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Objective Mild symptoms are the norm for children with coronavirus disease-2019 (COVID-19), but data on the Omicron form are few. One of the most frequent neurological symptoms of COVID-19 in children is febrile seizure (FS). Methods Patients with FS who visited the pediatric fever clinic between December 6 and December 31, 2022, when the Omicron version of SARS-CoV-2 was the predominant strain, were included in this retrospective, single-center analysis. Results Children who tested positive for COVID-19 had a 5.58% incidence of FSs. Compared to patients without COVID-19, a greater percentage of COVID-19 patients (29.5 vs. 7.5%, p < 0.01) experienced complex FSs. In the COVID-19-positive group, four cases were critically unwell and were admitted to the Intensive Care Unit (1.4 vs. 0%, p < 0.01), and the admission proportion was greater (18.9 vs. 1.9%, p < 0.01). The proportion of lactic acid and IL-6 increase was larger in the COVID-19-positive group (33.5 vs. 21.5%, 22.1 vs. 17.8%, p = 0.022, p = 0.006, respectively). Conclusion Infections with COVID-19 in children have been linked to FSs in the Omicron era. To fully understand the neuropathogenesis of seizures in children with COVID-19, more research is required. [ABSTRACT FROM AUTHOR]

Febrile seizures are the most common seizure disorder in childhood. Most febrile seizures have a benign course and children have a good prognosis. However, febrile seizures are traumatizing events for a child's family or caregiver to witness. Appropriate caregiver education is crucial to ease anxiety. This article reviews the risk factors, clinical presentation, diagnostics, treatment, and prevention of febrile seizures in addition to providing a guideline for effective caregiver education and support. [ABSTRACT FROM AUTHOR]

Hyperbaric oxygen (HBO2) breathing induces generalized tonic and clonic seizures through poorly understood mechanisms. The purpose of the research was to evaluate the mechanisms of involvement of monoamine oxidase (MAO) in the development of hyperbaric oxygen seizures. In rats placed in a pressure chamber under an oxygen pressure of 5 ATA, convulsive reactions were analyzed after the administration of pyrazidol, an MAO-A inhibitor, and pargyline, an MAO-B inhibitor. Studies have shown a decrease in the activity of MAO isoforms in HBO2 as well as a delay in the development of seizures in animals with inhibition of MAO-A and MAO-B. The level of GABA in the brain decreased with HBO2, and inhibition of MAO-B with pargyline prevented the decrease in the inhibitory transmitter. The results indicate that MAO isoforms play an important role in regulating epileptogenesis in extreme hyperoxia. Hyperbaric oxygen, inhibiting the catalytic activity of MAO by transforming its molecular structure, leads to disruption of the regulation of the exchange of monoamine neurotransmitters and a decrease in the level of GABA in the brain, which together leads to an imbalance of excitation/inhibition processes in the central nervous system, which is the basis for the development of oxygen epilepsy. [ABSTRACT FROM AUTHOR]

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Background: Globally, eclampsia is the leading cause of maternal and neonatal morbidity and mortality. Objective: The present community‐based study was conducted among rural tribal women of reproductive age in remote villages of central India to determine their awareness of eclampsia and its likely impact. Methods: This cross‐sectional analytic study included randomly selected 4500 tribal women, between 15 and 45 years of age, residing in 140 villages in the proximity of one village with a health facility (study center), and who were willing to undergo a personal interview. In‐depth face‐to‐face interviews (each lasting 15–30 min) of study subjects regarding awareness, knowledge, practices, and perceptions about eclampsia were conducted using a predesigned tool completed by research assistants (not the subjects). Results: Of the 4500 women interviewed, the majority (62.4%) were 20–29 years old, minimally educated (40.6%), laborers (41.3%), and of a low socioeconomic class (40.8%). Of all the participants, only 35.9% were aware of eclampsia, associated events during pregnancy, labor, and the immediate post‐delivery period; 81.7% of those who were aware understood about symptoms and signs like headache, blurring of vision, dizziness, swelling over the body, ad high blood pressure. Of all the women who knew about eclampsia, 73.9% were aware that the occurrence of convulsions during antenatal and postnatal periods was an emergency and required urgent management, whereas 88.4% were not aware that severe convulsions affected maternal and neonatal health seriously, only 38.2% knew that eclampsia was a preventable condition. Conclusion: There was lack of awareness about eclampsia in many women and, of those who knew, some were not aware that it was dangerous. There is a need for awareness among women and their families of the disorder, its impact, and what action is needed in case it occurs. [ABSTRACT FROM AUTHOR]

Introduction: A febrile seizure is a convulsion in a child that's caused by a fever. Disruptions in the balance of serum electrolytes significantly contribute to the onset of these issues. This study aimed to investigate serum electrolyte abnormalities in hospitalized children experiencing fever and seizures. Methods: In this cross-sectional study, a census was conducted to examine all children hospitalized with fever and convulsions at Taleghani Hospital in Gorgan during the years 2013 and 2014. Demographic information, seizure type, recurrence, and test results of patients were gathered using a checklist developed from the data available in the patients' inpatient records and the hospital's information system. Spearman and Mann-Whitney correlation tests were performed using software for statistical analysis. Results: The study's results indicated that the average age of the patients was 22.6 ± 13.9 months, with 117 of them (54.7%) being boys. Fever and convulsions were classified as simple in 163 patients (76.2%), while 28 patients (13.1%) experienced recurrent convulsions. The findings revealed an inverse and significant relationship between age and serum levels of potassium, calcium, and magnesium; however, no such relationship was found between age and sodium serum levels. Additionally, there was no correlation between gender, type of fever and seizures, or the recurrence of seizures with serum levels of sodium, potassium, calcium, and magnesium. Conclusion: It appears that measuring serum electrolytes in children with fever and convulsions should be conducted on a case-by-case basis, guided by a physician's assessment. [ABSTRACT FROM AUTHOR]

