Ayşe Aksoy

Prematurity poses a significant risk for neurodevelopmental disorders, including cerebral palsy (CP), in infants.1 This risk increases as gestational age decreases.2 Given that approximately 15 mil...

Baş ağrısı, çocukluk çağında en sık görülen rahatsızlıklardan biridir. Çocuklarda, baş ağrısının değerlendirilmesinde ilk adım, ayrıntılı bir öykü ve klinik muayenedir. Baş ağrısı şikayeti olan bir çocukta baş ağrısının birincil mi yoksa ikincil mi olduğunun belirlenmesi gerekir. Birincil baş ağrısı olan hastalar için nörogörüntüleme önerilmemektedir. Ancak, altta yatan nedeni dışlamak için kırmızı bayrakların varlığında nörogörüntüleme zorunlu hale gelir. Çocuklardaki nörogörüntüleme çalışmaları, radyasyon maruziyeti ve sedasyonun riskleri göz önüne alınarak tanı ve tedaviye olası katkıları ile değerlendirilmesi önemlidir.

Objective: This study aims to determine the satisfaction of mothers with a short telerehabilitation program for premature infants and to determine the relationship between satisfaction and characteristics of infants and their mothers. Methods: Sixty-two mothers who had previously received telerehabilitation for motor development support were interviewed by telephone. Information was collected on maternal and infant characteristics, willingness to continue telerehabilitation, and whether participants preferred the intervention to be implemented by themselves or by a professional. Mothers scored their satisfaction with telerehabilitation on a 10-point analog scale. Results: The mean (sd) satisfaction score was 9.8 (0.7) out of 10. Satisfaction decreased with longer infant hospitalization and more children, but increased with maternal age. Overall, 61.3% preferred to continue telerehabilitation, and same percentage preferred to carry out intervention themselves. Conclusion: Telerehabilitation can be a satisfactory service delivery model for mothers of premature infants, and this satisfaction may be affected by the characteristics of mothers and infants. It is important that telerehabilitation services are customized to meet the specific needs of each family.

This study aimed to investigate cardiac involvement in children and adolescents with neurofibromatosis type 1 (NF1), and to describe clinical correlates. Medical records of 114 NF1 patients (ages 1-18 years) followed at a tertiary center (2011–2017) were retrospectively reviewed. Among these patients, 58 (50.9%) underwent pediatric cardiology assessment with echocardiography (ECHO) and electrocardiography (ECG). ECHO abnormalities were defined a priori (valvular disease, septal hypertrophy, septal defects, and pulmonary valve stenosis); patent foramen ovale (PFO) was considered a normal variant. Demographics and NF1 features were compared between patients with and without cardiac pathology. Among the 58 evaluated patients, ECHO was abnormal in 18/58 (31.0%; 95% CI 20.6–43.8) and 1/58 (1.7%; 95% CI 0.3–9.1) had isolated ventricular extrasystoles, yielding 19/58 (32.8%; 95% CI 22.1–45.6) with any cardiac pathology. Valvular involvement occurred in 13/58 (22.4%; 95% CI 13.6–34.7); septal hypertrophy and septal defects each in 3/58 (5.2%; 95% CI 1.8–14.1); pulmonary valve stenosis in 1/58 (1.7%; 95% CI 0.3–9.1). No statistically significant difference in age, sex, or NF1 diagnostic features was observed between those with vs. without cardiac pathology (all p>0.05). Cardiac pathology was common among NF1 patients referred for cardiology evaluation, with valvular disease predominating. Given retrospective design and potential referral/selection bias, a routine baseline cardiology assessment at NF1 diagnosis appears reasonable, with a low threshold for follow‑up when symptoms, murmurs, or risk factors are present.

Objective: Chorea is a rare hyperkinetic movement disorder in children, characterized by involuntary, irregular, and rapid movements. Sydenham’s chorea (SC), an autoimmune complication of rheumatic fever, is the most common cause of chorea in pediatric populations. This study aims to retrospectively evaluate the clinical features, neuroimaging findings, treatment responses, and prognostic factors in children with choreiform movement disorders, with a focus on relapse rates and treatment efficacy.Materials and Methods: We conducted a retrospective review of pediatric patients diagnosed with choreiform movement disorders at Dr. Sami Ulus Children's Hospital between 2010 and 2018. Demographic data, clinical presentation, neuroimaging findings, treatments, and relapse outcomes were analyzed.Results: Of the 74 patients, 94.6% had secondary chorea, with 91.9% diagnosed with SC. The mean age at diagnosis was 133.5 ± 33.9 months, with 71.2% female. Brain magnetic resonance imaging findings were normal in 71.4% of the patients who underwent it. Haloperidol was the most commonly used treatment, with 87.3% of SC patients showing a positive response. Relapse occurred in 11.6% of patients, with no significant differences in symptom duration, treatment duration, or age at diagnosis between those with and without relapse (p > 0.05). The median time to relapse was 21 months.Conclusion: SC is the most common cause of chorea in children, and haloperidol is an effective first-line treatment. However, relapses remain a concern, highlighting the need for long-term follow-up. No significant differences were found in clinical parameters between relapsing and non-relapsing patients. Further research is needed to identify relapse predictors.

