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0009 Childhood GBS in western India — A clinico-electrophysiological study
Poster Abstracts One mechanism involves insufficient cerebral perfusion; the other, cytokine-mediated damage, potentially triggered by events such as maternal infection (e.g., intrauterine or periodontal infection), neonatal infection (e.g., sepsis and necrotizing enterocolitis), and neonatal oxygen- or ventilator-induced lung injury. Studies of biochemical markers of fetal inflanmmtion typically associated with infection also suggest that an inflammatory response may be an important independent etiologic factor. In some studies, cytokine levels in amniotic fluid or newborn blood have also been found to be significantly elevated in preterm and term clfildren with cerebral palsy compared to controls. Conclusion: These data suggest that factors related to the fetal inflammatory response, including cytokines, may be causal agents in brain damage and neurodevelopmental disability associated with intrauterine infection. We suggest that high risk infants should be carefully followed for cerebral palsy and delayed development. The prevention of cerebral palsy may be feasible by decreasing maternal and neonatal risk factors during the prenatal and neonatal period. 0008
The etti~ets of ethanol on glial eeU proliti~rafion: Meehanis~ns involved in central nervous system dysfunctions induced by prenatal ethanol expog~lre
Akbarzadeh, Reyhaneh, Akbarzadeh, Reza=, Akbarzadeh, Marjalleh ~.
2Departrnent of Psychology, Russian University of Economics and Culture, Moscow, Russia; 2Mashhad University of Medical Sciences, iVlashhad, Iron Introduction: Exposure to ethanol during pregnancy is detrimental to
brain development. Ethanol causes alterations of both neuronal and glial cells. A nmnber of in vitro studies have shown that ethanol can inlfibit the proliferation of various glial cells (mostly primary astrocytes or astrocytoma cells) at relatively lfigh concentrations. In turn, these may be the basis ofmicroencephaly and cognitive disturbances in children diagnosed with Fetal Alcohol Syndrome (FAS). Aims and Method: The aim of the present study was to analyze the effects o fethanol on the developing nervous systems; some molecular mechanisms of ethanol-induced behavioral dysfunctions will be discussed. Results: Recent evidence demonstrates that glial cells are profoundly affected by prenatal alcohol exposure, suggesting that alterations in these cells may participate in CNS abnormalities associated with ethanol-induced teratogenesis. Experimental evidence demonstrates that alcohol interferes with many molecular, neurochenfical and cellular events occurring during the normal development of the brain. Some brain areas are more affected than others and, even within a given region, some cell populations are more vulnerable than others. Studies on the mechanisms of ethanol's developmental neurotoxicJty have focused on its interaction with neurons; however, emerging evidence is suggesting that ethanol can significantly affect glial cells as well. These effects of ethanol may lead to a decreased number of glial cells and to a loss of neurons, which have been observed following in vivo alcohol exposure. These glial-neuronal disturbances can explain neuropath logical and clinical features of the (FAS). Conclusion: Central nervous system dysfunctions are the most severe and permanent consequence of maternal alcohol intake and can occur in absence of gross morphological defects associated with FAS. Mental retardation and long-term cognitive and behavioral deficits are some of the problems commonly found in children of women who were moderate or heavy drinkers during pregnancy. 0009 Childhood GBS in western India - A clinieo-dectrophysiological study Apte, A l, Choraria, N a, Apte, S 3, Desai, C 4. 1Nirrnal Children and
General Hospital, Surat, India; 2Nirmal Children and General Hospital, Surat, India; 3Government Medical College, Surat, India; 4Neuro-Electrophysiology Center, Surat, India
Monday, November 7, 2005
S103
Background: We present the results of an ongoing study of childhood
GBS in western India which to the best of our knowledge is the largest series fi'om south Asia. Method; Patients who presented with rapidly progressive limb weakitess of LMN type seen over last 5 years were assessed clinically and elect rophysiologically. Results: Data of 25 patients is presented here. The mean age was 7.14 years (Range - 0.75-15 yrs). There were 17 (168%) males and 8 (32?,';) females. The average duration o f symptoms was 4.9 days (Range - 12hrs-15 days). The involvement was as follows-Lower limbs 25/25 (100%), upper limbs in 22/25 (88%), bilateral facial weakness in 5/25 (20%), bilateral sixth nerve in 1/25 (14%). 