Opioids are commonly used for management of pain. The term opioids include compounds that are extracted from the poppy seed as well as semi synthetic and synthetic compounds. Their regular non-medical use, Prolonged use, misuse and the use without medical supervision can lead to opioid dependence and other health related problems. Opiate dependence is the disorder of regulation of opioid use arising from repeated or continuous use of opioids. In worldwide, about 275 million people or {5.5 percentage of global population aged 15 to 64 yrs.} Used drugs At least once in 2019. Among them about 62 million people used opioids. Opioid use can lead to death due to effects of opioids on the part of the brain which regulates breathing. The number of opioid overdoses has increased in recent years in several countries in part due to the increased use of opioids in the management of chronic pain. Males, People of older age and people with low social economic status are at higher risk of opioid overdose than women. In this article we highlighted about various types of opioids, how it causes effects and symptoms for acute poisoning and chronic poisoning and suggested some of the safety measures and treatment guidelines regarding the opioid overdose condition. [ABSTRACT FROM AUTHOR]

When conducting toxicology studies, the interpretation of drug-related neurological clinical signs such as convulsions, myoclonus/myoclonic jerks, tremors, ataxia, and salivation requires an understanding of the spontaneous incidence of those observations in commonly used laboratory animal species. The spontaneous incidence of central nervous system clinical signs in control animals from a single facility using cage-side observations or high definition video monitoring was retrospectively analyzed. Spontaneous convulsions were observed at low incidence in Beagle dogs and Sprague–Dawley rats but were not identified in cynomolgus monkeys and Göttingen minipigs. Spontaneous myoclonic jerks and muscle twitches were observed at low incidence in Beagle dogs, cynomolgus monkeys, and Sprague–Dawley rats but were not seen in Göttingen minipigs. Spontaneous ataxia/incoordination was identified in all species and generally with a higher incidence when using video monitoring. Salivation and tremors were the two most frequent spontaneous clinical signs and both were observed in all species. Data from the current study unveil potential limitations when using control data obtained from a single study for toxicology interpretation related to low incidence neurological clinical signs while providing historical control data from Beagle dogs, cynomolgus monkeys, Sprague–Dawley rats, and Göttingen minipigs. [ABSTRACT FROM AUTHOR]

Abstract Benign convulsions with mild gastroenteritis (CwG) characterized by afebrile seizures that occurred in the acute period of mild gastroenteritis often occur in infancy and toddlers. Until now, it has not been well acknowledged and thereby classified by the International League against Epilepsy (ILAE) as epilepsy syndrome or acute symptomatic seizures (ASS). Thus far, accumulating data suggest that CwG could fit all the mandatory criteria of ASS from the aspects of pathogenesis, clinical manifestations, and outcomes, rather than epilepsy in spite of the rare cases developing epilepsy over time. This review provides a comprehensive picture of this entity aiming to facilitate the pediatricians, particularly for general practitioners, to better recognize this unique entity and, ultimately, to minimize unnecessary evaluation and treatment.

Lafora disease is rare group of progressive myoclonic epilepsies, worldwide. It is more common in children and adolescents and is genetic, glycogen metabolism disorder. It has Autosomal recessive (AR) inheritance. Lafora bodies are inclusion bodies within cytoplasm of cells in heart, liver, muscle, and skin. Disease clinically has triad of seizures, myoclonus, and dementia. Lafora disease is a neurodegenerative disorder. In the absence of laforin function long glucose chains in specific glycogen molecules extrude water form double helices and drive precipitation of molecules which accumulate into Lafora bodies. That leads to impairment in development of cerebral cortical neurons. Clinical on set of disease is range in between 8-19 years of age and peaks around 15years of age. In our case, 16-year-old girl presented to emergency of tertiary care hospital with complain of episode of convulsions 40 minutes before admission. She is known case of generalized tonic-clonic seizures for past two years. Axillary skin biopsy on H&E staining showed pilosebaceous glandular unit with peri-adnexal and perivascular infiltrate. PAS-D stain showed round, globular, tiny PAS positive material noted within sweat glands. MRI brain was suggestive of right vertebral artery partial occlusion.

Background: Acute pesticide poisoning is a global health concern, with organophosphorus compounds contributing significantly. Neonicotinoids, like imidacloprid, have emerged as alternative insecticides due to their selective action on pest nervous systems. This case report explores imidacloprid poisoning, emphasizing clinical manifestations and the ongoing search for safer pesticides. Methods: A 46-year-old male, chronic smoker, and alcoholic, presented with suicidal imidacloprid poisoning. The patient experienced seizures, central nervous system (CNS) depression, hyponatremia, and respiratory arrest, necessitating mechanical ventilation. The case details the comprehensive evaluation, including imaging studies, and presents vital signs, laboratory results, and physical examinations. The patient received supportive care, and the discussion outlines the treatment strategy, highlighting the challenges and successes in managing imidacloprid toxicity. Conclusion: This case underscores the complexity of imidacloprid poisoning, particularly noting convulsions secondary to hyponatremia. It stresses the need for further research into imidacloprid's metabolic effects and advocates for vigilant monitoring and supportive care in such cases. The report calls for increased reporting to enhance understanding and knowledge sharing regarding the potential toxic effects of imidacloprid, contributing to better management strategies for pesticide poisoning. [ABSTRACT FROM AUTHOR]

