Search

Children and adults may suffer seizures that appear to be epileptic but are actually psychogenic, that is, of mental origin. These seizures may have both subconscious and volitional, or willed, components to them, and may involve thrashing motions, jerking of limbs, staring, and unresponsiveness. In children, such episodes are frequently associated with specific stresses or anxiety. Psychogenic seizures were diagnosed in a group of 21 nonepileptic children aged 8 to 18, using video and electroencephalographic (EEG) recording techniques. The diagnosis and cause of psychogenic seizures were discussed with each child and family, and the discontinuation of seizure medication was strongly urged. All except one child agreed to stop taking the medication. Patients were also urged to obtain psychiatric counseling, and 16 did so. Of the 18 patients who could be contacted by follow-up phone calls made 6 to 66 months after diagnosis of psychogenic seizures, 14 were seizure-free. Due to the small number of children studied, no differences in outcome could be attributed to gender, psychiatric treatment, or belief in the diagnosis of psychogenic seizure. The authors discuss the critical need to rule out epileptic seizures in these patients, which is made possible by the video-EEG recordings. The patients, once reassured, are then more likely to participate in their own psychiatric care. Specific criteria for differentiating among psychogenic seizures, partial epileptic seizures, and nonepileptic paroxysmal behavior are also discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

To the Editor.-- Bye has described a patient with a chronic barking cough and has proposed a treatment for what he considers a condition related to stress or anxiety.[1] I [...]

Abstract. Paroxysmal choreoathetosis is a rare, involuntary movement disorder. Attacks occur spontaneously or may be induced by movement, startle, or anxiety. The movements are tonic, dystonic, or choreoathetotic. Sporadic and, more commonly, familial cases have been reported. Onset occurs most often during childhood, and the course is nonprogressive. Response to anticonvulsant therapy is usually excellent. Five cases of the sporadic form of paroxysmal choreoathetosis are reported. Three of the five patients had attacks after initiation of movements such as rising from a chair. Results of physical examination were normal in four patients. One child had mild hemiatrophy and unilateral hyper-reflexia. Results of laboratory studies, including determinations of serum calcium and ceruloplasmin levels, EEGs, and CAT scans of the head, were normal. The attacks ceased in all patients after treatment with either phenytoin or carbamazepine. [ABSTRACT FROM AUTHOR]

Four cases of lead neuropathy in children with hemoglobin S-S or S-C disease are reported. Neuropathy is a rare manifestation of lead poisoning in children, and only ten other cases have been well documented in the pediatric literature. The last previous case report of lead neuropathy was also in a child with hemoglobin S-S disease. The neuropathy seen in the children with sickle cell disease was clinically similar to that seen in the previously reported cases in nonsicklers, but differed in both groups from that usually seen in adult cases. It is, therefore, postulated that children with sickle cell disease have an increased risk of developing neuropathy with exposure to lead. The exact mechanism for this association remains unknown, but in children with sickle cell disease presenting with symptoms or signs of peripheral weakness, the possibility of lead poisoning must be considered. [ABSTRACT FROM AUTHOR]

Provides information on the role and the pharmacology of medications used to treat children with attention deficit disorders. Potentially useful drugs; Dose levels; Adverse effects.

Discusses the Supplemental Security Income (SSI) program for children that was implemented by Congress in 1974. Financial and resource eligibility criteria; Evaluation process; Role of pediatricians in ensuring that eligible children receive the SSI cash and associated benefits.

Presents letters to the editor on pediatric topics. Validity of prescribing medication for all children with school behavior problems; Prevention of unintentional esophageal intubation; Use of diazepam in neonatal narcotic withdrawal syndrome; Susceptibility of medical students to mumps.

Focuses on the growth of the field of infant and child development. Increase in the knowledge about special services that can improve early development of children; Debate on the factors involved in the developmental outcome of a child; Awareness of the importance of the family in the development of children.

Defines the context in which rehabilitation therapies should be prescribed, emphasizing the identification and enhancement of the child's function and abilities. Therapy prescriptions; Spectrum of motor impairments; Multiple needs of children.

Presents guidelines for screening infants and young children for developmental disabilities. Importance of early identification to effective therapy; Utilization multiple sources of information for screening; Issues in methodology; Essential components of the screening process; Required skills and procedures.