Objective: To study the etiology and clinical profile of non-traumatic coma in children at tertiary care center and to determine the predictors of outcome. Methods: One hundred and four consecutive children between 2 mo-12 yr were studied. The clinical signs at admission; vital signs, Glasgow coma scale, respiratory pattern, papillary reflex, extra-ocular movements, fundus picture and motor deficits were recorded. Etiology of coma was determined by clinical history, examination and relevant investigations. Their progress was monitored clinically, biochemically and with multi-system monitors. Outcome was recorded as survived or died. Results: Etiology of coma in 65% cases was intracranial infections; other causes were metabolic (20%). Sixty-seven percent recovered completely, 16% had residual neurodeficits, 16% died. Survival was better in children with intracranial infections (13%) as compared to metabolic coma (33%). On multivariate logistic regression, bradycardia, hypotension, abnormal respiratory pattern (especially, ataxic type), duration of coma more than 48 h, Glasgow coma scale < 7 at admission, unequal and non-reactive pupils, papilledema, abnormal extra-ocular movements, motor deficits, signs of meningitis correlated with mortality. Requirement of ventilatory support and abnormal computerized tomography findings correlated with mortality. Conclusions: Intracranial infections were the most common cause of non-traumatic coma in children; the most common cause of death being metabolic coma. Simple clinical signs and relevant investigations served as prognostic indicators of outcome.

Kikuchi-Fujimoto disease (KFD) is a benign and self-limiting condition primarily affecting the cervical lymph nodes. Central nervous system involvement with acute cerebellar symptoms is a rare presentation in KFD. We report a 15-year-old girl presenting with intentional tremor, dysarthria and gait ataxia following episodes of recurrent fever and cervical lymphadenopathy. The diagnosis of KFD was made based on histopathology. Brain magnetic resonance imaging showed lesions in mid-pons and bilateral middle cerebellar peduncles. The patient's symptoms spontaneously resolved without any sequelae. A diagnosis of KFD should be considered when enlarged cervical lymphnodes are observed in patients with acute cerebellar symptoms. Selective inflammation of cerebellum and related structures by viral or immunological responses may be attributed to this rare presentation in KFD.

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QOLIE MINI Epilepsy a b s t r a c tBackground: Epilepsy is a neurological condition affecting both the sexes in all age groups and is associated with psychiatric co-morbid conditions. There is a paucity of available published data regarding psychiatric co-morbid conditions and quality of life in patients with Epilepsy (PWE) from developing countries. Methods:We evaluated the quality of life in 80 PWE, 80 with asthma (asthma control subjects: AC) and 80 normal healthy patients (normal control subjects: NC) using the QOLIE-31 item inventory.Results: Psychiatric co-morbid conditions are more common in PWE (32.50%) as compared to the AC (17.5%) and NC (7.5%). The quality of life in PWE was significantly lower when compared to control subjects and it was further low in the presence of co-morbid psychiatric disorders. Conclusion:Co-morbid psychiatric disorders should be identified and documented in PWE and treating these disorders apart from the control of seizures may significantly improve their quality of life.