111,878 research outputs found
No kinetic interaction between levetiracetam and cyclosporine: a case report.
No full textLevetiracetam is a new antiepileptic drug reported to be effective and well-tolerated in adults and children affected by epilepsy. Its lack of hepatic cytochrome metabolism is the theoretic basis for the absence of interactions with other drugs that follow this pathway. We present a 14-year-old girl who underwent orthotopic heart transplantation, followed by antirejection therapy including cyclosporine. Symptomatic occipital lobe epilepsy developed that was successfully treated with oxcarbazepine, but cyclosporine plasma levels decreased to below the antirejection threshold. Oxcarbazepine was replaced by levetiracetam. Levetiracetam did not affect the metabolism of cyclosporine, and cyclosporine plasma levels have remained in the therapeutic range up to now. The patient is still seizure-free and does not complain of any side effects after a 1-year follow-up. Further studies are necessary to confirm the lack of interactions between these drugs, which would make levetiracetam a useful therapeutic option in managing seizure control during antirejection therapy with cyclosporine
Focal nonconvulsive status epilepticus in children: clinical and electroencephalographic features in 38 patients
No full textPurpose: The aim of this study was to characterize clinically, etiologically, and electroencephalographically focal Nonconvulsive Status Epilepticus (NCSE) in children. Moreover, we tried to identify focal NCSE features distinguishing between different ages, NCSE etiologies, and cases of de novo onset. Methods: We retrospectively identified patients (aged 1 month to 18 years) who had EEG-documented focal NCSE between January 2001 and December 2019. We analyzed the clinical features, etiology, and EEG features of each event. Results: Thirty-eight patients were included in this study. NCSE had a de novo onset in 26 patients and was the first manifestation of previously undiagnosed epilepsy in 12 patients. NCSE etiology was acute symptomatic in 13 patients. Acute symptomatic NCSE events were mainly observed in hospitalized children, were usually longer, and had a significantly higher frequency of repetitive EEG patterns than other etiologies. In patients with epilepsy, the etiology of NCSE was remote symptomatic in 14, progressive in 6, and cryptogenic in 5; a definite or suspected genetic disorder was observed in 11. EEG localization was frequent in posterior regions (18 children). Eleven patients had refractory NCSE and 4 required admission to the intensive care unit. Conclusion: Focal NCSE in children is more frequent in the first years of life, mainly involves posterior regions, and often has de novo onset. In the case of de novo focal NCSE both acute symptomatic NCSE and new-onset epilepsy must be considered and investigated. A higher frequency of repetitive EEG patterns and an inpatient setting are significantly associated with acute symptomatic NCSE
Enuresi
No full textL’enuresi consiste nella perdita involontaria di urina durante il sonno notturno ad un’età in cui normalmente i bambini hanno già acquisito il controllo degli sfinteri. Si distingue poi tra enuresi primaria nel caso in cui il controllo della minzione non sia mai stato acquisito e secondaria qualora questo sia stato raggiunto per un periodo superiore ai sei mesi e poi perso. La patogenesi può comprendere cause di natura organica ma più spesso si parla di enuresi idiopatica che può derivare dalla somma di fattori psicologici e di predisposizione familiare. Molto spesso non è necessario ricorrere alla terapia farmacologica ma sono sufficienti alcuni accorgimenti comportamentali, tende comunque a risolversi spontaneamente nel tempo
Trauma cranico
No full textIn pediatria il trauma cranico è motivo molto frequente di accesso in Pronto Soccorso. Nonostante nella maggior parte dei casi non si riscontrino sequele neurologiche, esso rappresenta la maggior causa di disabilità e morte infantile dopo il primo anno di vita. Per questo è di fondamentale importanza saper gestire un corretto iter diagnostico-strumentale soprattutto sulla base dei sintomi clinici “di allarme” associati e conseguentemente, impostare un corretto trattamento
Epilessia focale e disturbo del movimento parossistico: quali possibili ipotesi diagnostiche?
No full textauthor-bios-SRD-19-0063.R1 – Supplemental material for The Network Structure of Police Misconduct
No full textSupplemental material, author-bios-SRD-19-0063.R1 for The Network Structure of Police Misconduct by George Wood, Daria Roithmayr and Andrew V. Papachristos in Socius</p
Case Report of Pyruvate Dehydrogenase Deficiency With Unusual Increase of Fats During Ketogenic Diet Treatment
No full textThis article describes a case of pyruvate dehydrogenase deficiency in a 3-year-old boy who presented generalized hypotonia, severe psychomotor development delay, and generalized and partial seizures and was refractory to antiepileptic drugs. After the diagnosis, the patient was put on a ketogenic diet. Six months later, seizure frequency was reduced and psychomotor development had improved. At the same time he presented some side effects, such as 2 episodes of significant increases in cholesterol and triglycerides associated with viral respiratory infections. The latter decreased with a supplementation of ω-3 fatty acids and an increase in caloric intak
Lo stroke in età pediatrica
No full textLo stroke, occlusione o rottura di vasi cerebrali, è certamente un evento raro in età pediatrica (3-10/100.000/anno), comunque
più frequente della meningite batterica; diventa subito un problema prevalente se si prende in considerazione non
la popolazione generale ma specifici gruppi nosografici, come le cardiopatie congenite, le vasculiti, i difetti dell’emostasi
e le condizioni protrombotiche. Nei soggetti falcemici, ormai non più rari in Italia, raggiunge il 10% sotto i 20 ann
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