1494 Neurofeedback as a Treatment of Tics in Children

Abstract

Panayiotopoulos syndrome is "a benign age related focal seizure disorder occurring in early and mid-childhood. It is characterized by seizures, often prolonged, with predominantly autonomic symptoms, and by an EEG that shows shifting and/or multiple foci, often with occipital predominance" (definition of International League Against Epilepsy).In literature the clinical features of PS was frequently mistaken as non-epileptic conditions such as acute encephalitis, syncope, migraine, cyclic vomiting syndrome, motion sickness, sleep disorder, or gastroenteritis.In our experience during the last 2 years we have observed 4 children misdiagnosed by clinical history for GERD. Until now PS is underestimated with the consequences of high morbidity and costly mismanagement.These 4 children were referred to general pediatrician at the age of 2-3 years because they started suffering from gastrointestinal emetic symptoms: nausea, retching, and vomiting. The attacks occurred mainly during sleep without sensory-motor clinical signs of seizure. One child also had monthly episodes of severe headache with clinical characteristics of migraine without aura.After a treatment with proton pump inhibitors (PPI) and antiacid without benefits, according to the literature, they were sent to neurologist for suspection of PS which was confirmed by EEGs occipital features.Because of the importance of the symptomatology, the children have been treated with Lamotrigine with benefit. Conclusions When a child presents symptoms suggestive of GERD but non responding to specific GERD therapy, there is indication to effect an EEG to investigate a PS. Background and Aim To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. Methods The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. Results The records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7±2.7 weeks, with a mean birth weight of 2967±755 g and head circumference of 35.8±3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33±1.2 cm. Newborns underwent surgery on average of 8.2±5.9 days after birth, with an overall mean duration of hospital stay of 30±25.1 days. Patients were divided into two groups based on timing of surgery (group 1, ≤5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). THE EFFECT OF SURGERY TIME ON PROGNOSIS IN NEWBORNS WITH MENINGOMYELOCELE