Objective: To analyze the clinical and genetic characteristics of a patient with long QT syndrome type 14 (long QT syndrome‐14, LQT14, OMIM # 616247) caused by a de novo CALM1 mutation. Methods: The clinical data of the patient were collected, next‐generation sequencing technology was used to determine the exome gene sequence of the patient, and the suspected pathogenic locus was verified by Sanger sequencing. Results: A 5‐year and 9‐month‐old girl was admitted to the hospital due to a syncopal episode. During the attack, the main symptoms were loss of consciousness, cyanosis of the face and lips, and weakness of limbs. The child had multiple seizures in the past, all of which occurred after emotional excitement and activity. She was diagnosed with epilepsy for more than 3 years, but the effect of antiepileptic treatment was not satisfactory. The electrocardiogram was normal in the past. A month ago, convulsions occurred again after exercise, and the electrocardiogram showed QTc 496 ms. The treadmill test showed a significant prolongation of QTc after exercise, and the genetic results suggested a new heterozygous variant of CALM1, c.395A>G; p. (Asp132Gly). Consequently, she was diagnosed with LQT14 and treated with propranolol. During a follow‐up of 15 months, there were no seizures or syncope. Conclusions: This patient had multiple episodes of convulsions or syncope after emotional stimulation or activity, with intermittent prolongation of the QTc on routine ECG, marked prolongation of the QTc after exercise, and T‐wave alternans, which differed from the LQT14 phenotype caused by the previous CALM1 mutation. [ABSTRACT FROM AUTHOR]

Background: Before reaching the age of 5, 2–5% of children will have had a febrile seizure. Most are categorised as simple but they can be complex and carry the risk of complications. They can be frightening for parents. UK guidelines advise against the use of antipyretic drugs to prevent febrile seizure recurrence while being mindful of parental sensitivities. Aim: This systematised literature review aimed to appraise the global body of evidence in relation to current guidelines on using conventional antipyretics for the prevention of febrile seizures and explore factors that influence their management. Method: A research question was developed using the PICO (population/participant(s); intervention(s); comparison/control; outcome) framework and two databases were searched for primary research, and abstracts were screened for relevance. Results: Thirty-four articles were identified, or which three were relevant to the research aim. These were critically appraised using the Mixed Methods Appraisal Tool and five themes were identified. Conclusion: One study found that paracetamol may prevent recurrent febrile seizures, one found a small reduction in febrile seizure recurrence when treated with an antipyretic and one found antipyretics ineffective at reducing febrile seizure recurrence. Similar contemporary studies conducted in the UK population may help to improve understanding of the factors influencing febrile seizure management and the effectiveness of antipyretics. [ABSTRACT FROM AUTHOR]

In experiments on mice, rats, guinea pigs, and dogs, the effectiveness of metabolic correction of cerebral radiation syndrome with nicotinic and succinic acids and Essentiale was evaluated. The animals were totally exposed to 5–8 and 16–20 MeV pulsed electron flux at doses of 85–110 or 500–570 Gy or to gamma irradiation at a dose of 100 Gy. The frequency and time of ataxia and convulsions, as well as the dynamics of animal death after radiation, were recorded. Nicotinic and succinic acids (500 mg/kg each) and Essentiale (20 mg/kg by nicotinamide) reduced the frequency and delayed the onset of ataxia and seizures equally in both small laboratory animals and dogs. In experiments on rats after exposure at a dose of 100 Gy under the influence of radiation and Essentiale, there was no significant change in the animal cognitive function according to the decision-making test at the first presentation of a new deposit. [ABSTRACT FROM AUTHOR]

Introduction: Eclampsia, characterized by generalized convulsions associated with preeclampsia during pregnancy, labor, or within 7 days post-delivery, remains a significant challenge in maternal healthcare. This study explores the incidence, management, and maternal characteristics of eclampsia, emphasizing the importance of early diagnosis and timely intervention. Materials and Methods: A two-year prospective study was conducted at a Tertiary Care Teaching Hospital, recruiting 821 pregnant mothers with eclampsia. Patients with other causes of pregnancy-related convulsions were excluded. Data on convulsion episodes, treatment modalities, and hypertension control were analyzed. Results: The majority (66%) experienced 2 to 5 convulsion episodes, with a range from 1 to 40. Patients with more than 10 convulsions showed improved outcomes after the Loading Dose of MgSO4. Hypertension control solely through delivery was observed in 29% of cases, with additional administration of Calcigard in some instances. Conclusion: Eclampsia, more prevalent in young primigravida patients, underscores the need for enhanced antenatal care surveillance. Early detection of pre-eclampsia through regular blood pressure monitoring and urine protein screening is crucial. Sensitization of healthcare providers at grassroots levels is imperative for ensuring timely diagnosis and effective management, thus positively impacting maternal and child care outcomes. [ABSTRACT FROM AUTHOR]

Abstract Objective Explore the clinical characteristics and prognosis of children with norovirus (NoV)‐associated benign convulsions with mild gastroenteritis (CwG). Methods We retrospectively analyzed the Clinical and laboratory data of children with NoV‐associated CwG admitted to the emergency department of Guangzhou Children's Hospital between January 2019 and January 2020. And patients were followed up for 23–36 months. Results There are 49 cases met the CwG criteria. Vomiting was the first symptom in 31 (63.3%) patients, and vomiting could be the main or the only gastrointestinal symptom. The mean frequency of seizures was 3.8 ± 2.4 episodes. Most patients (95.9%) experienced seizures that lasted for less than 5 min. Of the 43 (87.8%) cases followed up from 23 to 36 months, only one experienced recurrent convulsions (after rotavirus infection). Significance NoV‐associated CwG patients were prone to experiencing more convulsions. However, because most NoV‐associated CwG patients had good prognosis, long‐term use of anticonvulsants are unnecessary.

