Akashi Ishikawa

Subacute sclerosing panencephalitis Atypical absence attacks as first symptom

Subacute sclerosing panencephalitis was diagnosed in a 10-year-old girl who had suffered from atypical absence attacks for 3 months; diagnosis was made after 5 months of these attacks. Characteristic EEG findings included diffuse spike and wave complexes of about 2.5 Hz associated with desynchronization during the absence attacks, and recruiting rhythm during the tonic seizure. As the lesion responsible for these EEG patterns originated in the brainstem, subcortical structures were probably affected early in the disease. The SSPE complexes may have originated chiefly in the brainstem since, in this case, they were recognized even during the period of absence attacks.

Clonazepam monotherapy for epilepsy in childhood

Sixty patients (age-range one month to 14 years) with other types of epilepsy than infantile spasms were treated with clonazepam. Disappearance of seizures and normalization of abnormal EEG with disappearance of seizures were recognized in 77% and 50%, respectively. Seizures disappeared in 71% of the patients with generalized seizures and 89% of partial seizures. Improvement of abnormal EEG was noticed in 76% of diffuse paroxysms and in 67% of focal paroxysms. In excellent cases, mean effective dosages were 0.086 +/- 0.021 mg/kg/day in infants and 0.057 +/- 0.022 mg/kg/day in schoolchildren, this difference was statistically significant (p less than 0.005). The incidence of side effects such as drowsiness and ataxia was only 5%.

Magnetic resonance imaging of heterotopic gray matter

Heterotopic gray matter was detected by means of magnetic resonance imaging in a 3-year-old girl with left hemiparesis and atonic seizures. In the inversion recovery sequence, a large area of decreased signal intensity was noted in the right centrum semiovale and differentiation of the right basal ganglia was not clear. We speculated that the brain malformation in our patient occurred at ten weeks conceptional age.

Correlation between fetal activity and the neonatal behavioral assessment scale

Fourteen women were asked to record fetal movements by a subjective method during one week out of 36‐38 weeks of pregnancy. Brazelton Neonatal Behavioral Assessment Scale (NBAS) exams were performed on the 14 newborn infants born to these women from three to five days of life. Correlations were computed between fetal activity and neonatal behavior. Negative correlation coefficients were significantly found between orientation‐animate visual and the following fetal movements: Kicking, rolling and total movements, and orientation‐animate visual and auditory and fetal rolling movements. Hiccup‐like movements correlated significantly with pull‐to‐sit of NBAS. Prenatal‐neonatal correlations were found in only three items of NBAS. We could not demonstrate positively the continuity of the development from the fetal to neonatal period.