[Selective serotonin reuptake inhibitors for behavior disorders].
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Biomedical subjects
Publications and source records attributed to J Furusho.
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An 8 year-old boy with Asperger's syndrome had difficulties in communicating with his teachers and classmates. He occasionally stole out of the classroom. He could not sleep at night recalling his awful experience and kept crying every night and refused to go to school. The treatment with fluvoxamine was started at the dose of 25 mg daily. Four weeks after the treatment, his repetitive behavior and hyperactivity decreased and night crying diminished. Although he still has difficulties in communicating with others, he is now able to attend extra-curricular classes in a private school. Fluvoxamine, a selective serotonin re-uptake inhibitor that has been mainly used for patients with depression and obsessive-compulsive disorder, might be effective for compulsive symptoms and sleep disturbance of patients with pervasive developmental disorders.
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This study describes the usefulness of fluid-attenuated inversion recovery (FLAIR) pulse sequence for early diagnosis and treatment of herpes encephalitis. An 8-year-old boy with suspected herpes simplex encephalitis was examined by magnetic resonance imaging at 3 days post-symptom onset. Lesions in the right thalamus and insular cortex were detected by conventional T2-weighted images and images from FLAIR pulse sequence. Bilateral temporal lesions, however, were only detected by FLAIR images.
A 3-month-old male presented with right-side-dominant focal seizures. Focal spikes were observed on the left side of an electroencephalogram obtained at the time of onset. The immature development in the left middle temporal lobe was observed by initial magnetic resonance imaging (MRI). The hypoperfusion in the left temporal lobe observed with single-photon computed tomography was consistent with MRI findings. These MRI findings were not observed in a second MRI at 11 months of age. This observation may explain one of the causes of infant-onset focal epilepsy.
A morphometric magnetic resonance imaging study was performed, and the results were compared among three groups (group 1, periventricular leukomalacia patients with West syndrome; group 2, periventricular leukomalacia patients without West syndrome; and group 3, control patients) to clarify the characteristics and cause of West syndrome. This study included 21 infants (11 males and 10 females, 7 months to 2 years 8 months old) born at 24-32 weeks of gestation and weighing 625-1,908 gm. The Evans ratio, ratio of the posterior horns, Cella media index, width of the third ventricle, and the areas of the midbrain, pons, and medulla oblongata were measured and compared among the three groups. There were no differences of gestation or birth weight among the three groups. The Evans ratio, ratio of the posterior horns, Cella media index, and width of the third ventricle were larger in group 1 than in groups 2 and 3. The ratio of the posterior horns and Cella media index were larger in group 2 than in group 3, although the width of the third ventricle was not. Myelination was delayed in all patients in group 1 and in two patients in group 2. In group 1 the areas of the midbrain and pons were smaller than in groups 2 and 3 and the medulla oblongata was smaller than in group 3, although there were no differences in midbrain, pons, and medulla oblongata between groups 2 and 3. Although the infants with periventricular leukomalacia and West syndrome frequently demonstrated marked ventricular dilatation and delayed myelination, the atrophy of midbrain and pons was the most characteristic, and the damage may cause West syndrome.
Many children in Japan developed various neuropsychological problems, including seizures, while watching the program Pocket Monster, televised on 16 December 1997. To examine the basis for this incident, we have performed a survey of volunteering children and their parents who visited our pediatric clinics for other reasons from 8 January to 28 February 1998. Children and their parents filled out questionnaires. Among the total of 662 children surveyed, the great majority (603, 91.1%) was found to have watched the Pocket Monster program and 30 individuals (5.0% of viewers) complained of variable degrees of neuropsychological abnormalities. These included seizures (two cases), headache (nine cases), nausea (eight cases), blurred vision (four cases), vertigo (two cases), dysthymia (two cases) and vomiting (one case). Nearly half (14) of these children developed symptoms during or immediately after watching the program, while the remainder did so later. Representative cases are reported and other statistical aspects are discussed.
Carotid blood was measured with a ultrasonic volume flow meter in 38 infants. The carotid blood flow was 1.50 +/- 0.55 ml/sec. At the same time peak systolic flow velocity, mean blood velocity, end diastolic velocity, pulsatility index (PI) and resistance index (RI) in the middle and anterior cerebral arteries were measured by duplex Doppler scanning. There was a correlation between the carotid blood flow and the mean blood velocity in middle and anterior cerebral arteries. However, PI and RI were not well correlated with carotid blood flow.