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06 July 2006, Volume 21 Issue 07 Previous Issue    Next Issue
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Brain Voxelbased morphometry study in cryptogenic infantile spasms. Fang Fang,Jin Zhen,Liu Gang 2006, 21(07): 508-510 .  Abstract ( )   To determine whether cryptogenic infantile spasms had abnormal structural grey matter.To reveal the etiology of cryptogenic infantile spasms and investigate the pathogenesis. MethodsFrom October 2003 to October 2004,we performed a voxelbased morphometric(VBM)study of brain grey matter concentration in cryptogenic infantile spasms(n=23) and healthy control subjects(n=27) to identify difference in grey matter concentration between groups. ResultsVBM analysis identified significant decreases in grey matter concentration in the cryptogenic infantile spasms group compared with the normal control group at the uncorrected voxel level (P<0001)in right superior frontal gyrus(Bradmann 10),right middle frontal gyrus(Bradmann 9),left inferior frontal gyrus(Bradmann 47),left superior frontal gyrus(Bradmann 9/10),left medial frontal gyrus(Bradmann 10),right superior temporal gyrus (Bradmann 22/38),left middle temporal gyrus (Bradmann 21) and right hippocampal (Bradmann 36).Grey matter concentration increased in the bilateral inferior temporal gyrus(Bradmann20),left anterior central gyrus (Bradmann6) and left hippocampal (Bradmann 36) was detected in the cryptogenic infantile spasms groups at the uncorrected voxel level (P<0001). ConclusionThere are significant decreases in grey matter concentration in cryptogenic IS.There is dysplasia in the frontal and temporal lobe cortex in infants with IS,which might be the etiological origin and possible mechanism for cryptogenic IS in the studied group.

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Clinical value of serum insulinlike growth factor 1,serum growth hormone and urinary growth hormone measurement in shortstatured children. Yan Xueqin,Wei Hong,Liang Yan 2006, 21(07): 511-514 .  Abstract ( )   To investigate the significance of serum growth hormone,serum insulinlike growth factor1(IGF1) and urinary growth hormone(GH)levels in the diagnosis of short statured children. MethodsFrom Nov.2004-Jun.2005 to 106 short statured children and 19 normal children in prepuberty were selected,each having 12h (8：00pm~8：00AM) urine collection.The short statured children were given combined pituitary hormone provocating tests,and the corresponding serum GH，IGF1 and urinary GH were determined by ELISA kits. ResultsAccording to the serum GH levels of provocating tests,the shortstatured children were divided into three groups：complete growth hormone deficiency (cGHD) 25 cases,partial growth hormone deficiency(pGHD) 9 cases,disorders of growth hormone neurosecretion (GHND) 22 cases.IGF1 and urinary GH in cGHD groups were remarkably lower than those in normal children(P<001).IGF1 value of pGHD and GHND group fluctuated comparatively greatly,so there was no statistical significance compared to normal children.Urinary GH pg/mg creatinine(Cr)count in GHND group had significant difference vs.normal group(P<005)， although urinary GH ng/12h count value was lower than normal group，there is no statistical significance(P>005).The two kinds of urinary GH in pGHD group were between normal and cGHD，and there was predominant difference vs.normal group (P mean <005).Urinary GH pg/mg Cr count in cGHD and pGHD groups were positively correlated with the serum GH peak (rcGHD=0556,P<005; rpGHD=0423,P<005),respectively. ConclusionSerum IGF1 and urinary GH levels have important significance in the diagnosis of short statured children.

