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Background: In the population of children and adolescents, epilepsy affects 0.5-1% of individuals; approximately 3% of general population suffer from non-epileptic seizures, while endocrine disorders are several times more frequent. All of the above factors result in a relatively common non-accidental occurrence of endocrine disorders, epilepsy and neuropsychiatric disorders. However, structural central nervous system (CNS) abnormalities that cause both endocrine and neurologic disorders seem to be markedly less common. No reports addressing this problem are available in the literature., Aim of the Study: 1) Assessment of the frequency of non-coincidental occurrence of epilepsy and endocrine disorders in inpatients and outpatients with structural CSN abnormalities managed in Department Endocrinology. 2) Presentation of diagnostic and therapeutic difficulties in these patients, and 3) An attempt at defining a common etiology of both disorders., Material and Methods: A retrospective analysis of the medical records of the patients with coincidence of endocrine disorders and epilepsy and psycho-neurologic disorders (treated in Chair and Department of Children's and Adolescents Neurology, University Children's Hospital of Krakow or in another pediatric neurology center) and with organic CNS abnormalities (treated or followed up as inpatients and outpatient of Department of Pediatric Surgery, Children's University Hospital of Krakow, was performed. The patients were selected from among several thousands of children treated as inpatients and outpatients of the Department., Results: Various forms of symptomatic and idiopathic epilepsy and other psychoneurological disorders (disorders of behavior and emotions, obsession-compulsion syndromes, stereotypias, aggression, compulsive ideas and movements, anorexia or hypothalamic obesity) coincident with one or more endocrine disorders such as precocious or delayed puberty, multihormonal pituitary deficiency, panhypopituitarism and secondary hypothyroidism were detected in 42 patients with suprasellar arachnoid cyst (7 patients), septo-optic dysplasia (8 patients), craniopharyngioma (15 patients), glioma of the optic chiasm in neurofibromatosis type 1 (NF-1) (12 patients). There were no endocrine disorders in any of the ten patients with hamartoma of the hypothalamus and CPP. Endocrine and/ or neurological disorders did not resolve or were progressive after neurosurgery. Of 42 patients, a group of seven children representative for individual disorders was selected. In those patients, the etiology of both endocrine disorders, epilepsy and neuropsychiatric disorders was suspected to be common., Conclusion: 1. Various structural CNS abnormalities are the cause of concomitant epilepsy and endocrinopathy, although in some cases a direct impact of a genetic factor on the occurrence of both disorders or a mere coincidence cannot be ruled out. 2. Psychoneurological disorders usually precede the onset of endocrinopathy. 3. For this reason, MR or CT CNS imaging should be performed in any case of central neurological disorders, disorders of behavior, epilepsy, obsessive-compulsive syndrome, but also in patients with delayed psycho-motor development, delayed or accelerated growth and pubertal development. All of the above-mentioned manifestations may be symptoms of structural CNS abnormalities and their early treatment determines the child's future.

Background: In the group of adult patients being diagnosed from different neurological complaints frequency of pineal cyst occurrence is estimated at 0,1-4,9%. Frequency of its occurrence in pediatric population is unknown, however it is regarded as a common lesion at this age, more frequent in girls and older children. This structural lesion is usually asymptomatic, without sequels and clinical complications. However, neoplastic lesions may also localize in pineal cyst., Aim of the Study: Characterization of pineal cysts found in children diagnosed from different neurological diseases., Material and Methods: 45 children at the age range from 14 months to 17 years were hospitalized in the Department of Pediatric Neurology Chair of Pediatric and Adolescent Neurology in the years 2006-2010. MR examination with contrast (with the use of Siemens device 1,5 T) revealed lesions in pineal gland defined as pineal cysts. Predominance of girls was observed in the group (33/45). Additionally older children between 10 and 15 years of age were dominating (27/ 45). In 24/45 children serum tumor markers AFP and betaHCG were determined. Examined group of patients with clinical symptoms which indicated necessity of MR examination performance was very heterogenic., Results: The diameter of pineal cyst was between 3-10 mm in 40/45 children, 13 mm in 2 children and 11 mm in 3 children (most often 4-5 mm in 18 children). Usually this lesion accompanied other congenital or acquired CNS disorders. In 1/3 of children included to the study, headaches were cause of brain MR examination. In 15 children brain MR examination was performed due to epileptic paroxysmal events. No positive values of tumor markers were found in any of examined children., Conclusions: 1. Pineal cysts are common structural lesions in children hospitalized from different neurological symptoms. 2. Pineal cysts were usually found in children diagnosed because of headaches and epilepsy, and these were the most often final diagnosis. 3. In the examined group children over the age of 10 years and female sex predominate. 4. It is suspected that in majority of hospitalized patients pineal cyst was an incidental finding, with no association with clinical symptoms.

