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Pediatrics 2022 May 19. Epub 2022 May 19.

Divisions of Neurology.

Background And Objectives: To describe the etiology and clinical course of pediatric acute-onset unilateral peripheral facial palsy (FP), to define factors that distinguish Bell's palsy from Lyme-related FP (LRFP), and to determine if early corticosteroid use impacts facial strength recovery in Bell's palsy or LRFP.

Methods: Retrospective cohort study of children 1 to 18 years old who received clinical care within our pediatric clinical care network (Lyme-endemic region) between 2013 and 2018 for acute-onset unilateral peripheral FP.

Results: The study included 306 children; 82 (27%) had LRFP, 209 (68%) had Bell's palsy, and 15 (5%) had FP of different etiology. Read More

J Pediatr Endocrinol Metab 2022 May 19. Epub 2022 May 19.

Department of Neuroscience, Rehabilitation, Ophtalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.

Objectives: Endocrinopathy can occur as a postoperative sequel in children treated for supratentorial tumors (STTs). We assessed prediction of a residual hypothalamic/pituitary insufficiency (HPI) in these patients and factors associated with prolonged length of hospital stay (LOS).

Methods: This is a retrospective cohort study of children who had surgery for STTs in two tertiary centers in Saudi Arabia (2009-2019). Read More

Brain Dev 2022 May 11. Epub 2022 May 11.

Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 93, Joongbudae-ro, Paldal-gu, Suwon-si, Gyeonggi-do 16247, Republic of Korea. Electronic address:

Background: Headache is a common complaint in childhood and adolescence. Differentiating benign primary headaches from ominous secondary headaches is often difficult. Clinicians usually seek red flags to determine the need for neuroimaging. Read More

Brain Dev 2022 May 10. Epub 2022 May 10.

Department of Pediatrics, Faculty of Medicine, Saga University, Saga, Japan. Electronic address:

Background: Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with aphasia is a rare disorder, with the associated aphasia reported as either Wernicke's or Broca's. Herein, we report a patient with MELAS complicated by thalamic aphasia.

Case: A 15-year-old right-handed girl presented with headache, nausea, right homonymous hemianopsia, and aphasia. Read More

Cephalalgia 2022 May 11:3331024221099216. Epub 2022 May 11.

Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.

Background: There is limited prospective data on the prevalence, timing of onset, and characteristics of acute headache following concussion/mild traumatic brain injury.

Methods: Adults diagnosed with concussion (arising from injuries not related to work or motor vehicle accidents) were recruited from emergency departments and seen within one week post injury wherein they completed questionnaires assessing demographic variables, pre-injury headache history, post-injury headache history, and the Sport Concussion Assessment Tool (SCAT-3) symptom checklist, the Sleep and Concussion Questionnaire (SCQ) and mood/anxiety on the Brief Symptom Inventory (BSI).

Results: A total of 302 participants (59% female) were enrolled (mean age 33. Read More

N Engl J Med 2022 May 11. Epub 2022 May 11.

From the Vanderbilt Vaccine Research Program, Department of Pediatrics, Vanderbilt University Medical Center (C.B.C.), and Meharry Medical College (V.B.) - both in Nashville; the Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and the Department of Pediatrics, Emory University School of Medicine - both in Atlanta (E.A.); the Department of Pediatrics, Yale School of Medicine, the Department of Epidemiology of Microbial Diseases, Yale School of Public Health, and the Yale Institute for Global Health - all in New Haven, CT (I.Y.); the Medical University of South Carolina (A.M.A.) and Coastal Pediatric Associates (R.A.C.) - both in Charleston; Boca Raton Clinical Research Global, Edinburg (I.M.B.), Tekton Research, Austin (P.P.), Highland Woods Health, The Woodlands (C.Y.), Texas Health Care, Privia Medical Group-North Texas, Fort Worth, and Forest Lane Pediatrics, Dallas (R.B.) - all in Texas; Capitol Medical Group, Chevy Chase (D.F.), and the Department of Pediatrics, Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore (J.D.C.) - both in Maryland; Privia Medical Group, Arlington, VA (D.F., C.Y.); Velocity Clinical Research, Banning, CA (J.K.); Javara, Winston-Salem (C.Y., R.B.), and the Department of Surgery, Duke University Medical Center, Durham (D.C.M.) - both in North Carolina; Quality Clinical Research, Omaha, NE (M.D.); and Moderna, Cambridge, MA (J.E.T., X.Z., W.D., H.Z., D.R.S., K.H., B.G., K.S., R.M., R.P., R.D., J.M.M., S.S.G.).

