (IQR, 1.3 to 16.8) hours for HS ( P =0.376). Eleven patients, 9/25 (36.0%) HS and 2/11 (18.2%) AIS, did not have stroke as differential diagnosis at ED ( P =0.714). Common initial diagnoses were viral illness or headaches. On univariate analysis, age <1 (odds ratio [OR], 17.5; 95% confidence interval [CI], 1.2 to 250.4; P =0.035) and absence of focal neurological deficit (OR, 13.091; 95% CI, 1.5 to 117.9; P =0.022) were significant factors for delayed identification. Conclusion: Index of suspicion for pediatric strokes among caregivers and clinicians should be increased. Public awareness campaigns are recommended
{"title":"Early Recognition of Pediatric Strokes in the Emergency Department: Epidemiology, Clinical Presentation, and Factors Impeding Stroke Diagnosis in Children","authors":"S. Tan, W. Cher, S. Chong, A. Ang, S. Ganapathy, D. Chan, R. M. K. Tan","doi":"10.26815/acn.2022.00367","DOIUrl":"https://doi.org/10.26815/acn.2022.00367","url":null,"abstract":"Purpose: Strokes are challenging to diagnose in pediatric emergency departments (EDs) as level of suspicion is low and atypical presentations are common. We analyzed clinical features, epidemiology and factors of delayed identification in arterial ischemic strokes (AIS) and hemorrhagic strokes (HS). Methods: Single-centre retrospective cohort study of children aged between 29 days and 18 years old diagnosed with stroke between July 2016 to June 2021. Results: Among 36 children, 11 (30.5%) had AIS, 25 (69.4%) had HS. Median age for AIS was 9 years (interquartile range [IQR], 2 to 9) and HS 9 years (IQR, 1 to 11.5) ( P =0.715). Focal neurological deficit was seen in 72.7% of AIS and 20% of HS ( P =0.006). Only 18.2% of AIS and 52.0% of HS presented within 6 hours of symptoms. Median time from symptom onset to ED presentation was 24 hours (IQR, 12 to 28) for AIS and 7 hours (IQR, 1.8 to 48) for HS ( P =0.595). Most (85.6%) arrived by own transport. Median time from presentation to neuroimaging was 7 hours (IQR, 0.9 to 7) for AIS and 4.8 (IQR, 1.3 to 16.8) hours for HS ( P =0.376). Eleven patients, 9/25 (36.0%) HS and 2/11 (18.2%) AIS, did not have stroke as differential diagnosis at ED ( P =0.714). Common initial diagnoses were viral illness or headaches. On univariate analysis, age <1 (odds ratio [OR], 17.5; 95% confidence interval [CI], 1.2 to 250.4; P =0.035) and absence of focal neurological deficit (OR, 13.091; 95% CI, 1.5 to 117.9; P =0.022) were significant factors for delayed identification. Conclusion: Index of suspicion for pediatric strokes among caregivers and clinicians should be increased. Public awareness campaigns are recommended","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46413953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ported in Wuhan, China in 2019, is an infectious disease caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The incidence rate is lower in children than in adults, but as the number of infected patients has increased recently, the number of pediatric patients has also increased [1,2]. The typical symptoms of COVID-19 include fever, cough, chills, aches, headaches, anorexia, and anosmia [1]. Neurological manifestations can also occur in patients with COVID-19. Several studies have reported neurological manifestations of COVID-19 in children [1-4]. Panda et al. [4] reviewed these manifestations and reported that 16% of all such patients showed non-specific neurological symptoms, such as headache, myalgia, and fatigue, whereas 1% of them showed specific neurological symptoms, such as seizures and encephalopathy. Another study reported that neurological manifestations, including febrile and non-febrile seizures, were observed in 3% of children with COVID-19 [1]. Febrile seizures are relatively common neurologic disorders, affecting 2% to 5% of children under the age of 5 years. There are two types of febrile seizures: simple and complex seizures. Simple febrile seizures refer to generalized seizures pISSN 2635-909X • eISSN 2635-9103 Ann Child Neurol [Epub ahead of print] https://doi.org/10.26815/acn.2022.00374
2019年在中国武汉报告的一种由新型冠状病毒引起的传染病，称为严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）。儿童的发病率低于成人，但随着最近感染患者数量的增加，儿科患者的数量也有所增加[1，2]。新冠肺炎的典型症状包括发烧、咳嗽、发冷、疼痛、头痛、厌食症和嗅觉缺失[1]。新冠肺炎患者也可能出现神经系统表现。几项研究报告了新冠肺炎在儿童中的神经表现[1-4]。Panda等人[4]回顾了这些表现，并报告称，16%的此类患者表现出非特异性神经症状，如头痛、肌痛和疲劳，而1%的患者表现出特定的神经症状，例如癫痫发作和脑病。另一项研究报告称，在3%的新冠肺炎儿童中观察到神经系统表现，包括发热和非发热性癫痫[1]。发热性癫痫是一种相对常见的神经系统疾病，影响2%至5%的5岁以下儿童。发热性癫痫有两种类型：简单型和复杂型。单纯性热性癫痫是指全身性癫痫pISSN 2635-909X•eISSN 2635-9103 Ann Child Neurol[Epub提前出版]https://doi.org/10.26815/acn.2022.00374
