Alpha-Pattern Coma in Childhood and Adolescence

Rhythmic Coma in Children

“…However, the outcome may actually be more dependent on the etiology of the coma than on the electroencephalographic (EEG) findings.2 Only rare and scattered cases of alpha coma have been reported in the pediatric population. 1, [3][4][5][6][7][8][9] Etiologies included hypoxic-ischemic encephalopathy (cardiac arrest), hypoxia (strangulation and near drowning), metabolic and toxic derangements (Reye's syndrome and barbituate overdose), and head trauma (Table 1). Outcome in reported cases was varied; three survived and were normal neurologically, three survived with significant neurologic deficit, and three died.…”

Alpha-coma in an infant with hypoxic-ischaemic encephalopathy

“…In these days of evidence based medicine, should we not be using one of these? [3][4][5][6] The cardiac eVects of a short course of dexamethasone have been reported before, by Brozanski et al, in their trial of a three day repeatable pulsed course. 4 They also found significant hypertrophy which regressed by discharge.…”

“…But only the authors of two studies 2 3 actually defined how an immature neutrophil was differentiated from a segmented neutrophilthat is, morphological criteria, including the width of the connection between the nuclear segments. Segmented neutrophils are defined variably in published studies: most authors require an indentation of the nucleus to less than a third of the maximal nuclear diameter, 3 but others require an indentation to 50% or that the connections between nuclear segments are filiform. Discrepancies in the definition of bands and segmented neutrophils may be one of the reasons that the results for sensitivity and specificity vary largely between studies.…”

“…1 Alpha-coma in an infant with hypoxic-ischaemic encephalopathy EDITOR,-Alpha coma (AC) is the combination of coma and an electroencephalographic (EEG) pattern of synchronous, rhythmic 8-13 Hz activity which has been described in certain severe neurological conditions such as post anoxic or ischaemic encephalopathy, head trauma, brain stem infarcts and drug overdoses. [1][2][3] In neonates AC has been associated with chromosomal abnormalities and inborn errors of metabolism and rhythms have been described transiently during seizure activity. 4 5 Most reported cases have been associated with a poor outcome Case report A boy weighing 4080 g was born by vaginal delivery following prolonged fetal distress and meconium stained amniotic fluid to nonconsanguineous parents.…”

“…Indeed, Cummings et al, in the study in which he reported beneficial eVects of the 6 week course, found that an 18 day course was not eVective at reducing time in oxygen. 3 There are now at least four dexamethasone regimens described which do reduce the incidence of chronic lung disease. In these days of evidence based medicine, should we not be using one of these?…”