No abstract

Recent findings have focused on the possible role of linezolid as a suitable candidate for the treatment of central nervous system infections. The linezolid treatment for meningitis was sporadically reported in adults but there was no report in children. Here, we present a 6-month-old boy with meningitis and subdural empyema which was unresponsive to more conventional agents but successfully treated with linezolid therapy. A previously healthy 6-month-old boy was referred to our clinic for deteriorating general condition with fever, vomiting and seizures. He had fever and tense-bulging anterior fontanelle. Based on his first cerebrospinal fluid (CSF) results, empirical antibiotic therapy for bacterial meningitis consisting of vancomycin and ceftriaxone was started. However, CSF culture yielded no micro-organisms but blood culture showed coagulase-negative Staphylococci. On the 7th day, he still had high fever and the erythrocyte sedimentation rate (ESR) and serum CRP levels had risen by 105 mm/h and 36.2 mg/dl, respectively. On 10th day, computerized cranial tomography showed bilateral frontoparietal subdural empyema. Purulent material was evacuated by burr hole, and gram stains of the material showed polymorphonuclear leukocytes and no microorganisms. Clinical and CSF findings of our case were, unresponsiveness to vancomycin, ceftriaxone and consecutive meropenem treatment while we still observed subdural empyema during these treatments. For this reason we started linezolid 10 mg/kg twice daily. Clinical signs improved dramatically, with both completely normal neurological findings and normalization of CSF and radiological findings. To the of our best knowledge, linezolid treatment of meningitis in children has not been reported previously. Clinical and CSF findings of our case were improved completely with linezolid treatment. Also, control cranial computerized tomography showed the total recovery of subdural empyema. Here we present the youngest case with meningitis which was successfully treated with linezolid treatment.

No abstract

No abstract

Purpose: To obtain information on characteristics, management, current objective nutritional status and perception of nutritional status of children with cerebral palsy (CP) from healthcare professionals (HCPs) and caregivers. Materials and methods: A detailed survey of several items on eight main topics (general characteristics, motor function, comorbidities, therapies, anthropometry, feeding mode and problems and perceived ARTICLE HISTORY

ÖZ İKSST Derg 7(3):144-146, 2015 doi:10.5222/iksst.2015 GİRİş Serotonin sendromu nadir görülen, mortalite riski bulunan serotonerjik etkili ilaçların tedavi edici dozda veya aşırı miktarda alınmasından ya da serotonerjik etkili iki ilacın farmakolojik etkileşiminden kaynaklanan bir ilaç reaksiyonudur. Genellikle hekimler tarafından özellikle hasta semptomlarının hafif olduğu durumlarda akla gelmeyen ve atlanan bir hastalıktır. Geniş bir semptom yelpazesi vardır. Görülen bulgular tremor, diyare ve hipertansiyon şeklinde nispeten hafif olabileceği gibi ağır olgular rijidite, hipertermi, çoklu organ yetmezliği ve ölümle de sonuçlanabilir. Hafif semptom ve bulgularla seyreden olgular için serotonin toksisitesi terimi de kullanılmaktadır (1) . Biz burada serotonerjik etkili iki ilacı kombine kullanan ve serotonin sendromu gelişen bir hastamızı sunmak istedik. oLGUOn altı yaşında erkek hasta çocuk nöroloji polikliniğine jeneralize tonik klonik tarzda nöbet geçirme yakınması ile başvurdu. Daha önce nöbet öyküsü olmayan hastanın son bir aydır çocuk psikiyatrisi tarafından obsesif kompulsif bozukluk tanısı ile baş-lanan fluoksetin (20 mg/gün), aripiprazol (10 mg/ gün) ve imipramin hidroklorür (50 mg/gün) tedavilerini aldığı öğrenildi. Hastanın tedavi başlandıktan sonra huzursuz olduğu, aşırı sinirlenme, bağırma, bazen ağlama şeklinde davranışlarının olduğu öğre-nildi. Fizik muayenesinde hiperhidrozisi dikkat çeken hastanın ateş 39°C, tansiyon 150/60 mmHg, nabız 116/dk. olarak saptandı. Özellikle alt extremitelerde tonus artışı ve derin tendon reflekslerinde artış ile birlikte ellerinde belirgin tremoru mevcuttu. Laboratuvar tetkiklerinde, kan gazında pH: 7,062, pCO 2 : 41,3 mmHg HCO 3 : 10,9 mmol/L, baz açığı -19 mmol/L, CK: 599 U/L saptandı. Hastanın elektroensefalogram (EEG) ve beyin MRG çalışmaları normal sonuçlandı. Hastada mevcut bulgularla serotonin sendromu düşünüldü. Monitorize edilen hastanın fluoksetin ve imipramin tedavileri kesildi. Hastanın kliniğinde 24 saat içerisinde belirgin düzelme oldu. Metabolik asidozla birlikte hiperhidrozisi ve hipertansif değerleri giderek düzelen hastanın üç günlük