The aim of the present work was to present significant cognitive impairment in 7 children with normal neuroimaging and electroencefalography results. In 6 children we observed difficulties in verbal auditory learning, in 3 visual memory impairment, and in 1 a disorder of visuo-spatial analysis and synthesis abilities. The clinical examinations performed during the diagnostic process (MRI, CT, Eeg) revealed no neurobiological correlates of the observed neuropsychological impairment. The authors used the cases described to remind, that even though current neuroimaging techniques seem excitingly promising in the diagnostic process, psychological and neuropsychological assessment remains the most sensitive method for the measurment and description of cognitive functions.

Background: Epilepsy can be one of symptoms of the damage to CNS in children with neurodevelopmental deficits, it is more difficult however to diagnose seizures if they are the first symptom of severe brain damage., The Aim: This retrospective research was conducted to study causes of symptomatic epilepsy in children aged 3-18 year hospitalized between 2006 and 2007 year in the Department of Pediatric Neurology., Material and Methods: 156 children with symptomatic epilepsy occurred after 2 years of life were included. The diagnosis of symptomatic epilepsy was established including clinical picture, neuro-radiological tests and EEG. The information from parents was helpful to analyze the type of seizures. The clinical state of children was analyzed, especially psychomotor development, focal deficits, as well as results of CT and/or MRI, in some children psychological testing was performed, molecular or serological., Results: 156 children with epilepsy were hospitalized, within encephalopathy was diagnosed in 61 children. In 42 children static encephalopathy was associated with birth trauma, in 7 progressive encephalopathy was diagnosed, in 1 child CO intoxication caused encephalopathy, and in 11 cases the cause was not identified. Malformations of nervous system were associated with epilepsy in 37 children, geneticaly determined syndromes in 6, and the head trauma in other 6 children. Disorders of vascular origin caused epilepsy in 16 children, and neuroinfections in 9 children. In 2 children epilepsy was associated with ADEM, and in 11 children nonspecific de/dysmyelination was detected. The brain tumor was detected in 6 children with symptomatic epilepsy., Conclusions: The most common disorder leading to epilepsy in children aged 3-18 years was encephalopathy, within hypoxic-ischemic encephalopathy. The other in sequence were malformations of nervous system and vascular diseases.

Background: Cavum septum pellucidum (CSP) is commonly known marker of neurodevelopmental brain malformation. In MR imaging it is seen either as an isolated finding or with association of others developmental brain changes e.g. cavum vergae (CV)., Aim of the Study: was to assess the frequency of CSP and CV associated with others brain developmental malformations in children. We also classified clinical syndromes in children with these structural brain malformations., Material and Methods: The study was performed on 55 children, hospitalised in the Department of Pediatric Neurology, Jagiellonian University in Krakow, between 1998-2006 with diagnosed CSP and/or CV in MRI. There were 29 girls and 26 boys aged 4 months-16 years old. Clinical history, clinical status and neurological findings in physical examination were main indication to perform brain MRI. MRI scans was done in SE T1, FSE T2, PD, FLAIR, IR T1 sequences, 3 and 5 mm depth, in vertical, frontal and axial surfaces, performed on 1,5 T machine Signa Horizon HiSpeed General Electric., Results: There were 38 children with CSP, 12 children with CSP and CV, and 5 with CV. In 18/55 children (33%) CSP was isolated, but in 37/55 children (67%) CSP was coexisted with other brain structural malformations. The average age of diagnosis in isolated CSP was 10 years old, in coexisting malformation was 5 years. In half of the children, the reason of neuroimaging was epilepsy, in this 6/18 patient with isolated CSP or CV. 58% of the study group had a normal mental development, but 35% of children with additional brain malformation and 11% of children with isolated CSP and CV were mentally retarded., Conclusion: 1. The majority of the children with CSP and CV had also coexisting brain malformations diagnosed in MRI. 2. CSP and CV coexisting with large brain malformation e.g. dysplasia septo-optica and agenesis of corpus callosum. were diagnosed earlier. 4. Mental retardation was diagnosed in 1/3 children with different structural brain malformation but also in 11% of children with CSP and CV as well.

