Woldemar Mobitz, an early 20th century German internist, analyzed arrhythmias by graphing the relationship of changing atrial rates and premature beats to AV conduction. Through an astute mathematical approach, he was able to classify second-degree atrioventricular block into 2 types, subsequently referred to as Mobitz type I (Wenckebach) and Mobitz ...

Lidocaine has been used in neonates as an effective drug in controlling neonatal seizures not responding to traditional anticonvulsant therapy. Little is known about the effect of lidocaine on heart rate or occurrence of cardiac arrhythmias in neonates. The purpose of the present study was to assess the incidence of ...

Neonatal seizures typically indicate significant underlying disease.They are poorly classified, under-recognized, and often difficult to treat. Recognition of etiology is often helpful in prognosis and treatment; the most common is hypoxic-ischemic encephalopathy. Patients generally have a poor prognosis, with most developing a severe encephalopathy and epilepsy. Studies suggest that neonatal ...

PURPOSE: Extensive multilobar cortical dysplasia in infants commonly is first seen with catastrophic epilepsy and poses a therapeutic challenge with respect to control of epilepsy, brain development, and psychosocial outcome. Experience with surgical treatment of these lesions is limited, often not very encouraging, and holds a higher operative risk when ...

Neonatal seizures are difficult to detect, diagnose, and manage. Infants with a history of seizures often have long-term neurologic sequelae. Controversy exists as to whether neonatal seizures themselves cause damage to the developing brain, and thus, subsequent sequelae; or if these sequelae are due primarily to the underlying cause of ...

In a prospective cohort of 124 encephalopathic term infants, six infants had an acute focal stroke. All six encephalopathic patients with strokes presented with seizures. Neurodevelopmental outcome at 30 months was abnormal in all six patients and significantly worse when compared with the entire cohort overall. These findings suggest that ...

This study compared immediate (overnight) and progressive switching to oxcarbazepine monotherapy in patients with partial seizures unsatisfactorily treated with carbamazepine monotherapy. Patients were randomised to either an overnight (n = 140) or a progressive switch (n = 146) from carbamazepine to oxcarbazepine monotherapy at a dose ratio of 1:1.5. The ...

The objective of this study was to determine clinical and polysomnographic risk factors that might be early predictors for the development of postnatal epilepsy in a cohort of infants with seizures. The study sample included 158 infants who presented two or more clinically proven seizures. Gestational, perinatal, and polysomnographic data ...

Continuous amplitude-integrated electroencephalogram (aEEG) recording with a cerebral function monitor is a useful tool to evaluate prognoses following perinatal asphyxia in term infants. Drugs may change the pattern of the conventional EEG. This report presents three infants treated with midazolam for status epilepticus and repetitive seizures who proved resistant to ...

The present study delineates a benign generalized epileptic disorder during infancy and early childhood similar to the well-defined syndrome of primary generalized epilepsy in adolescence. The inclusion criteria for the study required infants under the age of 4 years mainly presenting with generalized nonfebrile seizures, requiring corroboration with generalized epileptic ...

We report a 2-month-old male with West syndrome associated with infantile hypophosphatasia. The male infant was born at term to a healthy mother after an uneventful pregnancy. He was born by cesarean section because of breech presentation. He was observed to have short extremities, and radiographs were consistent with achondroplasia. ...

The developing brain has an increased susceptibility to seizure activity, and neonatal seizures can adversely affect neurodevelopmental outcome. This study aimed to determine the incidence of neonatal seizures in very low birthweight infants and to identify perinatal and postnatal factors associated with the occurrence of clinical seizures. A population-based cohort ...

An eight-week-old infant, the fourth child of consanguineous parents presented with intractable neonatal seizures. The mother had two previous miscarriages. The infant initially presented on day one with multifocal myoclonus, complex partial and generalised tonic-clonic seizures. On examination, there were dysmorphic hands and feet, with absent nails and terminal phalanges ...