1/25/(47,';) patient presented with ataxia, ophthalmoplegia and areflexia but later developed lower limb and respiratory muscle weakness. Dysautonomia was seen in 4/25 (116"/o) patients and recurrent GBS in 1 (14"/o)patient. History of preceeding infection was available in 13/25 (52?,5) patients, 6 (1247,5) had respiratory infection, 4 (1167,5) had gastrointestinal infection and 3 (112%) had febrile illness. 6/25 (24%) patients needed ventilatory support and the average duration of ventilation was 11.3 days. IVIG was given in 18/25 (1727,';) patients. 2 (8?,';) patients died and 23/25 (92?,5) recovered in their motor power. 21 (84?,5) were walking independently at the end of 3 months. NCV studies were done in 24/25 (96"/o) patients. Acute demyelinating pattern was seen in 14 (56"/o) patients and axonal involvement in 10 (40"/o) patients. All 4 patients who had dysautonomia needed ventilatory support and 2 (150%) of them died. Of the 6 patients who were ventilated, 4 (166.6%) had A M A N picture on NCV. Conclusion: Majority o f childhood GBS patients recover fully. Dysautonomia and A M A N pattern on NCV predispose to ventilatory support and are poor prognostic features. 0010 A New Differential Diagnosis Proposal for ADHD: The Permeable Personality
Barrag~l, E 1. ~Ho,wital Inf antil de M~xico "Federico Grrnez"', M~xico Background: A D H D is the more common neuropsychiatric disorder
diagnosis in childhood. The prevalence is uncertain, but estimates ranges between 3 and 15 worldwide. Its more common in boys than in girls (13:1). The diagnosis is clinical (DSM-IV) and response to psychoestimulants very high. However, diagnostic labels for inattentive, impulsive and hyperactive children have changed numerous times over the last decades; and the difference seeing in develop course, high heterogeneity and pharmacological responses (even responding to non conventional treatments) may be due a different personality development and not a symptoms from nervous system disorder. Method: 410 children with symptoms of innatention, hyperactivity and impulsivity were evaluated in a pediatric neurology department between 1999 and 2003. We examined the core symptoms, Conner's test, EEG activity and response to medication. Results: 279 patients (68%) of the sample had criteria (DSMIV) for ADHD. Of the samples, 73"/o were boys, present academic achievement skills (45?,5) learning disabilities (18%) and normal physical examination. 20"/o of the rest of the population shows a problems in motor coordination (98%), delayed onset of language and speech impairments (83%), lean-ring disabilities (92%), poor self-regulation of emotion, visospatial problems, high sensibility, high internalization of own behavior but problems with conmmnication skills, noble, creative, and generalized hypotonia. These patients were a poor responders to psychostimulants, and had a frequent comorbility with anxiety disorders (90%). Conclusion: The permeable personality (Barragfin syndrome) is a proposal of a new differential diagnosis for A D H D patients who display differences in their development courses, need another strategies and pharmacological approaches and try to explain one of the pathways in these heterogenus group of patients.
The etti~ets of ethanol on glial eeU proliti~rafion: Meehanis~ns involved in central nervous system dysfunctions induced by prenatal ethanol expog~lre
Akbarzadeh, Reyhaneh, Akbarzadeh, Reza=, Akbarzadeh, Marjalleh ~.
2Departrnent of Psychology, Russian University of Economics and Culture, Moscow, Russia; 2Mashhad University of Medical Sciences, iVlashhad, Iron Introduction: Exposure to ethanol during pregnancy is detrimental to
brain development. Ethanol causes alterations of both neuronal and glial cells. A nmnber of in vitro studies have shown that ethanol can inlfibit the proliferation of various glial cells (mostly primary astrocytes or astrocytoma cells) at relatively lfigh concentrations. In turn, these may be the basis ofmicroencephaly and cognitive disturbances in children diagnosed with Fetal Alcohol Syndrome (FAS). Aims and Method: The aim of the present study was to analyze the effects o fethanol on the developing nervous systems; some molecular mechanisms of ethanol-induced behavioral dysfunctions will be discussed. Results: Recent evidence demonstrates that glial cells are profoundly affected by prenatal alcohol exposure, suggesting that alterations in these cells may participate in CNS abnormalities associated with ethanol-induced teratogenesis. Experimental evidence demonstrates that alcohol interferes with many molecular, neurochenfical and cellular events occurring during the normal development of the brain. Some brain areas are more affected than others and, even within a given region, some cell populations are more vulnerable than others. Studies on the mechanisms of ethanol's developmental neurotoxicJty have focused on its interaction with neurons; however, emerging evidence is suggesting that ethanol can significantly affect glial cells as well. These effects of ethanol may lead to a decreased number of glial cells and to a loss of neurons, which have been observed following in vivo alcohol exposure. These glial-neuronal disturbances can explain neuropath logical and clinical features of the (FAS). Conclusion: Central nervous system dysfunctions are the most severe and permanent consequence of maternal alcohol intake and can occur in absence of gross morphological defects associated with FAS. Mental retardation and long-term cognitive and behavioral deficits are some of the problems commonly found in children of women who were moderate or heavy drinkers during pregnancy. 