Objective: The frequent neurological condition epilepsy disrupts the brain's regular electrochemical processes. Similar to a seizure, epilepsy is a sign of aberrant brain activity. The developed world has an epilepsy prevalence of 0.5–1%, whereas the underdeveloped world has a larger prevalence due to more risk factors. There are several antiepileptic medications on the market, but their therapeutic efficacy is severely limited by their adverse effects and drug interactions. Owing to their widespread acceptance and beneficial efficiency with few side effects, herbal medicines are used extensively throughout the world. The current study's purpose is to ascertain whether different fruit components, such as fruit juice, residue, and pericarp of Citrus maxima Linn, have anti-seizure properties when used to treat rats with pentylenetetrazole (PTZ)-induced seizures. Methods: To test the antiepileptic potential in pentylenetetrazole-induced epileptic rats, the aqueous extract of fruit pericarp, an aqueous solution of lyophilized powdered fruit juice, and residues of Citrus maxima L were each administered at varying doses of 200 and 400 mg/kg body weight. The experimental animals' physical actions, such as immobility, swimming, and motor activity, were evaluated. By measuring and analysing Neurotransmitter levels, including those of GABA, glutamate, norepinephrine, serotonin, and dopamine, as well as the effects of PTZ on the animal's brain, were examined. Result: The results of the phytochemical screening showed that tannin, coumarin, quinine, glycosides, sugar, and phenols were present. On the thirty-day mark, acute PTZ injection at a dose of 75 mg/kg body weight resulted in seizures that lengthened immobility and reduced swimming time. The PTZ enhanced levels of lipid peroxidation, oxidative stress, and degeneration of neural and non-neural cells (glial cells), while the aqueous extract of various portions of the fruit of Citrus maxima Linn restored levels of glutamate, dopamine, serotonin, norepinephrine, and GABA. Conclusion: According to the findings, convulsions can be treated with Citrus maxima Linn, as a traditional source.

Convulsions are a neurological illness that has complexity. In clinical treatment, drug-induced convulsions appear from time to time. Drug-induced convulsions often begin as isolated acute seizures but may progress to persistent seizures. In orthopedics, topical administration of tranexamic acid is commonly used in conjunction with intravenous drip to achieve hemostasis during artificial joint replacement surgery. However, side effects induced by tranexamic acid accidental spinal administration should be taken seriously. We report a case of a middle-aged male treated with tranexamic acid locally in combination with intravenous drip for intraoperative hemostasis when undergoing spinal surgery. The patient had involuntary convulsions in both lower limbs after the operation. After symptomatic administration, the symptoms of convulsions gradually resolved. During the follow-up, the convulsions never occurred again. We reviewed the literature on cases with side effects of local tranexamic acid application in spinal surgery and discussed the mechanism of tranexamic acid-induced convulsions. Tranexamic acid is associated with an increased incidence of postoperative seizures. However, many clinicians are unaware that tranexamic acid causes seizures. This rare case summarized the risk factors and clinical features of these seizures. Moreover, it highlights several clinical and preclinical studies that offer mechanistic insights into the potential causes and treatments for tranexamic acid-associated seizures. A clear understanding of tranexamic acid-induced convulsions-related adverse reactions can help the first-line clinical screening of causes and adjustment of drug treatment. This review will aid the medical community by increasing awareness about tranexamic acid-associated seizures and translating scientific findings into therapeutic interventions for patients.

Aim and Objectives: The purpose of this study is to determine the prevalence of metabolic anomalies associated with neonatal convulsions. It was chosen to study the relationship between the early clinical symptoms and neonatal seizures. Methods: Hospital-based, prospective study of newborns admitted to a department of paediatric DR VRK, Women's Medical College, Aziz Nagar, Hyderabad, Telangana, India, within the first 28 days of life. 50 infants participated in the trial, which ran from March 2022 to February 2023. The most common type of infant metabolic abnormalities was observed in this investigation. Results: From day 1 to day 17, the median age at first seizure start was 3.26 (95% CI 2.40 to 2.72). Thirty-three of the seizures (33%) in our study began during the first 24 hours, while others began between 24 and 72 hours (days 1-3), 4 to 7 days (days 4-7), and beyond 7 days (9%). Nearly nine in ten cases of convulsions occur on day one. 14 (56%) premature infants had mild seizures, 7 (28%) of which were tonic and 4 (16%) were clonic. Conclusion: Newborns frequently experience convulsions. The numerous causes of newborn seizures affect the course of the condition and its long-term neurological prognosis, mortality, and morbidity. [ABSTRACT FROM AUTHOR]

Background: Reversible splenial lesion syndrome (RESLES) is a new clinico-radiological syndrome. We retrospectively analyzed the clinical features of 130 children with RESLES in China, which is the largest case series available in the literature. Methods: The clinical data of children diagnosed as RESLES in Jiangxi Provincial Children's Hospital between 2017 and 2023 were retrospectively analyzed. The 130 cases were divided into two groups: ≤3 years old group (group A) (n = 83) and > 3 years old group (group B) (n = 47). The chi-squared test or Fisher's test was used to evaluate the data. Results: The vast majority of patients (127/130 cases, 97.7%) had prodromal symptoms of infection. Preceding infections of the gastrointestinal tract were statistically more significant in group A (60/83, 72.3%) than in group B (11/47, 23.4%) (P < 0.05). Preceding infections of the respiratory tract were statistically more significant in group B (33/47, 70.2%) than in group A (17/83, 20.5%) (P < 0.05). Seizures were statistically more significant in group A (82/83, 98.8%) than in group B (24/47,51.1%) (P<0.05). The disturbance of consciousness and headache/dizziness were statistically more significant in group B (27/47, 57.4%; 37/47, 78.7%) than in group A (3/83, 3.6%; 1/83, 1.2%), respectively (P < 0.05). Convulsions with mild gastroenteritis (CwG) were statistically more significant in group A (50/83, 60.2%) than in group B (8/47, 17.0%) (P < 0.05). However, encephalitis/encephalopathy was statistically more significant in group B (20/47, 42.6%) than in group A (10/83, 12.0%) (P < 0.05). MRI showed cytotoxic edema in typical locations (RESLES type-1 limited to the splenium of the corpus callosum and RESLES type-2 spread to the entire corpus callosum, adjacent white matter, or both). There was full recovery of the lesions of MRI in all cases from 3 days to 50 days after the initial examinations. All the children showed normal neurodevelopment. Conclusion: Infection was the most common cause of RESLES. Infections of the gastrointestinal tract are common in ≤3 years old children, while infections of the respiratory tract are common in >3 years old children. Younger patients are more likely to develop convulsions, and older children were more likely to have symptoms with disturbance of consciousness and headache/dizziness. RESLES has characteristic MRI manifestations and a good prognosis. [ABSTRACT FROM AUTHOR]

