Serum sodium levels and probability of recurrent febrile convulsions

In a prospective study of 69 children with febrile convulsions, serum sodium levels were often lower than normal (52% had levels <135 mmol/l). The mean level (134.4±0.4 mmol/l) was significantly lower as compared to a group of children without fever (140.6±0.4 mmol/l,n=23) and as compared to a group with fever but without convulsions (137.6±0.6 mmol/l,n=31). The probability of a repeat convulsion within the same febrile period appeared to be significantly related to the serum sodium level.Conclusion Measurement of the serum sodium is a valuable investigation in the child with a febrile convulsion. The lower the serum sodium level, the higher the probability of a repeat convulsion. This knowledge may be of practical value in deciding whether to admit the child or allow it to return home and in advising parents or carers of the risk of a repeat convulsion.     

安定溶液舌下给药治疗小儿惊厥疗效观察

目的探讨安定溶液舌下给药治疗小儿惊厥的临床疗效及安全性。方法选择惊厥患儿92例,随机分为治疗组46例,舌下给药0.5mg/kg;对照组46例,直肠给药0.5mg/kg。比较两组控制惊厥显效率和总有效率及控制惊厥平均起效时间。同时观察治疗组的不良反应。结果治疗组显效率高于对照组(χ2=7.38,P=0.012),总有效率与对照组差异无统计学意义(χ2=0.548,P=0.714);治疗组平均起效时间较对照组短(t=5.42,P=0.000);治疗组除止惊后嗜睡、乏力外未见其它不良反应。结论舌下给药临床应用安全方便,止惊快速有效,值得临床推广。     

珠黄镇惊片抗癫痫的药效及作用机制研究

目的:研究珠黄镇惊片抗惊厥、抗癫痫的作用及作用机制。方法:从行为学和神经生化学两方面对珠黄镇惊片的抗惊厥作用和作用机制进行研究。结果:珠黄镇惊片可延长小鼠惊厥的潜伏期,减少惊厥发生鼠数,延长惊厥小鼠的存活时间,能明显降低脑组织内丙二醛(MDA)的含量,增加超氧化物歧化酶(SOD)的活性,增加三磷酸腺苷(ATP)酶的活力。结论:珠黄镇惊片可调节脑细胞能量代谢,具有确切的抗惊厥、抗癫痫作用。     

宁儿汤治疗儿童抽动症临诊体会

儿童抽动症为较常见的儿童行为障碍综合征，从中医及现代医学角度对本病病因病机加以探讨，自拟纯中药制剂“宁儿汤”为例，探索中医药在本病治疗中的应用。     

FC患儿发病年龄、发作次数及脑电图与预后的关系

目的 探讨热性惊厥(FC)患儿的发作年龄、发作次数与预后的关系.方法 对146例FC患儿的发病年龄、发作次数、24h动态脑电图和3年随访结果进行回顾性分析.结果 在 146例FC患儿中,总异常率为30.1%,在异常脑电图中,非特异性异常22.6%,特异性异常7.5%;分组比较,性别之间差异无显著性(X2=2.33,P>0.05);≥3岁组和<3岁组AEEG总异常率分别为14.7%和46.5%,差异有显著性(X2=-18.29,P<0.01);反复发作组明显高于首发组(x 2=-23.87,P<0.01)、有家族史组明显高于无家族史组(X2=-10.18,P<0.01).非特异性异常组脑电图组的患儿1-3年随访痊愈率分别51.7%(15/29)、69.O%(20/29)和82.8%(24/29);特异性异常组分别为10.0%(1/10)、20.0%(2/10)和40.0%(4/10).非特异性异常的患儿其预后明显优于特异性异常的患儿,两者比较差异有显著性(P<0.05).结论 FC患儿的预后与发病年龄、发作次数和家族史有密切关系.     