0009 Childhood GBS in western India - A clinieo-dectrophysiological study Apte, A l, Choraria, N a, Apte, S 3, Desai, C 4. 1Nirrnal Children and
General Hospital, Surat, India; 2Nirmal Children and General Hospital, Surat, India; 3Government Medical College, Surat, India; 4Neuro-Electrophysiology Center, Surat, India
Monday, November 7, 2005
S103
Background: We present the results of an ongoing study of childhood
GBS in western India which to the best of our knowledge is the largest series fi'om south Asia. Method; Patients who presented with rapidly progressive limb weakitess of LMN type seen over last 5 years were assessed clinically and elect rophysiologically. Results: Data of 25 patients is presented here. The mean age was 7.14 years (Range - 0.75-15 yrs). There were 17 (168%) males and 8 (32?,';) females. The average duration o f symptoms was 4.9 days (Range - 12hrs-15 days). The involvement was as follows-Lower limbs 25/25 (100%), upper limbs in 22/25 (88%), bilateral facial weakness in 5/25 (20%), bilateral sixth nerve in 1/25 (14%). 1/25/(47,';) patient presented with ataxia, ophthalmoplegia and areflexia but later developed lower limb and respiratory muscle weakness. Dysautonomia was seen in 4/25 (116"/o) patients and recurrent GBS in 1 (14"/o)patient. History of preceeding infection was available in 13/25 (52?,5) patients, 6 (1247,5) had respiratory infection, 4 (1167,5) had gastrointestinal infection and 3 (112%) had febrile illness. 6/25 (24%) patients needed ventilatory support and the average duration of ventilation was 11.3 days. IVIG was given in 18/25 (1727,';) patients. 2 (8?,';) patients died and 23/25 (92?,5) recovered in their motor power. 21 (84?,5) were walking independently at the end of 3 months. NCV studies were done in 24/25 (96"/o) patients. Acute demyelinating pattern was seen in 14 (56"/o) patients and axonal involvement in 10 (40"/o) patients. All 4 patients who had dysautonomia needed ventilatory support and 2 (150%) of them died. Of the 6 patients who were ventilated, 4 (166.6%) had A M A N picture on NCV. Conclusion: Majority o f childhood GBS patients recover fully. Dysautonomia and A M A N pattern on NCV predispose to ventilatory support and are poor prognostic features. 0010 A New Differential Diagnosis Proposal for ADHD: The Permeable Personality
Barrag~l, E 1. ~Ho,wital Inf antil de M~xico "Federico Grrnez"', M~xico Background: A D H D is the more common neuropsychiatric disorder
diagnosis in childhood. The prevalence is uncertain, but estimates ranges between 3 and 15 worldwide. Its more common in boys than in girls (13:1). The diagnosis is clinical (DSM-IV) and response to psychoestimulants very high. However, diagnostic labels for inattentive, impulsive and hyperactive children have changed numerous times over the last decades; and the difference seeing in develop course, high heterogeneity and pharmacological responses (even responding to non conventional treatments) may be due a different personality development and not a symptoms from nervous system disorder. Method: 410 children with symptoms of innatention, hyperactivity and impulsivity were evaluated in a pediatric neurology department between 1999 and 2003. We examined the core symptoms, Conner's test, EEG activity and response to medication. Results: 279 patients (68%) of the sample had criteria (DSMIV) for ADHD. Of the samples, 73"/o were boys, present academic achievement skills (45?,5) learning disabilities (18%) and normal physical examination. 20"/o of the rest of the population shows a problems in motor coordination (98%), delayed onset of language and speech impairments (83%), lean-ring disabilities (92%), poor self-regulation of emotion, visospatial problems, high sensibility, high internalization of own behavior but problems with conmmnication skills, noble, creative, and generalized hypotonia. These patients were a poor responders to psychostimulants, and had a frequent comorbility with anxiety disorders (90%). Conclusion: The permeable personality (Barragfin syndrome) is a proposal of a new differential diagnosis for A D H D patients who display differences in their development courses, need another strategies and pharmacological approaches and try to explain one of the pathways in these heterogenus group of patients.