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The experiment of wisconsin card sorting test in children with attention deficit hyperactivity disorder. He Shuhua,Jing Jin. 2006, 21(07): 515-517 .  Abstract ( )   To analyze characteristics of WCST when applied to handle children with ADHD under Chinese cultural background and to explore the function of prefrontal cortex in ADHD. MethodsFrom April 2003 to March 2004,we tested 57 children with ADHD (average age 944±197) and 63 normal control children (average age 931±182) by revised edition WCST to evaluate the set shifting,working memory,response inhibition,cognitive conversion and abstracting ability of subjects. ResultsThe performance of 7 among 13 scores on WCST among children with ADHD was significantly poorer than that of normal children(P<005,P<001).Children with ADHD had significantly more RA(12760±177 vs12286±1104,P<001),RPE(perseverative errors)(2684±1087 vs2283±1035,P<005),RE(5758±1806 vs4933±1855,P<005),and RP(Perseverative responses)(3039±1388 vs2549±1268,P<005)and less CC(Categories control)(286±146 vs378±181,P<001),RCP(5496±1400 vs6050±1338,P<005) and RFP(4080±1761 vs4777±1772,P<005) than that of normal children.The analysis of partial correlations controlling for age showed that the symptom of attention deficit was related to RA,CC,RCP,RE and RPE;the symptom of hyperactivity was related to CC,RP and RPE;diagnosis was related to RA,CC,RCP,RE and RFP. ConclusionChildren with ADHD have the deficiency of cognitive function,cognitive conversion and abstracting and insight of concept forming ability.The ADHD may be a brain disorder primarily affecting the prefrontal cortex or the regions projecting to the prefrontal cortex.It suggests that WCST is helpful for the diagnosis of ADHD,and CC(Categories control) is relatively steady scores.

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The serum adiponectin levels and insulin resistance in obese children Fu Xiaohui,Liu Geli,Jiang Lihong 2006, 21(07): 518-521 .  Abstract ( )   To study the relationship between serum adiponectin levels and hyperinsulinemia/insulin resistance. MethodsThe serum adiponectin levels were measured in 34 obeses children and 31 normal subjects by ELISA.We also measured the anthropometrics of all subjects,assessed insulin resistance by homeostasis model assessment ratio (HOMAR),assessed β cell function by homeostasis model assessment β cell (HOMAβ),and calculated the correlativity between adiponectin and other parameters. Results(1) The serum adiponectin levels in obese subjects were lower than normal subjects(P<0001).(2)The serum adiponectin levels were not significantly correlated with sex and age,but were negatively correlated with SBP,DBP,BMI,WHR and SF (r=-0369,r=-0405,r=-0330,r=-0282 and r= -0350，P<001),and negatively correlated with fasting glucose,fasting insulin and HOMAR ( r=-0264,r=-0357and r=-0370,P<005).They were not significantly correlated with HOMAβ.(3)Multiple linear regression analysis was used to determine correlation coefficient between adiponectin and various parameters.Only HOMAR entered the equation.For adiponectin,R2=0122,the standard partial coefficient being -0369(P<001). ConclusionSerum adiponectin levels are lower in obesity children compared with normal ones.Serum adiponectin levels are negatively correlated with fasting glucose,fasting insulin and HOMAR.The hypoadiponectinemia may be associated with insulin resistance.

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Clinical characteristics of hemiconvulsionhemiplegia syndrome and hemiconvulsionhemiplegiaepilepsy syndrome in 11 patients. Yang Zhixian,Qin Jiong. 2006, 21(07): 522-525 .  Abstract ( )   To summarize the clinical characteristics of hemiconvulsionhemiplegia syndrome (HH) and hemiconvulsionhemiplegiaepilepsy syndrome (HHE). MethodsThe clinical data of 11 children with HH or HHE admitted to the hospital from 1995 to 2003 were analyzed.Cranial MRI and / or CT,EEG and analysis of serum were done in all patients.Urinary organic acids were analysed in 6 patients. ResultsThe 11 patients were all male.Eight cases were diagnosed as HHE,while 3 cases were not observed the epilepsy and diagnosed as HH.The age of onset was from one month to eight years and five months,averaged two years and nine months.There were fever symptoms before initial convulsion in 4 cases.Choky happened during birth process in 3 cases.One patient suffered from vitamin K scarcity at one month old and intercurrent encephalic hemorrhage.One case had a history of head trauma.Status epilepicus occured in 5 cases before hemiplegy appeared.Another 3 cases twitched frequently one day which could not be affirmed status epilepicus because of simpe note.Five cases had hemiplegy symptoms in the right body,while 6 cases in the left body.Cranial MRI or/and CT was normal in 2 patients,7 cases had cerebrum hemisphere damage or marked unilateral predominance damage which was corresponding to the clinical symptoms.The brain damage was diffuse in one case.One case had right cyst which might be not related to the disease.Brain atrophy was observed in 5 cases.The EEG was abnormal in all patients.The waves in double cerebrum hemisphere were obviously asymmetrical in 8 cases.The damage hemisphere showed slowing and low voltage of background activity.Epileptiform discharges were found in 4 cases.Urinary organic acids analysis was all negative in 6 cases.One patient had elevated lactic and pyruvic acid and another one had ammonia increase in plasma.Most patients mainly received carbamazepine therapy. ConclusionHHE is one of the recognized sequelae of convulsive status epilepticus.Further recognizing this disease and treating it timely from clinical aspect will help to improve its prognosis.

