Discharge diagnoses in infants with apparent life‐threatening event

Okada, Kazuko; Miyako, Motoko; Honma, Sato; Wakabayashi, Yasuko; Sugihara, Shigetaka; Ōsawa, Makiko

doi:10.1046/j.1442-200x.2003.01792.x

Cited by 26 publications

(12 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…58,59,128 Although no documented cases of GERD were reported in children with acute gastric volvulus, 44 (13%) of 329 children with chronic volvulus had radiologic evidence of GERD at the time of the volvulus diagnosis. Initial treatment for each of these children was directed toward correction of the volvulus only.…”

Section: Discussionmentioning

confidence: 96%

Gastric Volvulus in Infants and Children

2008

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 96%

Gastric Volvulus in Infants and Children

2008

View full text Add to dashboard Cite

show abstract

“…The relationship of epileptiformic seizures and the presence of gastroesophageal reflux is discussed in the literature in regard to the diagnostic challenge distinguishing epileptic seizures from apneic events due to GER [17,18,[20][21][22]. Furthermore, both apparent life threatening events and apneic seizures are often found in association with GER [15,[23][24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Does epilepsy influence the outcome of antireflux procedures in neurologically impaired children?

2006

View full text Add to dashboard Cite

In neurologically impaired patients (NIP), surgical management of gastroesophageal reflux disease (GERD) has become a widespread standard. Several follow-up studies have shown a high incidence of complications and recurrent reflux. As one of the possible causes epilepsy is mentioned repeatedly in the literature. The aim of this study was to determine the effective impact of epilepsy on the postoperative outcome by comparing results of our patients suffering from epilepsy to those without this disorder. From 1984 to 1999, a total of 45 NIP underwent antireflux surgery, including 20 patients suffering from epilepsy (EP) and 25 patients without this disorder (nEP). The existence of epileptic disorders, incidence of epileptic seizures and administration of anticonvulsatory drugs as well as results of diagnostic procedures, postoperative complications and incidence and time of recurrence of pathologic GER were recorded and analysed retrospectively. Preoperatively all patients had pathologic results in 24 h pH-monitoring. Median RI was 15.75 (EP, range 5.2-28.6) and 17.55 (nEP; range 7.2-26.5). 12-months-postoperative 24 h pH-monitoring showed a median RI of 3.8 (EP; range 1.3-25.6) versus a median RI of 3.3 (nEP; range 0.7-26.3). During the long-term follow-up evaluation of 3.9 years, 17 EP suffered from persistent epileptic seizures despite medical treatment. 19 patients (42%) developed recurrent reflux. This included seven EP (35%) and 12 nEP (48%). The necessity of reoperation was higher in nEP (n = 5, 20%) than in EP (n = 1, 5%). This analysis did not show a significant correlation between recurrence of pathologic GER after fundoplication and the incidence of epileptic seizures. We consider our findings to strongly question the widespread opinion considering this correlation. We conclude, that cerebral seizures alone do not alter the operative outcome of antireflux surgery in NIP.

show abstract

“…1,2,5,6 Some of these manifest as apparent life-threatening events (ALTE), which often lead to extensive and costly investigations. It has been estimated that a careful history and examination would point to the underlying cause in 50% of ALTEs, therefore leaving a significant number of episodes undiagnosed.…”

Section: Discussionmentioning

confidence: 99%

Paroxysmal Events in Infants: Persistent Eye Closure Makes Seizures Unlikely

Korff

Nordli

2005

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objective. Paroxysmal events are frequent in infancy. A precise diagnosis is often difficult to assign despite adequate history and physical examination. Certain clinical signs may help to suggest the diagnosis, thereby avoiding unnecessary and costly investigations. The aim of this study was to determine the frequency of eye opening during infantile seizures and evaluate the potential usefulness of this simple observation in the differential diagnosis of acute events in infants.Methods. We performed a retrospective video electroencephalogram review of the seizures recorded in infants at our Epilepsy Center, paying specific attention to eye opening.Results. I nfants (children aged 1-24 months) can have a variety of peculiar paroxysmal events. 1,2 Most confusing can be the infant who suddenly has altered behavior or a dramatic fluctuation in the level of alertness for no clear reason. A variety of causes are often suspected, including syncope and epilepsy. Although it is clear that an accurate differential diagnosis depends on careful attention to the history, some simple features may be of use. During a recent presentation at the daily pediatric intake rounds, a resident observed that an infant's eyes were closed throughout the paroxysmal event. This struck us as unusual for an ictal event, so we carefully examined our experience with video electroencephalogram (EEG) recordings of infants with seizures to determine how often eyes were closed throughout recorded events. METHODSThe database of the Epilepsy Center at Children's Memorial Hospital (Chicago, IL) includes patients who are aged 1 day to 18 years and present with a great diversity of indications, ranging from new-onset paroxysmal spells to intractable epileptic seizures. Twenty-three gold electrodes are used for all recordings, including 3 references and the ground, and placed according to the rules of the 10 -20 international system. All recordings are interpreted by a pediatric epileptologist at Children's Memorial Hospital.The seizures and the epilepsy syndromes were classified according to the International League Against Epilepsy recommendations, 3,4 as described in Table 1. To increase the accuracy of the classification, we created a subcategory of partial seizures (2.4) for which it was impossible to determine alteration of consciousness or secondary generalization and further specified the event type by adding its predominant clinical manifestation.From a total of 2112 patients monitored in our video EEG laboratory from May 2000 through January 2005, 109 distinct seizures in 77 infants were analyzed. When several seizures were recorded during the same EEG, only 1 seizure type per EEG was considered (eg, if 100 spasms and 50 clonic seizures were noted during the same recording, then only 1 of each was considered; if spasms or clonic seizures were recorded during another EEG, then 1 event per seizure type was considered as well). The entire video file was reviewed throughout the ictus. Nonepileptic events were not analyzed for comparison ...

show abstract

Discharge diagnoses in infants with apparent life‐threatening event

Abstract: It is important to recognize that gastroesophageal impairments such as GERD or CGV could be responsible for many incidences of ALTE in infancy. The authors recommend a trial be established to investigate the causes of ALTE, including gastroesophageal evaluations in all infants with ALTE.

Cited by 26 publications

References 22 publications

Gastric Volvulus in Infants and Children

Gastric Volvulus in Infants and Children

Does epilepsy influence the outcome of antireflux procedures in neurologically impaired children?

Paroxysmal Events in Infants: Persistent Eye Closure Makes Seizures Unlikely

Contact Info

Product

Resources

About