{"title":"Complex Febrile Seizures in Children with COVID-19 Infection","authors":"L. Kim, J. Han, A. Cho, Hunmin Kim","doi":"10.26815/acn.2022.00374","DOIUrl":"https://doi.org/10.26815/acn.2022.00374","url":null,"abstract":"ported in Wuhan, China in 2019, is an infectious disease caused by a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The incidence rate is lower in children than in adults, but as the number of infected patients has increased recently, the number of pediatric patients has also increased [1,2]. The typical symptoms of COVID-19 include fever, cough, chills, aches, headaches, anorexia, and anosmia [1]. Neurological manifestations can also occur in patients with COVID-19. Several studies have reported neurological manifestations of COVID-19 in children [1-4]. Panda et al. [4] reviewed these manifestations and reported that 16% of all such patients showed non-specific neurological symptoms, such as headache, myalgia, and fatigue, whereas 1% of them showed specific neurological symptoms, such as seizures and encephalopathy. Another study reported that neurological manifestations, including febrile and non-febrile seizures, were observed in 3% of children with COVID-19 [1]. Febrile seizures are relatively common neurologic disorders, affecting 2% to 5% of children under the age of 5 years. There are two types of febrile seizures: simple and complex seizures. Simple febrile seizures refer to generalized seizures pISSN 2635-909X • eISSN 2635-9103 Ann Child Neurol [Epub ahead of print] https://doi.org/10.26815/acn.2022.00374","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44590118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rahul Sinha, Sonali Singh, Gautam Kamila, A. Upadhyay
Purpose: This study investigated the diagnostic utility of short-term video electroencephalography (EEG) recordings at a tertiary care center in North India. Methods: A retrospective analysis was conducted of 30 minutes of video EEG recordings done between January 2021 and January 2022 in children between 1 and 10 years of age. Demographic and clinical data were collected from the EEG register. Age, sex, the clinical diagnosis, the number of anti-seizure medicines (ASMs), the activation procedures used, and EEG abnormalities were recorded. Results: Data from 100 children (male-to-female ratio, 1.9:1) were analysed. The mean age was 5.39±2.02 years. The indications for EEG recordings were epileptic disorders, neurodevelopmental disorders, paroxysmal non-epileptic events, and miscellaneous in 66%, 18%, 9%, and 7% of children, respectively. EEG abnormalities were seen in 50 children (50%) and about 45% of children were on two or more ASMs. EEG abnormalities in sleep were seen in 35 of 66 (53%) children, whereas abnormalities were observed on awake recordings with activation procedures (hyper-ventilation and photic) in 23 of 34 (68%) children; this difference was not statistically significant ( P =0.16) Conclusion: EEG abnormalities were significantly more common in children taking multiple ASMs; however, there was no statistically significant difference in the EEG yield between asleep and awake records with activation procedures. A better selection of patients for routine EEG, through an assessment of their clinical history and comorbidities, is warranted to increase its diagnostic yield.
{"title":"The Diagnostic Utility of Short-Term Video Electroencephalography at a Tertiary Care Center in North India: A Retrospective Study","authors":"Rahul Sinha, Sonali Singh, Gautam Kamila, A. Upadhyay","doi":"10.26815/acn.2022.00332","DOIUrl":"https://doi.org/10.26815/acn.2022.00332","url":null,"abstract":"Purpose: This study investigated the diagnostic utility of short-term video electroencephalography (EEG) recordings at a tertiary care center in North India. Methods: A retrospective analysis was conducted of 30 minutes of video EEG recordings done between January 2021 and January 2022 in children between 1 and 10 years of age. Demographic and clinical data were collected from the EEG register. Age, sex, the clinical diagnosis, the number of anti-seizure medicines (ASMs), the activation procedures used, and EEG abnormalities were recorded. Results: Data from 100 children (male-to-female ratio, 1.9:1) were analysed. The mean age was 5.39±2.02 years. The indications for EEG recordings were epileptic disorders, neurodevelopmental disorders, paroxysmal non-epileptic events, and miscellaneous in 66%, 18%, 9%, and 7% of children, respectively. EEG abnormalities were seen in 50 children (50%) and about 45% of children were on two or more ASMs. EEG abnormalities in sleep were seen in 35 of 66 (53%) children, whereas abnormalities were observed on awake recordings with activation procedures (hyper-ventilation and photic) in 23 of 34 (68%) children; this difference was not statistically significant ( P =0.16) Conclusion: EEG abnormalities were significantly more common in children taking multiple ASMs; however, there was no statistically significant difference in the EEG yield between asleep and awake records with activation procedures. A better selection of patients for routine EEG, through an assessment of their clinical history and comorbidities, is warranted to increase its diagnostic yield.","PeriodicalId":33305,"journal":{"name":"Annals of Child Neurology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69138205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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