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Biomedical subjects

A Visudtibhan

Publications and source records attributed to A Visudtibhan.

10 recordsLinked to original sources
PubMed2001

West syndrome in Thailand: a hospital-based survey.

The prevalence of West syndrome in Thailand had not been studied. During January 1997 to December 1999, at the Department of Pediatrics, Ramathibodi Hospital, Bangkok, Thailand, of the total 628 first seen epileptic patients, aged 0-15 years, 31 patients (4.9%) with West syndrome were encountered. Sixteen were males. The mean age at presentation was 9.7 months (range 4-32 months) and at seizure onset was 5.7 months (range 2-11 months). Twenty-two patients had typical spasms, four each had generalized tonic seizures and focal seizures prior to the onset of infantile spasms, and another patient had myoclonic seizures. Nineteen patients were classified as symptomatic. Electroencephalogram revealed hypsarrhythmia in six patients, multifocal independent epileptiform discharges in 24 patients, and focal epileptiform discharges in four patients. Abnormal brain-imaging findings were demonstrated in six of the 11 patients investigated. Vigabatrin was given to 17 patients whereas one patient was given valproate. Others who had been severely retarded were given phenobarbital in combination with benzodiazepine. Six patients were lost to follow-up. Of the remaining patients, the duration of follow-up ranged from 7 to 44 months (mean 28 months). Infantile spasms disappeared in 11 patients, persisted in six patients, and changed to other form in eight patients. The developmental outcome was apparently normal in five, slightly delayed in four, moderately delayed in ten, and severely delayed in eight patients.

Adolescent↗
PubMed2001

Cavernous sinus thrombophlebitis in children.

Eight Thai patients less than 15 years of age who were diagnosed with cavernous sinus thrombophlebitis at Ramathibodi Hospital, Bangkok, Thailand over the past 30 years were reviewed retrospectively. The predisposing infections and causative microorganisms were similar to previous reports in children and adults. Despite severe neurologic dysfunction during admission, including blindness, there was neither death nor severe permanent deficit found in the majority of the patients. Only one patient experienced mild hemiparesis caused by cerebral infarction, which was secondary to this condition. Early recognition of this condition, the appropriate selection of empirical antibiotic therapy, and the awareness of associated complication were the key factors leading to excellent outcome.

Adolescent↗
PubMed2001

Adverse cutaneous reactions to phenobarbital in epileptic children.

INTRODUCTION: Cutaneous adverse reaction to phenobarbital is not uncommon. According to previous studies, around 3 per cent of children taking phenobarbital have reactions. However, there has been no report in Thai children. OBJECTIVE: To study adverse cutaneous reactions to phenobarbital in children with epilepsy. PATIENTS AND METHOD: A retrospective study from medical records of epileptic children aged under 15 years diagnosed at the Department of Pediatrics, Ramathibodi Hospital, Bangkok, Thailand from January 1989 to December 1993 was done. Adverse cutaneous reactions were categorized into 3 groups according to severity. Duration from the initiation of phenobarbital to the onset of reactions and the clinical course were collected for analysis. RESULT: There were 18 children from the total of 572-retrievable medical records of children with epilepsy who had adverse cutaneous reactions. The prevalence was 3.2%. There were 5, 10 and 3 patients categorized into mild-form, moderate-form, and severe form respectively. All except one patient had the onset of cuteneous reactions within 3 weeks. No morbidity or mortality was observed in these patients. Recovery of the cutaneous reactions was obtained between 5 and 14 days in those with mild or moderate form. CONCLUSION: Adverse cutaneous reactions to phenobarbital observed in Thai epileptic children were similar to those found in previous reports. Physicians who prescribe phenobarbital must be aware of the serious adverse reactions which might occur. Early recognition of the adverse reactions and prompt intervention including discontinuation of the drug must be exercised to prevent any serious complications.

Anticonvulsants↗
PubMed1999

Stroke and seizures as the presenting signs of pediatric HIV infection.

The authors report two pediatric patients with definite human immunodeficiency virus infection whose initial presentation was stroke and seizure. The first patient was a 3-year-old female who developed acute hemiparesis as the first manifestation. The other, a 2-month-old infant, had focal seizures secondary to cerebral infarction. Investigations revealed ischemic infarction of the thalamus, hypothalamus, and internal capsule in the first patient and cerebral cortex in the second. Further investigations failed to demonstrate any other causes of these cerebral infarctions. Opportunistic infection of the central nervous system was not documented. The authors emphasize that cerebrovascular accident may be the initial presentation in human immunodeficiency virus infection in children. Human immunodeficiency virus infection must be included in the differential diagnosis, and testing for the disease is mandatory in the investigation of stroke in any child who is at risk of having this infection.

Cerebrovascular Disorders↗
PubMed1999

Temporal lobectomy for intractable complex partial seizures in pediatric patients.