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Clinical characteristics and electroencephalographyic features of benign childhood epilepsy complicated with centrotemporal spikes in childre. Chen Chunhong,Wu Husheng,Zou Liping 2006, 21(07): 526-528 .  Abstract ( )   This study aimed to recognize the clinical characteristics and electroencephalographic features of BECT. MethodsThe clinical data of 59 patients with BECT were analyzed who were treated from July 2002 to September 2004.and the patients were treated with anticonvulsants after definite diagnosis.Among the 59 cases,28 were reexamined on EEG three and six months after treatment,and the location,the frequency and the morphology of epileptic discharges were compared before and after treatment. ResultsOf the 59 patients,age at onset of BECT was of a peak at 7~9 years.The seizure types were partial seizure(27/59 cases) and generalized partial seizure(48/59 cases);16/59 patients had these two seizure types.The seizure was associated with sleep closely,usually shortly after falling asleep(46/59 cases) or before awakening(25/59 cases).All patients presented unilateral convulsions involving mouth(542%),drooling(407%) and speech arrest(271%),and they tended to generalize tonicclonic seizures.The background activity of EEG was normal.The location of epileptic discharges was in centrotemporal area,midtemporal area and central area.During treatment,the spikes(21/28 cases) tended to spread from side to side.The focal discharges(7/28 cases) disappeared three months after treatment,but 5/7 patients were found again six months after treatment.Two patients had convulsion during videoEEG monitoring;the ictal EEG was frequent rhythmic lowvoltage spikes originating from the centrotemporal region in hemisphere,then spreading to the entire ipsilateral hemisphere and finally to the contralateral side. ConclusionBECT has two seizure types connected with sleep closely,and the type of generalized partial seizure is more common.EEG has important diagnostic value in diagnosing BECT.The centrotemporal spikes tend to vary,shift or disappear sometimes.

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The epileptic seizure EEG of the children's heads hit by parents and the followup. Cui Yanmin. 2006, 21(07): 529-531 .  Abstract ( )   To investigate the EEG which causes epileptic seizure after children's heads are hit by parents and the following changes. MethodsFrom 1990 to 1999,we recorded EEG of 36 cases of the children's heads hit by parents and epileptic seizure.We followed them for three to eight years. ResultsAmong the 36 cases there were 32 abnormal cases(889%).Among them there were 28 epileptiform discharge(875%,28/32).When we followed them up,we found there were 22 abnormal disappearance(687%,22/32) and 18 epileptiform discharge disappearance(643%,18/28).It was hard to make the epileptiform discharge disappear for the patients whose routine tracing had epileptiform discharge,background activity(slow wave) and epileptic seizure mach later ( >1week ) ( P<005).It was very difficult to control the epileptic seizure which contained the epileptiform discharge in the first EEG(P<005).It was more difficult to control the epileptic seizure whose epileptiform discharge didn't disappear in the EEG (P<001). ConclusionThe abnormal rate of the EEG is very high when the children's heads are hit by parents,which causes epileptic seizure.The epileptiform discharge appearance or disappearance is connected to the its features and the time when it causes epileptic seizure.And it affects the clinical prognosis deeply.We must attach importance to it.