Infants with congenital hyperinsulinism often require pancreatectomy. Recessive mutations of the ATP-dependent plasma membrane potassium channel (K(ATP)) genes, SUR1 and K(ir)6.2, cause diffuse hyperinsulinism. K(ATP) channel mutations can also cause focal disease through loss of heterozygosity for maternal 11p, resulting in expression of a paternal mutation. This study evaluated whether ...

Monitoring infants with amplitude integrated electroencephalography (aEEG) in neonatal units is becoming widespread. A case of a preterm infant who was monitored with aEEG due to suspected seizures is presented. The case emphasizes both the usefulness and drawback of aEEG. An erroneous diagnosis of seizure lead to phenobarbital overdose and ...

BACKGROUND: Neonatal onset hypopituitarism is a life-threatening, potentially treatable endocrine disease. A possible cause is congenital absence of the anterior pituitary gland, a condition very rarely reported in the literature. METHODS: A series of 5 cases of children with pituitary aplasia referred to the Centre of Paediatric Endocrinology 'Rina Balducci', ...

OBJECTIVE: This study was undertaken to determine the value of a neonatal encephalopathy score (ES) and the presence of seizures for predicting 30-month neurodevelopmental outcome. STUDY DESIGN: In a cohort study, 68 term newborn infants with encephalopathy were evaluated with an ES based on alertness, feeding, tone, respiratory status, reflexes, ...

The standard anesthetic agent for electroconvulsive therapy (ECT) has been methohexital. We compared sevoflurane, a short-acting halogenated anesthetic, to methohexital for induction in ECT. Twelve subjects received sevoflurane or methohexital on alternating treatment days. Seizure duration, time to administering ECT, emergence and recovery, as well as several hemodynamic measures were ...

Infantile spasms is a catastrophic form of epilepsy found only in infants and young toddlers, with the peak incidence between 4 - 7 months of age. Estimated prevalence is 1 in 2000 - 6000 live births. There are many causes of infantile spasms, including tuberous sclerosis, hypoxic-ischaemic injury, congenital infectious ...

There are four unresolved clinical issues at bedside with respect to the recognition, differential diagnosis, prognosis, and treatment of infants who present with seizures. There is also an overriding fifth question which bridges these four clinical issues, based on a laboratory researcher's perspective at the "bench". Given the increasing understanding ...

Electroencepholographs (EEGs) of neonatal seizures differ from those of children and adults. This study evaluated whether wavelet transform analysis, a nonstationary frequency analysis of EEG, can recognize and characterize neonatal seizures. Twenty-second segments were analyzed from 69 EEG seizures in 15 neonatal patients whose seizures lasted 10 seconds or longer. ...

The neonatal EEG remains one of oldest, yet most valuable, diagnostic and prognostic tests in neonates. The goals of this study were to determine the relationships between the morphology, frequency, and distribution of ictal discharges in the neonatal EEG with age, EEG background activity, and etiology. A total of 156 ...

In women with epilepsy, seizures can be influenced by variations in sex hormone secretion during the menstrual cycle. The proconvulsant effects of estrogen have been demonstrated in both animals and humans, whereas progesterone has been found to have anticonvulsant properties. Catamenial epilepsy affects approximately one-third of women with epilepsy. This ...

The objective was to investigate how early electrocortical background pattern, as recorded with amplitude integrated EEG (aEEG), correlates with global and regional cerebral glucose metabolism (CMRgl) measured by positron emission tomography during the subacute phase after birth asphyxia. Nineteen term infants with hypoxic-ischemic encephalopathy were investigated. The aEEG background was ...

We present the case of a 6-week-old male infant who had a convulsion due to pertussis pneumonia. He was admitted to our emergency department because of lethargy and hypothermia. He developed a generalized tonic-clonic convulsion, requiring various treatments, including artificial ventilation. A chest CT showed bilateral pneumonia and laboratory data ...

