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Introduction This study aimed to investigate selective muscle involvement by shear wave elastography (SWE) in patients with spinal muscular atrophy (SMA) types 2 and 3 and to compare SWE values with magnetic resonance imaging (MRI) in demonstrating muscle involvement. Methods Seventeen patients with SMA types 2 and3 were included in the study. SWE was used to evaluate stiffness of the upper and lower extremities and paraspinal muscles. Involvement of the paraspinal muscles was evaluated using 1.5-T MRI. Results Among the upper extremity muscles, SWE values were the highest for the triceps brachii; however, no significant difference was noted (p = 0.23). In post hoc analysis, a significant difference was observed between triceps brachii and biceps brachii (p = 0.003). Patients with a longer disease duration have the highest SWE values for the triceps brachii (r = 0.67, p = 0.003). Among the lower extremity muscles, SWE values for the iliopsoas were significantly higher than the gluteus maximus (p < 0.001). A positive correlation was found between SWE values and MRI scores of paraspinal muscles (r = 0.49, p = 0.045; r = 0.67, p = 0.003). Conclusion This is the first study to report muscle involvement assessed by SWE in patients with SMA types 2 and 3. Our findings are similar to the presence of selective muscle involvement demonstrated in previous studies, and also SWE and MRI values were similar. SWE is an alternative noninvasive practical method that can be used to demonstrate muscle involvement in patients with SMA, to understand the pathogenesis of segmental involvement, and to guide future treatments or to monitor the effectiveness of existing new treatment options. [ABSTRACT FROM AUTHOR]

Antiepileptic drugs (AEDs) lead to seizure freedom in about 70% of all children with epilepsy. Appropriate drug selection is determined by the patient's age, seizure semiology, epileptic syndrome, and pharmacogenetic approach. The aim of treatment is to prevent seizures by maintaining the effective dose of one or more antiepileptic drugs. In recent years, many new generation AEDs with less side-effect profiles and drug interactions have been used in clinical practice. The clinical uses and side effects of AEDs are different in children than adults. The characteristics of AEDs in the pediatric age group are extremely important in the success of treatment. In this review, many current sources are examined, and the mechanisms of action, pharmacokinetic properties, clinical use and doses, side effects and drug interactions of AEDs that are frequently used in children are discussed. [ABSTRACT FROM AUTHOR]

In this case we report on an adolescent male with new onset weakness of the low extremities after heavy load lifting. Spinal magnetic resonance imaging (MRI) demonstrated cerebrospinal fluid (CSF) leakage in the lumbar and thoracal region in the T2 sequence. Orthostatic headache was the main symptom in the following period. After bed rest and fluid replacement, the patient's symptoms completely recovered. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke is rare in children, but it is one of the important causes of neurological morbidity. The etiology of AIS in childhood includes cardiac pathologies, cerebral arteriopathies, hypercoagulation, chemicals, drugs, inflammatory and autoimmune causes. In this article, we present an infant who has a genetic predisposition to hypercoagulation and comes with AIS clinic when multifactorial risk factors are added. The diagnosis, the underlying etiology, the risk factors affecting the process, the treatment of acute phase, the secondary treatment and the associated preventive approach on prognosis were discussed. [ABSTRACT FROM AUTHOR]

Background: The objective of this study is to investigate the efficacy of continuous renal replacement therapy (CRRT), mainly continuous venovenous hemodiafiltration (CVVHDF), and evaluate vasoactive requirements in hyperammonemic neonates and infants. Methods: Patients who underwent CRRT for hyperammonemia were retrospectively analyzed. Measurements and Main Results: Patients in 7 of the encounters were treated solely by CVVHDF. During 3 encounters, patients who received continuous venovenous hemodialysis (CVVHD) were transitioned to CVVHDF. CVVHD was used in 3 encounters. The median 50% reduction time for ammonia was 8 h (range 3–15 h). The median duration of CRRT treatment was 40 h (range 24–89 h). Survival to hospital discharge occurred in 12 encounters (92.3%). Eleven encounters (84.6%) were treated with different vasoactive agents. In those encounters, the median vasoactive medications' start time was the 6th hours (range 2–60 h) of CRRT. There was no association between the vasoactive index score and pre-dialysis ammonia concentration. Conclusions: CRRT achieves timely control of hypeammonemic states. Hemodynamic instability necessitating intervention with vasoactive medications is a common finding in patients with hyperammonemia. [ABSTRACT FROM AUTHOR]