Thebaine is an alkaloid in poppy seeds that is neurotoxic to animals. Data on its clinical effects and toxicokinetics in people are minimal. In 2022, poppy seeds high in thebaine entered the Australian food market, and people consuming tea made from these poppy seeds developed poisoning. Three patients who drank poppy seed tea and developed neuromuscular toxicity consented for thebaine to be quantitated in serial blood samples. Blood samples were analyzed by liquid chromatography with high-resolution mass spectrometry. Case 1: A man in his 60s presented with drowsiness, vomiting, malaise and myoclonus. He developed metabolic acidosis with hyperlactataemia, acute kidney injury requiring haemodialysis, convulsions, rhabdomyolysis, and was in the hospital for 18 days. The admission thebaine blood concentration was 2.1 mg/L, and the apparent elimination half-life was 14.8 h. Case 2: A man in his 30s presented with myoclonus, rigidity, vomiting, and dizziness. He developed metabolic acidosis with hyperlactataemia, acute kidney injury, and myalgias. The admission thebaine blood concentration was 4.1 mg/L, and the apparent elimination half-life was 11.6 h. Case 3: A man in his 30s presented with myoclonus, rigidity, clonus, diaphoresis, and abdominal pain. The admission thebaine blood concentration was 2.2 mg/L, and the apparent elimination half-life was 8.3 h. Neuromuscular toxicity, metabolic acidosis with hyperlactataemia, acute kidney injury, and gastrointestinal symptoms were prominent clinical features in these patients after drinking poppy seed tea. Effects persisted for days, and all survived, despite thebaine concentrations far exceeding those in published forensic reports, although human data are sparse. Compared to rats, the thebaine apparent elimination half-life is much longer in humans who develop symptoms at lower concentrations. Despite relatively high thebaine blood concentrations and moderate to severe poisoning, outcomes were favourable with early presentations. It is possible that acute kidney injury prolongs the apparent elimination half-life of thebaine. [ABSTRACT FROM AUTHOR]

Objective: Explore the clinical characteristics and prognosis of children with norovirus (NoV)‐associated benign convulsions with mild gastroenteritis (CwG). Methods: We retrospectively analyzed the Clinical and laboratory data of children with NoV‐associated CwG admitted to the emergency department of Guangzhou Children's Hospital between January 2019 and January 2020. And patients were followed up for 23–36 months. Results: There are 49 cases met the CwG criteria. Vomiting was the first symptom in 31 (63.3%) patients, and vomiting could be the main or the only gastrointestinal symptom. The mean frequency of seizures was 3.8 ± 2.4 episodes. Most patients (95.9%) experienced seizures that lasted for less than 5 min. Of the 43 (87.8%) cases followed up from 23 to 36 months, only one experienced recurrent convulsions (after rotavirus infection). Significance: NoV‐associated CwG patients were prone to experiencing more convulsions. However, because most NoV‐associated CwG patients had good prognosis, long‐term use of anticonvulsants are unnecessary. [ABSTRACT FROM AUTHOR]

In rural India, it is fairly common for infants to be brought in with symptoms such as failure to gain weight and a history of recurrent respiratory tract infections. Congenital Heart Disease (CHD) is often associated with various syndromes, including Down syndrome, Turner syndrome, Holt-oram, and others. It is widely understood and practiced to investigate for other systemic and congenital anomalies when a child is suspected or diagnosed with CHD or any other congenital condition. On the other hand, one of the most prevalent malformations of the cerebral cortex involves the corpus callosum. The corpus callosum consists of white matter tracts that connect the left and right cerebral hemispheres. Agenesis of the Corpus Callosum (ACC), which can be partial or complete, may occur alone or in combination with other cerebral abnormalities. It can manifest as hypoplasia or complete absence of the corpus callosum. In the present case report, the authors present a three-month-old infant who presented with complaints of failure to gain weight and a history of convulsions despite being on anticonvulsant medication. Further evaluation revealed complete agenesis of the corpus callosum on Magnetic Resonance Imaging (MRI). Additional examination findings included microcephaly, left-sided microphthalmia, low-set ears, retrognathia, suggesting a dysmorphic facies, and a left-sided inguinal hernia. The patient was also diagnosed with Patent Ductus Arteriosus (PDA) based on a 2D echo. The presence of multiple systemic anomalies in the present case makes it a rare occurrence, with only a few similar cases reported.

Dengue is a global public health concern, affecting around 50 million individuals and causing mortality in 20,000 patients per year. It is an arboviral disease caused by a single-stranded Ribonucleic Acid (RNA) virus belonging to the Flavivirus group and is transmitted by mosquitoes, specifically Aedes aegypti or albopictus. It comprises four serotypes, DENV1 to DENV4, and infection from one serotype only provides lifelong immunity for that subtype. Due to antibody-dependent enhancement, past infection with one serotype increases the prevalence of dengue haemorrhagic fever. The disease spectrum can range from asymptomatic infection to fever, fatal dengue haemorrhagic fever, or dengue shock syndrome. Due to improved disease knowledge, its involvement in the neurological system has been explored. Neurological abnormalities in dengue infection are rare and can be misdiagnosed due to other causes. Present case is of a young 23-year-old male with a history of fever 3-4 days prior, which later manifested with seizures and drowsiness. Despite emergency treatment, encephalitis and viral myocarditis developed, eventually leading to brain death within 24 hours of admission.