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Effects of topamax on the changes of the pentetruzole–induced epileptic rats’ weight and the levels of insulin in serum and insulinlike growth factor1 in hippocampus. Xi Yanhua,Wei Hongyan,Wang Haiyan 2006, 21(07): 532-534 .  Abstract ( )   To study the effects of topamax on the serum level of insulin,the expression of insulinlike growth factor1 in hippocampus,and also their relationship with weight changes in pentetruzoleinduced epileptic rats.To explore the mechanism in which topamax causes the reduction of the rats weights. MethodsFrom Mar.2005 to Sep.2005 114 Wistar rats were randomly divided into four groups:the blank control group,the TPM contrast group,the PTZ model group and the TPM treated group.Weight changes were measured every 3 days.The level of serum insulin and the expression of IGF1 in hippocampus were surveyed,using the method of radioimmunity and the immunohistochemical method respectively on the 2nd、the 4th and the 6th weekends. ResultsTPM contrast group and TPM treated group showed the reduction of the rats’ weights,comparing with the other two groups on the 3rd weekend,and then fell to the nadir on the 4th weekend(P<005).Serum insulin descended clearly but IGF1 in hippocampus rose clearly on the 4th weekend,comparing the TPM contrast group、the PTZ group and the TPM treated group with the blank group,also the TPM treated group with the blank group(P<005).The level of IGF1 in hippocampus rose clearly on the 6th weekend,comparing the TPM treated group with the blank group,the TPM contrast group and the PTZ group(P<005). ConclusionTopamax can reduce the weights of rats,but not by reducing the level of serum insulin and raise the level of insulinlike growth factor1 in hippocampus.Moreover,it needs further study whether the descending of the level of serum insulin and the rising of the level of insulinlike growth factor1 in hippocampus in epileptic rats both participate in the process of pathophysiology of epilepsy.

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Assessment of cerebrospinal fluid cytology in 170 children. Sun Suzhen,Shi Rongfu,Wang Chunxiang 2006, 21(07): 535-536 .  Abstract ( )   To study one experiment room 's cerebrospinal fluid cytology results from 170 specimens. MethodsA retrospective study of 170 cytology specimens was done between 2000 and 2004.The MayGrunwaldGiemsa 'stain was applied to routine cytology. ResultsA total of 170 CSF specimens were interpreted.Specific findings were identified in 4 specimens and analyse its significance in children with diseases of central nervous system.Specific infectious organisms were identified in specimens:cryptococcus was the most common infectious agent observed (n=2),metastatic leukemia (n=2).The changes of 89 specimens were observed before and after treatment,including 20 cases of cerebral tuberculosis,29 cases of purulent meningitis and 40 cases of virogenetic encephalitis.The main changes were components and amounts of cells in CSF before and after treatment. ConclusionAlthough specific findings in CSF cytology account for a small percentage of total specimens,they are of great significance in reaching final diagnoses.The most commonly identified malignancy is metastatic leukemia.The most commonly identified infectious organism was cryptococcus.The clinical results after treatment might be assessed directly and objectively by CSF cytology.

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MRI and clinical analysis of severe viral encephalitis in children. Hou Xiaojun,Xie Wenhuang. 2006, 21(07): 537-538 .  Abstract ( )   To explore the MRI presentative characteristics of severe viral encephalitis in children and to evaluate its clinical value. MethodsMRI manifestations of 30 patients with severe viral encephalitis confirmed clinically from June 2004 to October 2005 were retrospectively analyzed.The axial and sagittal T1WI，T2WI in all cases were performed routinely,and coronal T2WI was added if necessary.In addition,6 cases were performed diffusion weighted imaging (DWI). ResultsTwentyfive of 30 cases were abnormal.The MRI manifestations of viral encephalitis showed the viral encephalitis had relatively low or equal signal on T1WI and relatively high signal on T2WI，high signal intensity on DWI.The apparent diffusion coefficient(ADC)values dropped. ConclusionMRI can find the viral encephalitis in the early stages and this method should be the first choice for imaging examinations in diagnosis of viral encephalitis.MRI has high value in the diagnosis，evaluation of severity,treatment and followup of the viral encephalitis.Viral encephalitis is shown on DWI better than on T2WI and can be assessed quantitatively by ADC values.The more the extent of the disease involved，the severer the disease and the worse the prognosis.