Zeitschrift für pädiatrische Neurologie und Medizin

Background: Stroke is one of the major public health problems in the world today. It is the third leading cause of death worldwide after ischaemic heart disease and cancer. Stroke mortality is especially high in sub Saharan Africa (SSA) which accounts for as much as 87% of all the stroke deaths. Stroke however has become a treatable disease.
Methods: We reviewed the literature on Stroke in SSA. We searched the PubMed database for studies on stroke in SSA, and included those that were community based, conducted in any SSA country and reported on awareness, mortality, risk factors and care.
Results: We found few community-based studies. Most of the studies were hospital based. There were more studies on stroke mortality and risk factors in SSA. Few studies dealt with issues of access to stroke care. Most of the studies on stroke care showed that care is still mostly supportive. South Africa however had more stroke units and state of the art stroke care than other countries in SSA.
Conclusion: There have not been many studies on optimal stroke care in SSA. The few studies seen showed that care has been majorly supportive.

M.S. was delivered at 40 weeks by emergent caesarian section after late decelerations were noted on exam. Her Apgar scores were 8 and 9 at one and 5 min, respectively. Although she had difficulty sucking a bottle, she was released from the hospital without neurological consultation. She went on to develop persistent physical and mental disabilities, including generalized hypotonia, impaired language development, and severe ADHD. The patient’s symptoms were never definitively linked to perinatal distress, and the possibility of hypoxic-ischemic encephalopathy was not investigated. Her parents, deeply distressed by their lack of answers, brought her to our clinic as an 18- year-old. We ordered DW-MRI and found evidence of remote hypoxia. Paired with the clinical history, these findings suggest the patient suffered HIE due to fetal distress. This case demonstrates that overreliance on the Apgar score can lead clinicians to miss abnormalities in the critical window of early infancy and fail to connect later pathologies with birth trauma.

Tuberculosis (TB) remains a major public health problem worldwide and China is one of 22 high-burden countries. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis infection, period of pediatric tuberculosis (TB) in the most common primary tuberculosis. Children after initial contact named tuberculosis bacili is main with the body's immunity, bacterial virulence and quantity. Recently, pediatric TB incidence certainly has a rising trend, the original hairstyle tuberculosis is named tuberculosis bacili of primary infection occurred after first invasion of the lung, is the main type of pediatric tuberculosis, the vast majority of the total number of children of various tuberculosis. Adult tuberculosis (TB), and the presence of resistant strains, bring children tuberculosis prevention and control of the difficulties, childhood tuberculosis prevention and control of can only strengthen and not weaken. From 1979 to 1979, our country has carried on the four national tuberculosis epidemiological sampling survey (flow), childhood tuberculosis accounts for about 10% of all TB, estimates that new TB patients more than 100 children each year, about 250000 death Childhood tuberculosis diagnosis is difficult, the lack of diagnostic gold standard, always views the tuberculin skin test (tuberculin skin test, TST), the typical imaging and clinical manifestations, in recent years, some new diagnostic method for diagnosis of childhood tuberculosis. The Molecular biology technology, molecular device MTB/RIF system linear probe technique; the basis of etiology examination for diagnosis of tuberculosis. Because of its low incidence, low light symptoms, sputum smear positive rate and diagnosis difficult, childhood tuberculosis are easy to be overlooked. According to the types and present status of tuberculosis and activity, and check the lungs outside have other parts of the body without the existence of active tuberculosis, to determine treatment. There are systemic therapy, anti-tuberculosis drug treatment (chemotherapy) chemicals, hormone therapy, surgical therapy. In this paper, the children and clinical manifestations of the disease is associated with TB diagnosis and treatment measures and the research progress of the status quo of the diagnosis and treatment in recent years.

HMGB1 is known as a representative of danger-associated molecular patterns (DAMPs), which play an important role in triggering inflammatory responses. In order to know the role of high mobility group box 1 (HMGB1) in children with acute encephalopathy and other neurological disorders we analyzed HMGB1 and other cytokines in serum and cerebrospinal fluid. Comparing HMGB1 in Kawasaki disease as a control, serum levels in influenza-associated encephalopathy and West syndrome were significantly lower. However, two cases of influenza-associated encephalopathy having sequelae showed extremely high levels. The levels of HMGB1 in acute encephalopathy and purulent and aseptic meningitis in cerebrospinal fluid were low; however, they were significantly higher than those in West syndrome. Serum HMGB1 levels were correlated with those of interleukin-6 and interleukin-8 in cerebrospinal fluid. HMGB1 is suspected to have a pivotal role in pathophysiology of acute encephalopathy and other neurological disorders.

Objective: To analyze the density spectral array (DSA) on the digital electroencephalography (EEG) in a patient with Lennox-Gastaut syndrome (LGS) who developed non-convulsive status epilepticus (NCSE) after initiation of oral levetiracetam (LEV). Methods: Digital EEG was performed on the patient for a 30 min period during the daytime while he was asleep status without hypnotic drugs. The DSA, which incorporated a conventional program of the digital EEG, was sequentially evaluated. Result: The DSA demonstrated that the continuous and periodic high voltages and broad ranges of oscillation, reflecting epileptic activity and the clinical conditions. The EEG demonstrated obvious bilateral frontopolar and/or diffuses 2-3 Hz slow spike-and-wave complex activities, which were not evident before initiation of LEV. Development of LEV-induced NCSE was suspected. Discontinuation of LEV and increasing the dose of clobazam resulted in recovery from NCSE, followed by gradual restoration of the original DSA and EEG findings. Conclusion: On administering of LEV for patients with LGS, the occurrence of NCSE should be carefully monitored. The DSA based on digital EEG was useful for both the diagnosis of NCSE as a drug side-effect and the recovery from its epileptic status.