Fourteen children, 7 boys and 7 girls, who failed conventional medical treatment for complex partial seizures underwent anterior temporal lobectomy at Ramathibodi Hospital, Bangkok, Thailand, from July 1993 to June 1998. The mean age at onset of patients was 6.7 years old and the mean duration of seizures before surgery was 6.4 years. The age of patients at surgery ranged from 8 to 22 years old. These patients had had limited presurgical evaluation which included video-electroencephalography (EEG), magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). All patients demonstrated concordant among clinical symptoms, EEG, MRI and SPECT on the same side of the temporal lobe. Ten and 4 patients had unilateral and bilateral temporal lobe lesions respectively. The operations were done on the left in 10 patients and on the right in 4 patients. Seizure free after 1/2-5 years of follow-up was obtained in 70 per cent of patients which included 9 of 10 patients with unilateral temporal lesion and 1 of 4 patients with bilateral temporal lesions. The rest of the patients showed marked reduction of seizures except for one patient with bilateral lesions in whom only 50-70 per cent reduction was obtained. Marked improvement of behaviour was also observed in 70 per cent of patients. Resected brain specimens revealed mesial temporal sclerosis, gliosis, tumors and cavernoma in 6, 5, 2 and 1 patients respectively.

Child↗
PubMed1999

Vigabatrin in infantile spasms: preliminary result.

PURPOSE: To evaluate the efficacy of vigabatrin in the treatment of infantile spasms in Thai children. PATIENTS & METHOD: From March 1996 to May 1998, patients aged under 2 years presenting with infantile spasms at Ramathibodi Hospital were initiated with vigabatrin 35-50 mg/kg/day in two-divided doses. The dosage was escalated by 25 mg/kg weekly until spasms ceased or the maximum dose of 130 mg/kg was reached. RESULTS: There were 20 patients enrolled. The ages ranged from 3 to 23 months (mean 7.6 months). They were categorized as 4 cryptogenic and 16 symptomatic. Infantile spasms were completely controlled in 12 patients (60%). Six patients (30%) had at least 50 per cent reduction of seizure frequency. There were 2 patients whose seizure frequencies and severity were not altered. Only one patient whose infantile spasms partially responded to vigabatrin developed orofacial dyskinesis which disappeared after discontinuation of vigabatrin. Five patients had their vision evaluated which was unremarkable. Based on parental global evaluation, there was an increase in alertness, cheerfulness and interaction to the environment and stimulation in 8 out of 15 patients who were still taking vigabatrin and responded to treatment. CONCLUSION: Vigabatrin is effective for infantile spasms. A long-term follow-up of these patients is necessary to evaluate its efficacy and side-effects.

Anticonvulsants↗
PubMed1998

Guillain-Barre syndrome in Thai children: retrospective analysis of the clinical and outcome prior to intravenous immune globulin era.

The authors retrospectively reviewed Guillain-Barre syndrome (GBS) in 48 Thai children over a period of 20 years from 1970 to 1989. The clinical presentations of this syndrome were compared to those reported in previous studies of children in Western and Asian countries. Antecedent infection, including respiratory tract infection and nonspecific viral infection, in this group of patients is similar to previous studies in children. Cranial nerve involvement found in this study (45.8%) was higher than that in other studies. The outcome of GBS in Thai children in this study was not different from other reports even without IVIG administration. The authors emphasize that respiratory and supportive care are important in managing patients suffering from this syndrome.

Adolescent↗
PubMed1998

Recurrent acute cerebellar ataxia of childhood following nonspecific respiratory tract infection.

Acute cerebellar ataxia in childhood following viral infection is a self-limited disease. The disease with recurrent course has rarely been reported. At the Department of Pediatrics, Ramathibodi Hospital, three children with recurrent episodes of acute cerebellar ataxia following nonspecific viral infection were encountered. The age at onset of each patient was 2 years, 18 months and 2 years old. The clinical symptoms were similar and improved rapidly after gluco-corticoid was given. All patients recovered without residual deficit. Six, 5 and 3 recurrent attacks of similar illness were noted in each patient respectively after the first episode. However, no further attack occurred after the age of 5 years and the age of last follow-up was 17, 16 and 14 years old respectively. The pathogenesis of the recurrent episodes is uncertain. The abnormal immunological response is postulated.

Acute Disease↗
PubMed1997

Intrathecal production of measles-specific IgA in subacute sclerosing panencephalitis.

OBJECTIVE: We measured measles-specific IgA in matched pairs of cerebrospinal fluid (CSF) and sera of patients with subacute sclerosing panencephalitis (SSPE), multiple sclerosis (MS), other central nervous system (CNS) infectious diseases (INF) and other neurological diseases (OND) by using enzyme linked immunosorbent assay. MATERIALS AND METHODS: CSF and sera from 23 patients with SSPE, 15 with MS, 14 with INF, and 15 with OND were included in the study. RESULTS: The ratios of measles-specific IgA in CSF to serum were increased in SSPE patients compared to patients with MS, INF or OND. CONCLUSION: The data indicate a local production of measles-specific IgA in the CNS of SSPE patients.

Adolescent↗