136Objectives. Headache is a very common symptom that can be seen in the children. It can be seen due to primary or secondary causes. Migraine and tension-type headache are the most commonly seen primary headache types in children. In this study, we retrospectively evaluate etiologic and clinical features of the 228 patients. Methods. In this study, clinical features and neuro-imaging characteristics of the patients, who admitted Eskisehir Osmangazi University pediatric neurology department between 2007 and 2011 were evaluated retrospectively. Headache classification was made according to "International Headache Society" criteria. Results. The ages of the patients ranged from 4 to 18 years (average 12.9±3.1). There were 136 (59.6 %) girls, and 92 (40.4%) boys. The most frequent causes of the headache were migraine (37.3%) and tension type headache (25%). There were other associating diseases at 54 (23.7%) patients. Allergic rhinitis and asthma bronchilitis were the most commonly associated diseases. Abnormalities were encountered in 3 (6.8%) of the 44 (19.3%) patients taken computerized brain tomography, 18 (20.2%) of the 89 (39%) patients taken magnetic resonance imaging and 8 (3.5%) of the 77 (33.8%) patients taken electroencepahlography. No serious problem is established in patients undergoing neuro-imaging. Conclusions. In this study, it was seen that migraine and tension-type headache are the most frequently seen causes of the headache in the children. It is concluded that unnecessary neuroimaging examination should be avoided by detailed anamnesis and neurologic examination of children that admitted hospital with headache complaint.

Background. We evaluate here the effect of the ketogenic diet (KD) on children with drug-resistant epilepsy (DRE) in terms of clinical effectiveness, anthropometric measurements, and some electroencephalogram (EEG) and biochemical findings. Methods. Included in the study were 18 children (median age 70 months, 61.1% female) who received the classical KD and modified Atkins diet (MAD) for at least one year due to DRE. The patients` demographic and laboratory data; weight, height and body mass index values; EEG and electrocardiographic findings; abdominal ultrasonography findings; and biochemical parameters were recorded at baseline and at 12 months after the initiation of the diet. A reduction of ≥50% in the number of seizures was accepted as a response to KD. Results. Classic KD was chosen for 14 patients (77.8%), and MAD for four patients (22.2%). The response to KD therapy (≥50% reduction) was 55.5% (n = 10) (p = 0.008), and one patient even became seizure-free. By the 12th month of treatment, 10 patients had experienced a reduction of more than 50% in epileptiform discharges, as indicated by EEG findings. There was no difference in seizure reduction between the patients who received classical KD and MAD. A total of 11.1% of the children lost weight during KD treatment. The most common side effect was constipation (n = 10, 55.6%). At the end of one year of treatment, total cholesterol and low density lipoprotein cholesterol (LDL-C) LDL-C levels had increased dramatically, while fasting blood glucose levels had decreased significantly. Conclusions. Our study suggests that KD treatment provides good clinical efficacy in the treatment of pediatric DRE, and can significantly reduce the frequency of epileptic discharges. Also, total cholesterol and LDL-C levels increased significantly, and fasting blood glucose levels decreased significantly compared to the baseline levels.