Febrile seizures (FS) are well-known manifestations of viral illnesses. The purpose of this study is to assess the prevalence and factors associated with FS among pediatric patients with COVID-19 admitted to the National Isolation Centre in Brunei Darussalam. All pediatric patients (< 12 years) during the first (n = 12), second (n = 418), and third (n = 219) waves were included in the study. In Brunei, the first, second, and third waves were caused by the original SARS-CoV-2, Delta, and Omicron variants, respectively. Data was extracted from a prospective database and the national electronic health record system. Patients with and without FS were compared to identify any significant risk factors. FS were only encountered in the third wave (n = 29, 13%) giving an overall prevalence of 4.5%; 24 (83%) occurring in the typical age group for FS (≥ 6 months to < 6 years). Five cases (17%) occurred in children 6 years and older. Comparing patients in the third wave, univariate analyses showed typical age group, previous history of FS, family history of FS, higher temperature (> 38.6 °C), and fewer symptoms on presentation (3 or less) were associated with FS. On multivariate analyses, typical age group, family history of FS, and fewer reported symptoms remained significant (all p < 0.05). Conclusions: The overall prevalence of FS in COVID-19 patients is comparable to rates reported. However, in Brunei Darussalam, FS only occurred in the third wave that has been associated with Omicron variant. Younger age group, family history of FS, and fewer symptoms on presentation are correlated with risk of FS. What is Known: • Viral infections are the most common cause of FS in children. •Young age and a personal and family history of FS are correlated with the risk of FS. What is New: • There were high rates of FS (13%) among pediatric patients admitted with COVID-19 due to the Omicron variant but not with the original and Delta variants. • FS with COVID-19 were correlated with reporting fewer symptoms on presentation. [ABSTRACT FROM AUTHOR]

Aim: To systematically review the clinical features and outcomes of paediatric patients developing neurological complications associated with a rotavirus infection. Methods: A systematic literature review and meta‐analysis was performed, including articles published from 1984 to 2020. Neurological complications were classified into four groups: encephalitis, cerebellitis, encephalo‐cerebellitis and benign convulsions with mild gastroenteritis (CwG). Results: Out of 68 reports that fulfilled the research criteria, 99 cases of CwG, 39 cases of encephalitis, 18 cases of encephalo‐cerebellitis and five cases of cerebellitis were collected. Ninety‐five patients were from Asia. Median age was 22 (IQR 14–29) months, and the children who developed CwG were significantly younger (19, IQR 12–24 months, p < 0.0001) than the others. Status epilepticus was observed in 23% and 5% of the encephalitis and CwG groups respectively. The most frequently described neuroimaging finding were lesions of the splenium of corpus callosum. Four deaths were reported in the encephalitis group, whereas no fatal events were described in the other groups. Among the surviving children, the encephalo‐cerebellitis group showed the most severe long‐term outcome. All cases of CwG recovered completely. Conclusion: Older age at diagnosis and the development of encephalo‐cerebellitis are associated with a higher risk of long‐term complications. [ABSTRACT FROM AUTHOR]

Copyright of Archives de Sciences Sociales des Religions is the property of Editions EHESS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The frequent neurological condition epilepsy disrupts the brain's regular electrochemical processes. Similar to a seizure, epilepsy is a sign of aberrant brain activity. The developed world has an epilepsy prevalence of 0.5–1%, whereas the underdeveloped world has a larger prevalence due to more risk factors. There are several antiepileptic medications on the market, but their therapeutic efficacy is severely limited by their adverse effects and drug interactions. Owing to their widespread acceptance and beneficial efficiency with few side effects, herbal medicines are used extensively throughout the world. The current study's purpose is to ascertain whether different fruit components, such as fruit juice, residue, and pericarp of Citrus maxima Linn, have anti-seizure properties when used to treat rats with pentylenetetrazole (PTZ)-induced seizures. Methods: To test the antiepileptic potential in pentylenetetrazole-induced epileptic rats, the aqueous extract of fruit pericarp, an aqueous solution of lyophilized powdered fruit juice, and residues of Citrus maxima L were each administered at varying doses of 200 and 400 mg/kg body weight. The experimental animals' physical actions, such as immobility, swimming, and motor activity, were evaluated. By measuring and analysing Neurotransmitter levels, including those of GABA, glutamate, norepinephrine, serotonin, and dopamine, as well as the effects of PTZ on the animal's brain, were examined. Result: The results of the phytochemical screening showed that tannin, coumarin, quinine, glycosides, sugar, and phenols were present. On the thirty-day mark, acute PTZ injection at a dose of 75 mg/kg body weight resulted in seizures that lengthened immobility and reduced swimming time. The PTZ enhanced levels of lipid peroxidation, oxidative stress, and degeneration of neural and non-neural cells (glial cells), while the aqueous extract of various portions of the fruit of Citrus maxima Linn restored levels of glutamate, dopamine, serotonin, norepinephrine, and GABA. Conclusion: According to the findings, convulsions can be treated with Citrus maxima Linn, a traditional source. [ABSTRACT FROM AUTHOR]

Copyright of Health & Society is the property of Instituto de Ensino e Pesquisa Periodicojs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective Tissue damage caused by febrile convulsion has not still been proved or refuted completely. Given the fact that lactate dehydrogenase as an intracellular enzyme can be increased due to tissue damage, we decided to evaluate serum and cerebrospinal fluid lactate dehydrogenase in children with febrile convulsion. Materials & Methods This is a cross-sectional study on 166 children aged 6-24 month, in three groups of simple febrile convulsion (n=56), complex febrile convulsion (n=27) with 3 different subgroups (recurrence in 24 hours, duration >15 minutes, and with focal components), and control (n=83). Patients' serum and cerebrospinal fluid specimens were collected after meeting the inclusion criteria. Demographic information was documented and patients' serum and cerebrospinal fluid lactate dehydrogenase and glucose were measured. Data were analyzed using SPSS software. Result The mean serum lactate dehydrogenase in simple febrile convulsion, complex febrile convulsion, and controls were 501.57± 143.70, 553.07±160.22, and 505.87±98.73 U/L, respectively. The mean cerebrospinal fluid lactate dehydrogenase in simple, complex febrile convulsion, and control groups were 22.58±11.92, 29.48±18.18, and 21.56±17.32 U/L, respectively. Only cerebrospinal fluid lactate dehydrogenase difference between complex febrile convulsion and control group (p=0.039) (In the duration >15 minutes subgroup and controls, p=0.028) was statistically significant. There was a significant difference between sex and serum lactate dehydrogenase in the same subgroup of complex group (p=0.012). Conclusion Complex febrile convulsion may lead to increase of lactate dehydrogenase in cns of CNS cellular damage. [ABSTRACT FROM AUTHOR]

