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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report the data of 878 selected children between 1 month and 6 years, presenting a first episode of seizure with fever. Two-hundred-fifty-five children underwent lumbar puncture. In 7 cases the CSF findings showed a bacterial meningitis, in 14 cases a viral meningitis. In 598 of the 623 children who did not undergo LP, a bacterial meningitis could be excluded on the basis of the clinical course. The data show that the probability of finding a bacterial or viral meningitis is high in children under 6 months of age even if no significant neurological signs are found on examination performed shortly after the seizure. In our study, older children affected by bacterial meningitis were clinically identifiable. In children aged 6 months to 3 years without important neurological signs, a complex seizure has been found to be a significant discriminating factor between patients with and without viral meningitis.
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PMID:Lumbar puncture and febrile convulsions. 372 92

Movement disorders developed in five children, ages 6 to 21 months, during the course of bacterial meningitis caused by Hemophilus influenzae (one), Streptococcus pneumoniae (one), Neisseria meningitidis (one), or Mycobacterium tuberculosis (two). Athetosis, choreoathetosis, and hemiballismus occurred, ranging in duration from hours to months. Cranial computed tomography, performed in four cases, showed no lesion of the basal ganglia. The movements were of such abrupt onset and severity that in four cases they were initially misinterpreted as seizures, and anticonvulsant therapy was contemplated. It is important to recognize the potential development of movement disorders during the acute phase of bacterial meningitis to preclude the inappropriate administration of anticonvulsant medication.
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PMID:Movement disorders in bacterial meningitis. 373 62

Auditory brainstem responses were measured in 94 children under 24 months of age immediately following treatment for bacterial meningitis. Evidence of peripheral hearing loss (thresholds of 30 dB HLn or greater) was found in 47% of the patients. In addition, 9% had prolonged interwave latencies, indicating the possible presence of retrocochlear pathology. Other clinical data were examined as well. CSF glucose concentration correlated with both the presence and magnitude of hearing loss (as measured by auditory brainstem responses). Magnitude of hearing loss also was associated with the presence of seizures. Although all children recovering from meningitis should be assessed for hearing loss, those who have had low CSF glucose concentrations and seizures appear to be at high risk.
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PMID:Cerebrospinal fluid parameters and auditory brainstem responses following meningitis. 388 Mar 98

Of 207 patients with acute bacterial meningitis previously reported by Dodge and Swartz, seizures occurred in 56 (27%). Most seizures began on the first or second day, and most stopped within two days. Seizures occurred most often at the extremes of life. Age-adjusted seizure frequency was greater with Hemophilus influenzae meningitis than with Streptococcus pneumoniae or Neisseria meningitidis. When seizures complicated bacterial meningitis, age-corrected mortality increased from 24% to 38%. Though seizures after recovery were infrequent (2.7% of cases), recurrences were five times more frequent in patients who convulsed acutely than in those who did not. When focal seizures accompanied focal pathology (extracranial or intracranial), the seizures were usually not lateralized to the opposite side of the body. Of factors of potential importance in causation of seizures, fever was the most important risk factor regardless of patient age.
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PMID:Seizures in bacterial meningitis: prevalence, patterns, pathogenesis, and prognosis. 393 45

Lactate concentrations in the cerebrospinal fluid of 104 patients were determined by the Monotest Lactate Kit. Lactate values were found higher in cases of bacterial meningitis than in patients not suffering from acute CNS disorders. Elevated lactate levels were also found in patients suffering from aseptic meningitis, septicemia, CNS trauma and cerebrovascular accidents, seizures and diabetes mellitus. The highest levels were found in cases of bacterial meningitis, but there was considerable overlapping between the groups. CSF lactate thus appears to have limited diagnostic value in the differential diagnosis between bacterial meningitis and other diseases with meningeal involvement.
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PMID:Value of CSF lactate in the differential diagnosis between bacterial meningitis and other diseases with meningeal involvement. 398 42

Bacterial infections are frequent events in premature and newborn infants. The reason is a defective specific and nonspecific defence of bacterial organisms. Some immunoglobulins like IgM and IgA including secretory IgA are absent. Premature infants also show a decreased level of IgG. Cellular immunity is anatomically intact but functionally defective. A number of complement factors are lacking, the activation of the alternative pathway is impaired. Newborn infants with perinatal problems like asphyxia or difficult delivery, show defects of leucocyte function like decreased deformability, defective chemotaxis and defective killing of ingested bacteria. Certain diseases, like hypoxia and malformations of immature organ functions in this age group (decreased acid production in the stomach), facilitate bacterial colonization of surface epithelia and the invasion of tissues. Consequences of these pathogenetic mechanisms are an unimpaired propagation of bacterial organisms into the blood and meninges without localization of the infecting organisms at the entry site. Bacterial meningitis is not considered a separate disease entity but a complication of bacteremia and sepsis. Clinical symptoms are nonspecific at the onset of the infection. Fever is frequently absent; decreased appetite, vomiting, a bloated abdomen, diarrhea, tachycardia, tachypnea are early signs of a bacterial infection, a grey mottled appearance, cyanosis, jaundice, petechiae, apneic spells, seizure activity and a metabolic acidosis are symptoms of advanced infection. Successful treatment at this stage is often not possible. Every sign of a decreased well being of a newborn of premature infant warrants laboratory and bacteriologic work up for septicemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Chemotherapy of severe bacterial infections in pediatrics]. 631 69