Pentylenetetrazol-induced seizures produce an increased release of IR-Met-enkephalin from rat striatum in vitro

In this work we analyzed the immunoreactive-methionine-enkephalin (IR-Met-enkephalin) levels in several brain regions of rats sacrificed during the tonic extension, induced by acute treatment with pentylenetetrazol (PTZ). The results show an increase of IR-Met-enkephalin content in striatum but not in amygdala, hypothalamus, septum, hippocampus and cortex. To characterize whether this elevation of enkephalin levels in striatum corresponded to the releasable pool, we studied the intro efflux of this peptide in striatal slices of rats sacrificed during the seizures, in acute PTZ and in PTZ-kindled rats (kindling group I). In addition, PTZ-kindled rats were analyzed 24 h after the last stimulus (kindling group II). The striatal slices of acute group and kindling group I displayed a significant increase in the evoked release of IR-Met-enkephalin. However, no significant changes occurred from striatal slices of kindling group II animals. In vitro superfusion of GABA (100 μM) produced a 63% decrease in IR-Met-enkephalin released from striatal slices in both saline and acute PTZ-treated rats. Several studies suggest that opioid peptides may be released in the ictal phase of seizure in order to mediate some transient postictal behavior. Our results suggest that of several brain regions tested, only the striatal IR-Met-enkephalin may be released during the ictus to mediate postical behavior in the acute PTZ treated and in PTZ-kindled rats. This effect may be regulated by the GABA system.     

Seasonal variation of febrile convulsion in Japan

The 6-year incidence rates of febrile convulsions in all 3-year-old children in Fuchu (covering 95% of children, number examined 17,044) was 8.2%. The incidence was higher in boys than in girls (9.0%: 7.5%, P less than 0.001). The incidence rates varied with the month and year of birth, but the variations observed were slight. Two peak appearances of seasonal variation of the first febrile convulsion were found in November-January and in June-August. The former could be interpreted as a tendency to winter virus infection of the upper respiratory tract in children. The other peak in summer could be explained as a tendency to gastrointestinal infection. Liability to febrile convulsion was influenced by the age of children and by the seasonal variations of febrile illness, but not by the season of birth.     

Myoglobinemia and myoglobinuria in unconscious children

Myoglobinemia and/or myoglobinuria was demonstrated in 12 of 17 unconscious children studied. Myoglobinemia was noted in patients with serum CPK levels above 200-250 units. Ten of the 12 patients in whom myoglobinemia was present had convulsions. Some degree of renal disturbance was noted in six of seven patients with myoglobinuria. Five patients, including four with renal disturbance, died. In unconscious children with myoglobinuria the possibility of a disturbance of renal function should always be considered.     

How local community knowledge about malaria affects insecticide-treated net use in northern Ghana

Large-scale trials of insecticide-treated nets (ITNs) throughout Sub-Saharan Africa demonstrated that they reduce child mortality in malaria endemic communities. These encouraging results have generated interest in ITNs as a viable malaria control strategy in many malaria endemic countries. However, regular use of ITNs under routine or non-project conditions has been beset with several problems. This paper explores how local community knowledge about malaria acts as a barrier to the use of ITNs in three settings. We employed structured formal observation and a range of interviewing techniques which included informal interviews, focus group discussions, semi-structured in-depth interviews, and structured survey interviewing. People recognize the term 'malaria' but have limited biomedical knowledge of the disease, including its aetiology, the role of the vector, and host response. Convulsions and anaemia are rarely linked to malaria. The people acknowledged a role for ITNs in nuisance reduction, but not for malaria prevention.     

Zinc in CSF of patients with febrile convulsion

OBJECTIVE: This prospective study was carried out from July-December 1999 to see the status of zinc in CSF of children with febrile convulsion and to compare this to that of control. METHODS: Forty-two cases of febrile convulsion and 30 controls (fever without convulsion) were enrolled into the study. CSF zinc was estimated by atomic absorption spectrophotometry (AAS) in Atomic Energy Center, Dhaka and compared between the two groups. RESULTS: The mean zinc level in CSF in the study sample was 40.19mgm/L and that in control was 74.98mgm/L. This difference was statistically significant (p<0.001). CONCLUSION: The study concludes that a significantly lower of zinc exists in CSF of children with febrile. However no relationship was found between CSF zinc status with age, sex, degree & duration of fever and time of lumbar puncture after convulsion.