In rural India, it is fairly common for infants to be brought in with symptoms such as failure to gain weight and a history of recurrent respiratory tract infections. Congenital Heart Disease (CHD) is often associated with various syndromes, including Down syndrome, Turner syndrome, Holt-oram, and others. It is widely understood and practiced to investigate for other systemic and congenital anomalies when a child is suspected or diagnosed with CHD or any other congenital condition. On the other hand, one of the most prevalent malformations of the cerebral cortex involves the corpus callosum. The corpus callosum consists of white matter tracts that connect the left and right cerebral hemispheres. Agenesis of the Corpus Callosum (ACC), which can be partial or complete, may occur alone or in combination with other cerebral abnormalities. It can manifest as hypoplasia or complete absence of the corpus callosum. In the present case report, the authors present a three-month-old infant who presented with complaints of failure to gain weight and a history of convulsions despite being on anticonvulsant medication. Further evaluation revealed complete agenesis of the corpus callosum on Magnetic Resonance Imaging (MRI). Additional examination findings included microcephaly, left-sided microphthalmia, low-set ears, retrognathia, suggesting a dysmorphic facies, and a left-sided inguinal hernia. The patient was also diagnosed with Patent Ductus Arteriosus (PDA) based on a 2D echo. The presence of multiple systemic anomalies in the present case makes it a rare occurrence, with only a few similar cases reported. [ABSTRACT FROM AUTHOR]

Dengue is a global public health concern, affecting around 50 million individuals and causing mortality in 20,000 patients per year. It is an arboviral disease caused by a single-stranded Ribonucleic Acid (RNA) virus belonging to the Flavivirus group and is transmitted by mosquitoes, specifically Aedes aegypti or albopictus. It comprises four serotypes, DENV1 to DENV4, and infection from one serotype only provides lifelong immunity for that subtype. Due to antibody-dependent enhancement, past infection with one serotype increases the prevalence of dengue haemorrhagic fever. The disease spectrum can range from asymptomatic infection to fever, fatal dengue haemorrhagic fever, or dengue shock syndrome. Due to improved disease knowledge, its involvement in the neurological system has been explored. Neurological abnormalities in dengue infection are rare and can be misdiagnosed due to other causes. Present case is of a young 23-year-old male with a history of fever 3-4 days prior, which later manifested with seizures and drowsiness. Despite emergency treatment, encephalitis and viral myocarditis developed, eventually leading to brain death within 24 hours of admission. [ABSTRACT FROM AUTHOR]

Carbidopa-levodopa has been used for more than 50 years in the treatment of Parkinson disease (PD) and other movement disorders. Pyridoxal 5′-phosphate (PLP), an active form of vitamin B6 (pyridoxine), is involved in the decarboxylation of levodopa to dopamine; carbidopa, which is combined with levodopa to reduce peripheral levodopa conversion and minimize peripheral dopamine side effects, binds irreversibly with PLP. As a result, carbidopa-levodopa may cause vitamin B6 deficiency and associated sequelae, including seizures, especially in high doses. A 78-year-old gentleman with a 6-year history of PD on carbidopa-levodopa therapy and recent weight loss presented with new-onset myoclonus and focal to bilateral tonic-clonic seizures. Workup for vascular, infectious, malignant, metabolic, and autoimmune causes of seizure was unrevealing. The folate level was critically low at

Objective: To evaluate the clinical pattern of secondary seizures which includes acute and remote symptomatic seizures among hospitalized patients in two healthcare centers and to assess the outcomes among hospitalized patients having secondary seizures. Methods: This multicentric cross-sectional study was conducted in two tertiary hospitals in Odisha and Tamil Nadu, India, for a period of four years. A total of 274 patients in the age group between 6 months to 12 years participated in the study. A structured proforma was used to document the clinical pattern and causes of the secondary seizures. Results: Among the participants in Odisha and Tamil Nadu hospitals, focal seizures constituted 67.5%. Generalized seizures were present in 32.4%. The key causes of seizures in Odisha were malaria, cerebral palsy, and viral meningitis, while in Tamil Nadu, the causes were neurocysticercosis, cerebral palsy, and viral meningitis. Conclusion: Since the majority of the causes are preventable, it is important to address the issue at the public health level, by providing improved sanitation and adequate awareness on the secondary seizure and its causes. It is also important that the physicians are well conversant with the early case detection and treatment of primary diseases causing secondary seizures.

This paper examines infant mortality amongst newborns in Trondheim city, 1830–1907, working specifically with individual level cause of death data. Findings show that infant mortality in the city started to drop from 1895, primarily as a result of a decline in post-neonatal mortality. At the start of the decline air-borne diseases accounted for nearly half of the deaths, and water-food borne for around one third. The drop was predominantly driven by a decline in these two causal groups, and seasonal fluctuations became less pronounced. Because of the fall in post-neonatal mortality, the relative risk of dying amongst neonates rose towards the end of the period. Although 'convulsions' accounted for 50–70% of all infant deaths between 1830 and 1860, this cause had faded away to near insignificance by the beginning of the 1900s. Here we aim to assess the extent to which this particular aspect of decline can be explained by alterations to official instructions regarding registration and in registration practice itself. This article proposes that the decline in deaths from 'convulsions' can be explained by a relabelling of such deaths into 'congenital and birth disorders' amongst neonates, and a mix of 'water-food borne' and 'air-borne diseases' amongst post-neonates. This argument is supported by the fact that the timing of the decline corresponds with the introduction of cause of death certificates issued by medical practitioners, and which most likely resulted in fewer causes of death being reported by lay informants who could only offer vague symptoms rather than informed diagnoses.