A retrospective record study of six cases of meningitis caused by group A beta-hemolytic Streptococcus is presented. Associated findings included otitis media, pharyngitis, and erysipelas. All patients survived their infections despite major complications including seizures, shock, coma, renal failure, and hepatitis. Two patients had neurologic sequelae. Group A Streptococcus causes a severe form of bacterial meningitis in apparently healthy children.
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PMID:Group A streptococcal meningitis. 633 34

Over the past years the use of phenobarbital in so called "brain orientated neonatal intensive care" has gradually become established. It is the recommended drug for the treatment of seizures in term neonates. It also should be given to neonates who are being treated with curare like muscle relaxants and whose EEG may show paroxysmal activity. It is recommended to administer phenobarbital before curare is given. This may result in more effective mechanical ventilation. Seizures occurring in the premature baby can hardly be influenced. The prophylactic treatment of premature infants to avoid intraventricular haemorrhage is controversial. It is, however, generally accepted that full term babies with neonatal asphyxia should receive phenobarbital. Bacterial meningitis is also an indication for its use in a similar manner. A loading dose of 15-20 mg/kg body weight given intravenously is recommended. The plasma concentration of phenobarbital will usually reach therapeutic levels (15-30 micrograms/ml) within a few minutes of the injection and will hardly change during the following 48 hours. No other anticonvulsant drug should be used until the phenobarbital plasma level exceeds 40 micrograms/ml. As maintenance therapy a dose of 3-4 mg/kg/day is recommended. Due to the long plasma half-life (69-165 h) accumulation of the drug may be possible. It can be avoided if the dose does not exceed 5 mg/kg/day. The duration of therapy depends on the condition of the baby. In general early discontinuation after 1-2 weeks should be possible.
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PMID:[Phenobarbital in newborn infants. Overview]. 637 32

The EEG of the newborn consists of a mixed activity which varies from 1 to 22/s. Waves in the alpha band may occur, but they indicate cerebral dysfunction if they are seen in a rhythmic uninterrupted sequence. Eight newborns who showed rhythmic alpha activity in their EEG are included in our study. This activity occurred together with rhythmic theta waves or was followed by them as part of ongoing electrographic seizure activity. All newborns studied were very sick. Three suffered from severe perinatal asphyxia with persistent fetal circulation; in addition one of them had bacterial meningitis. Two infants suffered from herpes encephalitis. In those cases the rhythmic alpha activity temporarily showed a certain periodicity. This EEG pattern was also seen in a small for gestational age premature infant who had septicemia and subarachnoid hemorrhage and in two extremely premature babies with intraventricular hemorrhage. Four infants were curarized. All of the others also had clinically observed seizures. Rhythmic alpha-activity in the neonatal EEG represents an electrical seizure discharge. It may also occur in premature infants who suffer from intraventricular hemorrhage. Obviously it does not have a diagnostic value. The prognostic value depends upon the underlying disease and the grade of background suppression in the EEG. Anticonvulsant therapy should be administered early using a sufficient dosage.
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PMID:[Rhythmic alpha activity in the EEG of premature and newborn infants]. 640 15

Clinical records of 181 children, aged between one month and seven years, admitted in a four year period, from 1978 through 1982, with the diagnosis of bacterial meningitis are revised. Peak incidence occurred in the age group between six months and three years, and during the months of January to May. N. meningitidis (35%), pneumococcus (4.9%) and H. influenzae (2.7%) were the most frequently isolated bacteria. CSF culture was negative in 56% of the children. All of them had previously taken antibiotics. Complications were present in 6.4%, with highest incidence in the known-agent group, on the following order: septic shock, 11%, seizures, 6.6%, and subdural effusion, 2.2%. Permanent sequelae were present in 3.8%, being deafness predominant. Twelve (6.3%) out of the 181 died, and death was result of fulminant meningococcal sepsis with endotoxic shock in ten of these patients. Clinical and psychological followed-up of twenty-nine children with isolated causal agent, were compared with a control group, finding no statistically-significant difference.
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PMID:[Bacterial meningitis in children. Analysis of 181 cases]. 650 29


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