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Incomplete posterior ossification of the immature spine permits infants with cutaneous changes suggestive of occult spinal dysraphism to be examined for anomalies of the spinal cord and canal by real time sonography In this study three cases with occult spinal dysraphism diagnosed by spinal sonography and confirmed by spinal magnetic resonance imaging are presented and the emergency of early diagnosis is stressed Key words: Occult Spinal Dysraphism Spinal Sonography, Orta hatta deri bulguları nedeniyle okült spinal disrafi şüphesi olan bebeklerin omurgaların arka kısmının kemikleşmesinin tamamlanmamış olmasından yararlanılarak ultrasonografi ile kord ve kanal anomalileri açısından incelenmeleri mümkündür Bu çalışmada ultrasonografi ile okült spinal disrafi tanısı alan ve manyetik rezonans görüntüleme ile tanısı doğrulanan üç olgu sunulmuş ve erken tanının önemi vurgulanmıştır Anahtar kelimeler: Okült Spinal Disrafi Spinal Ultrason

Alternan hemipleji nadir görülen üst ekstremiterde daha belirgin olan hemipleji distoni atakları ile seyreden bir çocukluk çağı hastalığıdır 15 aylık erkek hasta ilk kez 11 aylık iken sol kolunu kullanmama yakınması nedeni ile başvurmuştu Üç gün içinde şikayetleri gerileyen hastanın ataklarının her iki üst ekstremitede tekrarlaması üzerine alternan hemipleji tanısı konuldu Anahtar Kelimeler: alternan hemipleji non epileptik paroksismal sütçocukluğu, Alternating Hemiplegia is a rare childhood disease characterized by the hemiplegia and dystonic attacks especially on the upper extremities A 15 month old male patient had been admitted for the first time for left arm plegia at the age of eleven months 3 days later his complaints had disappeared But as the same attacks on both upper extremities had recurred the patient was diagnosed as alternating hemiplegia Key words: alternating hemiplegia childhood nonepileptic paroxsymal

Headache is a common symptom in pediatric practice and migraine is said to be the most common cause of primary headache in children Since children have a variety of migraine syndromes strict diagnostic criteria have been developed In this review the prevalance classification and management of childhood migraine are discussed Key words: Migraine Childhood, SummaryHeadache is a common symptom in pediatric practice and migraine is said to be the most common cause of primary headache in children Since children have a variety of migraine syndromes strict diagnostic criteria have been developed In this review the prevalance classification and management of childhood migraine are discussed Key words: Migraine Childhood

The primary tethered cord syndrome is well known in patients suffering from occult spinal dysraphism including diastematomyelia congenital intraspinal mass lesions and abnormal development of the spinal cord conus medullaris and filum terminale; and the secondary tethered cord syndrome is one of the delayed consequences of the postrepaired myelomeningocele The literature support an aggressive and early diagnostic and when indicated surgical approach to the tethered spinal cord Key words: nbsp;Tethered Cord Occult Spinal Dysraphism Meningomyelocele, SummaryThe primary tethered cord syndrome is well known in patients suffering from occult spinal dysraphism including diastematomyelia congenital intraspinal mass lesions and abnormal development of the spinal cord conus medullaris and filum terminale; and the secondary tethered cord syndrome is one of the delayed consequences of the postrepaired myelomeningocele The literature support an aggressive and early diagnostic and when indicated surgical approach to the tethered spinal cord Key words: nbsp;Tethered Cord Occult Spinal Dysraphism Meningomyelocele

Non epileptic events are similar to epileptic seizures in appearance but do not have the same characteristic changes in brain activity Nonepileptic events are common in children and may be difficult to distinguish from epileptic events In most instances the clinical history and an agebased approach leads to the diagnosis and ancillary testing serves as confirmation A failure to identify this disorder may lead to certain risks for the patient including anticonvulsant toxicity and a lack of recognition or neglect of any underlying psychological Key words: childhood epilepsy non epileptic event, Non epileptik olaylar görünüşte epileptik konvülsiyonlara benzer ancak beyin aktivitesinde aynı özellikleri göstermez Non epileptik olaylar çocukta sıktır ve epilepsiden ayrılması güçtür Çoğunlukla öykü ve yaş tanıya gitmeyi kolaylaştırır ve yardımcı testler tanıyı doğrular Tanı konulamazsa hastada başlanmış antikonvülzanlara bağlı toksisite görülebilir tanı konulamamış olur ve altta yatan herhangi bir psikolojik sorun da anlaşılamaz Anahtar Kelimeler: çocukluk çağı epilepsi non epileptik olay

Febrile seizure is a common pediatric problem that affects between 2 and 5 of all children Most of them are brief uncomplicated and unassociated with any long term sequelae But there is a tendency to recurrence of febrile convulsions in about one third of those affected The indications for prolonged drug prophylaxis against recurrence of febrile convulsions are more clearly defined now and the majority do not require it Key nbsp;words: nbsp;Febrile Convulsion Prognosis Prophylactic Treatment, SummaryFebrile seizure is a common pediatric problem that affects between 2 and 5 of all children Most of them are brief uncomplicated and unassociated with any long term sequelae But there is a tendency to recurrence of febrile convulsions in about one third of those affected The indications for prolonged drug prophylaxis against recurrence of febrile convulsions are more clearly defined now and the majority do not require it Key nbsp;words: nbsp;Febrile Convulsion Prognosis Prophylactic Treatment