OBJECTIVE: To evaluate the effect of cisapride on corrected QT (QTc) interval in neonates at the Queen Sirikit National Institute of Child Health. METHOD: A prospective study was performed to see the effects of cisapride on QTc interval in 20 neonates between 1st July 2001 and 31st January 2002. QTc ...

It has been demonstrated that intractable seizures in children can be eliminated or become more responsive to anticonvulsant medication after surgical resection of the epileptogenic focus or dysfunctional hemisphere. We describe our surgical experience with 4 infants treated at Children's Healthcare of Atlanta Egleston Hospital between 1994 and 2002. All ...

PURPOSE: This study used magnetic resonance spectroscopy (MRS) to examine metabolite abnormalities in the temporal and frontal lobe of patients with temporal lobe epilepsy (TLE) of differing severity. METHODS: We investigated myoinositol in TLE by using short-echo MRS in 34 TLE patients [26 late onset (LO-TLE), eight hippocampal sclerosis (HS-TLE)], ...

A previously healthy one-year-old boy, the youngest child of unrelated parents, presented with a four-week history of episodes of myoclonus triggered only by tactile stimulation to his head. There had been no loss of developmental skills. The electroencephalogram (EEG) revealed generalised polyspike wave activity both with and without clinical correlate. ...

BACKGROUND: Selective serotonin reuptake inhibitors (SSRIs) and venlafaxine have been regarded as less toxic in overdose than tricyclic antidepressants (TCAs). Within the TCAs, dothiepin has greater toxicity. Venlafaxine may be more toxic than SSRIs. AIM: To assess the toxicity in overdose of venlafaxine and SSRIs compared to TCAs, and of ...

RATIONALE: Seizures may produce a variety of autonomic alterations. These alterations may occur due to evoked autonomic reflexes or as a direct cortical effect on autonomic control. In animal studies, lock step phenomena of interictal discharges to autonomic output have been repeatedly documented. However, the association of interictal discharges and ...

BACKGROUND: Jaundice is one of the most common and one of the vexing problems that can occur in newborns. A newborn screening test for biotinidase deficiency has been added to many national screening programmes. AIM: To clarify the problem of false-positive screening tests in neonates, especially in term babies, we ...

BACKGROUND: Glucose-6-phosphate dehydrogenase (G-6-PD) is an enzyme in the first step of the hexose-monophosphate shunt required for the generation of nicotinamide adenine dinucleotide phosphate (NADPH). Red blood cells of neonates with deficient G-6-PD are potentially susceptible to acute severe haemolysis and may result in haemolytic jaundice. This study was to ...

To assess the efficacy, safety, and tolerability of topiramate in infants younger than 24 months of age, we conducted an open-label, multicenter chart review study of infants who received topiramate. Twenty-eight patients were evaluated. All had refractory epilepsy. The mean age of seizure onset was 3.8 months (range 0-10 months). ...

OBJECTIVE: To investigate the excess mortality due to remote symptomatic epilepsy, taking account of frequency and type of seizures. METHODS: The authors compared mortality in persons with (n = 8,156) and without (n = 72,526) history of epilepsy in a 1988 to 1999 California population of persons with mild developmental ...

INTRODUCTION: Information on the spatiotemporal organization of atrial activity at the onset of atrial fibrillation (AF) is limited. METHODS AND RESULTS: The study consisted of 26 consecutive patients (22 men and 4 women; mean age 56 +/- 9 years) with AF in whom the left atrium (LA) was mapped using ...

In this study, we investigated whether a TATA box polymorphism in the promoter of the UGT1*1 exon I, the most common detected DNA polymorphism in Gilbert's syndrome, is a contributory factor in unexplained pathologic or prolonged jaundice. 38 neonates who had unexplained pathologic jaundice, 37 neonates who had unexplained prolonged ...