Parechovirus type 3 (PeV-3) presents with sepsis-like syndrome in neonates and young infants. PeV-3 has neurotropism and occasionally causes encephalitis. We evaluated the cytokine/chemokine profile in the cerebrospinal fluid of a young infant with PeV-3 encephalitis. The patient was a 1-month-old boy who developed fever, loss of consciousness, and seizures. On admission (2nd day of illness), no abnormalities were found on MRI. Thereafter, head MRI on the 4th day revealed abnormal intensities in the white matter around the bilateral lateral ventricles, corpus callosum, and bilateral hippocampus and amygdala. Although intravenous thiopental failed to stop the seizures, ketamine and phenobarbital were effective. Bilateral hippocampal lesions were unusual in HPeV-3 encephalitis and considered to be caused by super-refractory status epilepticus, indicating the strength of the disease. PeV-3 was detected in the blood, cerebrospinal fluid, nasal discharge, and fecal samples upon admission. The cytokine and chemokine levels in the cerebrospinal fluid were significantly elevated. Characteristically, neopterin levels in the cerebrospinal fluid increased as the white matter lesions appeared. These results suggested that cytokine/chemokine overproduction may be deeply involved in the pathology of the PeV-3 encephalitis. Although super-refractory status epilepticus and cytokine/chemokine overproduction indicated the strength of the disease, our patient was discharged without neurological sequelae and the combination of immunotherapy as well as seizure control may have contributed to the good outcome.

• Vero cell culture-derived Japanese encephalitis vaccine (JE-VC; Ixiaro) was approved for adults in 2009. • We retrospectively evaluated adverse events of special interest following JE-VC, including hypersensitivity and neurologic events. • Data from U.S. military personnel who received JE-VC were compared to data from recipients of Vi capsular polysaccharide typhoid vaccine, a vaccine with a favorable safety profile. • The risk of adverse events of special interest was similar between groups, supporting the safety of JE-VC. Vero cell culture-derived Japanese encephalitis (JE) vaccine (JE-VC; Ixiaro) was approved in the United States in 2009. The previous JE vaccine, an inactivated mouse brain-derived vaccine, had been associated with rare, but serious, allergic and neurologic adverse events (AE). Studies and AE surveillance have supported JE-VC's safety, but one evaluation among military personnel found elevated hypersensitivity and neurologic AE rates. However, co-administration of multiple vaccines to some personnel might have affected results. We retrospectively compared rates of hypersensitivity and neurologic AEs within 28 days following vaccination of military personnel with JE-VC or parenteral Vi capsular polysaccharide typhoid vaccine administered without other vaccines from July 1, 2011, through August 31, 2019. Rates of most events were similar between the vaccines. Only delayed hypersensitivity reactions occurred more frequently following JE-VC (rate ratio: 4.2, 95 % CI 1.2–15.3; p = 0.03), but rates were low for both vaccines. These results support JE-VC's safety. [ABSTRACT FROM AUTHOR]

This paper examines infant mortality amongst newborns in Trondheim city, 1830-1907, working specifically with individual level cause of death data. Findings show that infant mortality in the city started to drop from 1895, primarily as a result of a decline in post-neonatal mortality. At the start of the decline air-borne diseases accounted for nearly half of the deaths, and water-food borne for around one third. The drop was predominantly driven by a decline in these two causal groups, and seasonal fluctuations became less pronounced. Because of the fall in post-neonatal mortality, the relative risk of dying amongst neonates rose towards the end of the period. Although 'convulsions' accounted for 50-70% of all infant deaths between 1830 and 1860, this cause had faded away to near insignificance by the beginning of the 1900s. Here we aim to assess the extent to which this particular aspect of decline can be explained by alterations to official instructions regarding registration and in registration practice itself. This article proposes that the decline in deaths from 'convulsions' can be explained by a relabelling of such deaths into 'congenital and birth disorders' amongst neonates, and a mix of 'water-food borne' and 'air-borne diseases' amongst post-neonates. This argument is supported by the fact that the timing of the decline corresponds with the introduction of cause of death certificates issued by medical practitioners, and which most likely resulted in fewer causes of death being reported by lay informants who could only offer vague symptoms rather than informed diagnoses. [ABSTRACT FROM AUTHOR]

Background: To look into the frequency of metabolic abnormalities connected to newborn convulsions, in the newborn section of the Department of Pediatrics, Government Medical College, Ongole, Andhra Pradesh, India. It was decided to do research on the clinical signs as soon as they appeared and how they related to neonatal seizures. Material and Methods: Retrospective hospital-based research approach on neonates hospitalised to a Department of Pediatrics, Government Medical College, Ongole, Andhra Pradesh, India, from birth until 28 days after birth. The trial, which lasted from January 2022 to November 2022 involved 100 newborns. This study identified the metabolic abnormality is the most common cause of neonatal seizures. Results: The mean seizure onset day was 3.26, ranging from 1 to 17. (95% CI 2.40 to 2.72). In our study, 33 seizures (33%) started within 24 hours, 24--72 hours (days 1--3), 4--7 days (days 4--7), and more than 7 days (9%) respectively. Convulsions on the first day account for 91%. Mild seizures were experienced by 14 (56%) preterm babies; 7 (28%) of them were tonic, and 4 (16%) were clonic. There were mild, tonic, and clonic seizures in 75 term newborns. Preterm infants in my study experienced 56% more mild seizures than term infants. Compared to term babies, preterm infants experienced 28% fewer tonic seizures. 16% of preterm and 14.6% of natal clonic seizures occur. Conclusion: Convulsions in newborns are frequent. The progression of the disease as well as its long-term neurological prognosis, mortality, and morbidity are influenced by the various causes of newborn seizures. Quick assessment, diagnosis, and strong treatment are required to stop these consequences. Biochemical anomalies may be the primary or secondary issue. Transient abnormalities have a good prognosis and are simply treated. The prognosis and outcome of the newborn are improved and neurological repercussions are avoided when metabolic disorders are treated early. [ABSTRACT FROM AUTHOR]