In childhood; the incidence of intracranial thrombosis is 2 5 2 7 100000 They may present with different symptoms according to the location and size of the occluded vessel and age of the patient In most cases; cranial imaging is necessary to confirm the lesion Pediatric cerebrovascular thrombosis may be related to more than one etiologic factor so detailed evaluation is mandatory A thirteen year old boy presented to our emergency room with a complaint of seizure His cranial imaging showed thrombosis in left transversesigmoid sinuse His father had been diagnosed to have deep venous thrombosis In our case and in his father; protein S levels were found as 11 9 and 10 6 N: 80 120 respectively and they were started on anticoagulation therapy Our patient’s homocsyteine level was 15 5 mmol lt N:0 12 His methylene tetrahydrofolate reductase thermolabile enzyme C677T mutation was found homozygous He was also started on oral folic acid therapy A year after his first presentation his protein S level was 16 and homocysteine level was 7 5 mmol lt His last cranial imaging showed no progresssion in the prior lesion and no new lesion Key words: childhood homocysteine methylene tetrahydrofolate reductase proteins thrombosis, Çocukluk döneminde intrakraniyal tromboz görülme sıklığı 2 5 2 7 100 000’dir Semptomlar etkilenen damarın boyutuna intrakraniyal yerleşimine ve hastanın yaşına göre değişir Birçok faktör etiolojide rol oynayabileceği için hastaların ayrıntılı tetkik edilmesi gerekir Konvülziyon nedeni ile acil servisimize başvuran on üç yaşındaki erkek olgunun kraniyal görüntülemesinde sol tranvers sigmoid sinüste tromboz saptandı Babasında derin ven trombozu öyküsü olan olgumuzun protein S düzeyi 11 9 80 120 babasında ise protein S’i 10 6 saptanarak her ikisine de oral antikoagülasyon tedavisine başlandı Aynı zamanda homosistein düzeyi 15 5 mmol lt 0 12 bulunan hastamızdan metil tetrahidrofolat redüktaz enzim aktivitesi gönderildi Sonuç homozigot mutant olarak değerlendirildi C 6775 ve oral folik asit tedavisine başlandı Bir yıl sonra hastanın protein S düzeyi 16 ve homosistein düzeyi 7 5 mmol lt olarak saptandı Kraniyal manyetik rezonans görüntülemesinde yeni bir tromboz oluşumu yoktu ve konvülziyonu tekrarlamamıştı Anahtar Kelimeler: çocukluk çağı homosistein metil tetrahidrofolat redüktaz protein S tromboz

Sandhoff disease also known as GM2 gangliosidosis variant 0 is caused by the deficient activity of both hexosaminidase A and hexosamirudase B We report a 15 months old boy diagnosed as Sandhoff disease by demonstrating the enzyme deficiency The interesting finding was bilateral thalamic hyperdensity on the CT scan Then hyperdensity in all previously published cases was homogeneous and symmetric and limited to the thalamus the cause remain still unknown We suggest that the finding of dense thalami may be useful as a spesific diagnostic criterion f or the GM2 gangliosidosis and especially for Sandhoff disease Key words: Sandhoff Disease Thalamic Hyperdensity, GM2 gangliosidozların 0 variantı olarak da bilinen Sandhoff hastalığı hexosaminidaz A ve B aktivitelerinde eksiklik sonucu gelişir Fibroblast enzim analizi sonucu Sandhoff tanısı alan 15 aylık olgunun ilginç özelliği BBTde saptanan bilateral talamik hiperdansite idi Yayınlanmış az sayıdaki olgunun ortak özelliği hiperdansitenin homojen ve simetrik olup sadece talamusda sınırlı kalmasıdır oluş mekanizması ise henüz bilinmemektedir Bu bulgunun GM2 gangliosidozlarda ve özellikle Sandhoff hastalığında önemli bir tanı kriteri olabileceği düşünülmektedir Anahtar kelimeler: Sandhoff Hastalığı Talamik Hiperdansite

Neurogenic bladder due to acute disseminated encephalomyelitis is a rare disorder in childhood Differential diagnosis with acute transverse myelitis and Guillain Barre syndrome is important because of different therapeutic approaches of each During the illness clean intermittent catheterisation may prove necessary if urinary retention occurs We present the differential diagnosis of a child with acute disseminated encephalomyelitis Key words: Acute Disseminated Encephalomyelites Acute Transverse Myelopathy Neurogenic Bladder, Akut dissemine ensefalomiyelite bağlı nörojen mesane çocukluk çağında ender görülmektedir Benzer bulguları verebilen akut transvers miyelit Guillain Barre sendromu ile ayırıcı tanısının yapılması tedavi açısından önemlidir Fonksiyon kaybının olduğu dönemde temiz aralıklı kateterizasyon ile böbreklerin korunmasına özen gösterilmelidir Bu çalışmada akut transvers miyelopati bulguları ile başvuran bir çocuğun ayırıcı tanısı tartışılmıştır Anahtar kelimeler: Akut Dissemine Ensefalomiyelit Akut Transvers Miyelopati Nörojen Mesane