The authors retrospectively compared the seizure duration, ictal EEG, and cognitive side effects of ketamine and methohexital anesthesia with ECT. This comparison was carried out with data from consecutive index ECT treatments that occurred immediately before and after a switch from methohexital to ketamine in 36 patients. Ketamine was well ...

Stressful events during gestation and in the neonatal period have important effects on the later physical and mental health of the offspring. The present study tested the hypothesis that pre- and/or postnatal stress would affect seizure susceptibility in infant and adult rats, using the hippocampal kindling model. Prenatal stress consisted ...

Using a sample of 262 undergraduate volunteers, correlational and regressional analyses were completed to examine the relation of self-reported complex partial epileptic-like signs to a five-dimensional model of spirituality assessed by the Expressions of Spirituality Inventory. Analyses show that spirituality is significantly predictive of Complex Partial Epileptic-like Signs. Scores from ...

A 3-month-old girl who developed severe measles encephalitis after neonatal measles is reported. Her mother had measles when she was ten days old and she was admitted to our hospital with low grade fever, Koplik spot, and mild exanthema seventeen days after birth, and she recovered in 7 days without ...

PURPOSE: Juvenile neuronal ceroid lipofuscinosis (JNCL), or Batten disease, is a pediatric neurodegenerative disease characterized by vision loss, seizure activity, cognitive decline, and premature death. Discovery of the Batten disease-related gene, CLN3, led to creation of a Cln3 protein-deficient mouse model (Cln3-/-), which recapitulates some of the histopathologic characteristics of ...

Follow-up investigations were undertaken on a previously reported patient who had severe familial giant cell hepatitis in infancy associated with substantially increased urinary excretion of bile alcohol glucuronides. By the age of 11 years, he had developed a profile of cholanoids in plasma and urine that closely resembled the pattern ...

OBJECTIVE: To determine whether postnatal MgSO(4) infusion (250 mg/kg per day) for 3 days is both safe and able to improve outcome in infants with severe birth asphyxia, as had been suggested by a small pilot study. METHODS: A multicenter randomized controlled trial was conducted. Entry criteria included 5-min Apgar ...

OBJECTIVE: To correlate umbilical blood gas variables with neonatal seizures in neonates with significant acidosis at birth (pH < or = 7.1). METHODS: We reviewed the maternal and neonatal charts of 238 patients at a gestational age of 32 weeks or more with cord gases done at delivery and an ...

Experimental evidence indicates that ammonia causes neuroexcitation and seizures. This contrasts with the lethargy, confusion and other manifestations of global CNS depression commonly considered to be major components of hyperammonemic encephalopathies. Substantial data now indicates that ammonia can modulate GABAergic neurotransmission through direct and indirect mechanisms. This modulation consists of ...

Urea Cycle Disorders (UCD) is an inborn error of urea synthesis in which ammonium and other nitrogenous precursors of urea accumulate leading to episodic coma and a high mortality rate. Therapy with peritoneal dialysis, essential amino acids or their nitrogen-free analogues has increased survival. The authors report 5 cases of ...

BACKGROUND: Benzodiazepines are being used in neonatal intensive care units for sedation and control of seizures. However, anecdotal reports suggest that their use in infants may be associated with serious adverse effects (AEs). OBJECTIVE: To determine the incidence of AEs from benzodiazepine use in preterm and full-term infants. METHODS: Retrospective ...

In this preliminary clinical investigation, hypnosis was used in the differential diagnosis of epileptic versus psychogenic seizures (PS). Eight patients with a clinical profile suggesting the presence of PS were given a hypnotic suggestion in which they had to go back in time to the exact moment of their last ...

OBJECTIVES: To investigate the efficacy, tolerability, and kinetics of lamotrigine during the first year of life. STUDY DESIGN: We studied 13 infants with intractable seizures; 7 had partial seizures and 7 had infantile spasms (1 had both). Patients received open-label lamotrigine as add-on therapy for 3 months. Seizure frequency, response ...