Hypothesis: It is possible that bioelectric activity of the both brain hemispheres is changed in children with a cavum of the spectrum pellucidum (CSP), a marker of brain dysgenesis. It could be connected probably with neuropsychological impairment in children with CSP., Material: Visual analysis of EEG was done in 41 children with CSP aged 2 months to 17 years and in 32 children without CSP aged 3 months to 17 years. It induced 8 EEG curve pairs from each child, that means 328 pairs in CSP and 256 pairs without CSP children., Methods: EEG pattern was analysed by two physicians with an electro-encephalography license and data are a mean value of both analysis. Analysed were 40 minute EEG patterns, registered by 16 channels MedtronicDantec EEG PL-270 Video Option Aparat., Results: Brain bioelectric activity was significantly more often immature and basic activity irregular in children with CSP than in the group without CSP. Asymmetry of frequency and amplitude and slow activity were also significantly more often observed in children with CSP. Abnormal graphoelements were also significantly more often disclosed in children with CSP., Conclusions: Visual analysis disclosed significant differences of EEG pattern in children with and without CSP. For identification of EEG from patient with CSP the quantitative method of analysis is necessary.

Background: Visual EEG analysis in children with a cavum of the septum pellucidum (CSP) disclosed asymmetry and immaturity in the majority of them. In this project authors try to determine significance of difference in quantification of bioelectric activity of both hemispheres in the brain of children with CSP and in control group., Material: 41 children with CSP and 32 without CSP were examined. Analyzed were 328 pairs of EEG (curves from left and right hemispheres) in children with CSP and additional 256 in the control group. 7 seconds fragments of EEG were analyzed, which were selected by two physicians with an electroencephalography license., Methods: Mathematic and statistic evaluation of EEG pattern, with Fourier transform, was done., Results: It is impossible to differentiate of EEG in children with and without CSP by partial (frequency, statistic) methods. Recursive-adaptative discrete Fourier transform with m measure is able to identify EEG pattern in child with CSP.

A total of 225 video-EEG examinations were performed in 179 children with various types of paroxysmal events, including 41 children aged 1-24 months of life and 138 patients aged 3-18 years. The studies were repeated in 25 patients; 80 one-hour recordings, 115 two-hour and 30 three-hour recordings were made. In selected cases EEG stimulating methods were employed, as well as tests provoking psychogenic events. In younger children video-EEG allowed confirming and more precise characterization of seizures in 19 of 41 patients (46.3%), whereas the corresponding number in older children was 17.4% (24 of 138 patients). In two children whose epilepsy was treated surgically, video-EEG was a significant element of preoperative diagnostic management. The use of the method allowed for diagnosing epileptic syndromes, Landau-Kleffner syndrome, reflex epilepsy, photogenic epilepsy and infant myoclonus epilepsy in 11 children. Video-EEG made it possible to rule out epilepsy in 3 of 41 younger children (7.3%) and in 24 of 138 older patients (17.4%). In 10 of 138 patients aged 12-17 years (7.3%), the method facilitated the diagnosis of psychic epilepsy, what allowed for initiation of an appropriate management without the administration of anti-epileptic drugs. In approximately one third of patients, video-EEG evaluation was helpful in selecting appropriate therapy.