Objectives: To evaluate the demographic, clinical, laboratory, and prognostic data of children with acute disseminated encephalomyelitis with respect to anti-myelin oligodendrocyte glycoprotein (MOG) antibody status. Methods: Acute disseminated encephalomyelitis patients (n = 245) from 24 centers followed up between 2010 and 2022 were evaluated retrospectively. The short- and long-term outcome characteristics (disease severity and course, clinical relapse, and recovery rates) were assessed. Incomplete clinical recovery was defined as modified Rankin Score ≥1 or the presence of epilepsy. Univariant and multivariant analysis were performed for outcome characteristics. Results: The mean age at diagnosis was 6.3 ± 3.8 (0.5-17.7) years and the median follow-up was 22 (3-132) months. The outcome characteristics were evaluated in 180 of 245 patients (73.4%) with at least 12 months’ follow-up. Twenty-three patients (12.6%) relapsed. The multivariable logistic regression analysis revealed the following clinical parameters as predictors of relapse: sex, visual impairment, and ataxia at initial presentation. Incomplete clinical recovery (n = 42/180, 23.3%) was associated with the presence of seizures on admission and the need for an intensive care unit. Anti-MOG antibody positivity was not associated with an increased risk of relapse (25% vs 13.1%, P = .164) or incomplete clinical recovery ( P = .511). Conclusion: The nationwide cohort presented further supports the typically monophasic nature of acute disseminated encephalomyelitis, and a high rate of complete recovery. The presence of certain symptoms in the acute period may assist the clinician in estimating the outcome.

Purpose This study investigates the morphometric changes in the brains of patients with frontal focal cortical dysplasia (FCD) Type II, distinguishing between right and left FCD, using voxel-based morphometry (VBM), surface-based morphometry (SBM), and subcortical shape analysis. Methods The study included 53 patients with frontal lobe FCD Type II (28 left-sided, 25 right-sided) and 66 age- and gender-matched healthy controls. VBM and SBM analyses were conducted using Computational Anatomy Toolbox 12.8 (CAT12.8) and Statistical Parametric Mapping 12 (SPM12). Subcortical structures were segmented using FSL-FIRST. Statistical analyses were performed using non-parametric tests, with a significance threshold of p < 0.05. Results VBM revealed increased gray matter volume in the bilateral ventral diencephalon, left putamen, and left thalamus in the left FCD group. SBM indicated reduced sulcal depth in the right precentral, postcentral, and caudal middle frontal gyrus in the right FCD group. Subcortical shape analysis showed internal deformation in the left hippocampus and external deformation in bilateral putamen in the left FCD group, and external deformation in the left caudate nucleus, left putamen, and right amygdala in the right FCD group. Conclusion Morphometric changes in frontal FCD Type II patients vary depending on the hemisphere. Right FCD Type II is associated with sulcal shallowing and external deformation in contralateral subcortical structures, while left FCD Type II shows internal and external deformations in the hippocampus and putamen, respectively, along with increased gray matter volume in the basal ganglia. These findings highlight the need for hemisphere-specific analyses in epilepsy research.

Introduction In addition to seizure care, it has been well-established that a holistic approach to the treatment of children with epilepsy that addresses the social, behavioral, and psychological dimensions also benefits their quality of life (QoL). The aim of this study was to investigate the patient and parental perceived stigma, seizure self-efficacy of children with epilepsy, and the relationship with quality of life in terms of sociodemographic and epilepsy-related factors. Method The study group consisted of children, aged between 8 and 18 years and with a diagnosis of epilepsy of at least six months duration and their parents. Pediatric Quality of Life Inventory (PedsQL), Child-Parent Stigma Scales, and the Seizure Self-Efficacy Scale for Children (SSES-C) were used for evaluation. Results One hundred and forty-four children (mean age 12.6 ± 2.9 years) took part, of whom 48.6% were female. The mean Child Stigma Scale score was 1.77 ± 0.82, Parent Stigma Scale score 2.41 ± 0.75, SSES-C score was 3.37 ± 0.98, and PedsQL score was 72.8 ± 18.6 for children self-reports (CsR) and 73.2 ± 18.8 for parent proxy-reports. The intraclass correlation coefficient for parent–child PedsQL indicated a good level of agreement. There was a significant negative correlation between the Child Stigma Scale and the PedsQL-CsR scores. A significant positive correlation was identified between the SSES-C scores and the PedsQL-CsR scores. Discussion Perceptions of stigma in children with epilepsy and their parents were high in this study population. Of note, the elevated stigma perception reported by the patients had a detrimental impact on seizure self-efficacy. This relationship may affect the children’s QoL and further complicates epilepsy management in this patient group.