Simultaneous posterior decompression and occipitocervical fixation with an alternative instrumentation technique is discussed. The procedure can be performed regardless of the size of suboccipital craniectomy. Screw insertion into the diploic layer of the occipital bone has not been described previously.
Zonisamide was tried on 44 children, 18 girls and 26 boys, from 8 months to 15 years of age at the start of the trial. In 6 children the drug has been stopped because of side effects. The drug was introduced at a dose of 2-4 mg/kg/day and increased to 12 mg/kg/day unless a satisfactory response occurred at a Power dose. A 1OOyo control of seizures was achieved in 5 of 5 cases of idiopathic generalized epilepsies, in 7 of 8 cases of symptomatic generalized epilepsies, in one of one case of idiopathic partial epilepsies, and in 17 of 24 cases of symptomatic partial epilepsies. The main side effect was drowsiness, especially during the introduction.
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