Background: Vaccination of children to prevent coronavirus disease 2019 (Covid-19) is an urgent public health need. The safety, immunogenicity, and efficacy of the mRNA-1273 vaccine in children 6 to 11 years of age are unknown.

Methods: Part 1 of this ongoing phase 2-3 trial was open label for dose selection; part 2 was an observer-blinded, placebo-controlled expansion evaluation of the selected dose. Read More

J Med Case Rep 2022 May 11;16(1):187. Epub 2022 May 11.

Department of Pediatrics, Saint Peter's University Hospital (SPUH), New Brunswick, USA.

Background: Mutations or polymorphisms of genes that are associated with inflammasome functions are known to predispose individuals to Crohn's disease and likely affect clinical presentations and responses to therapeutic agents in patients with Crohn's disease. The presence of additional gene mutations/polymorphisms that can modify immune responses may further affect clinical features, making diagnosis and management of Crohn's disease even more challenging. Whole-exome sequencing is expected to be instrumental in understanding atypical presentations of Crohn's disease and the selection of therapeutic measures, especially when multiple gene mutations/polymorphisms affect patients with Crohn's disease. Read More

Infect Drug Resist 2022 3;15:2409-2416. Epub 2022 May 3.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Background: Ethiopia was using the ChAdOx1 COV-19 vaccine, and health professionals were targets of the first phase of the vaccination strategy. Evidence on the adverse events following immunization (AEFI) was barely available. The study aimed to assess the magnitude and associated factors of adverse events following ChAdOx1 COV-19 immunization among health professionals of the University of Gondar Specialized and Comprehensive Hospital, 2021. Read More

Neurol India 2022 Mar-Apr;70(2):796-798

Department of Pediatrics, West China Second Hospital, Sichuan University; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, People's Republic of China.

Headache 2022 May 6;62(5):588-595. Epub 2022 May 6.

Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.

Objective: The objective of this study was to describe treatment preferences and perceived quality of existing outcome measures among children and adolescents with migraine and their caregivers.

Background: Across disciplines, there is increasing recognition of the value of direct input from stakeholders. Little empirical work has been done to determine what outcomes matter most to pediatric patients with migraine and their caregivers. Read More

Dev Med Child Neurol 2022 May 5. Epub 2022 May 5.

Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Aim: To characterize child neurology telemedicine visits flagged as requiring in-person evaluation during the COVID-19 pandemic.

Method: We analyzed 7130 audio-video telemedicine visits between March and November 2020. Visits of concern (VOCs) were defined as telemedicine visits where the clinical scenario necessitated in-person follow-up evaluation sooner than if the visit had been conducted in-person. Read More

Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022 Apr;36(4):247-252

Department of Otolaryngology Head and Neck Surgery，Children's Hospital Capital Institute of Pediatrics，Beijing，100020，China.

To assess the presentation of allergic fungal rhinosinusitis（AFRS） in children and the role of long-term comprehensive therapy of endoscopic surgery combined with drug therapy. The 3 children with AFRS were routinely examined by nasal endoscopy, CT scan, MRI scan and allergen detection before surgery, and mycological and histomathological examination were performed on the secretions in the sinus and the mucosa of the affected sinuses. All the 3 patients underwent endoscopic surgery, preoperative and postoperative treatment with oral and nasal corticosteroid, nasal irrigation, and individualized anti-allergy therapy and immunotherapy. Read More

Indian J Pediatr 2022 May 5. Epub 2022 May 5.

Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Center, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India.

Objective: Multisystem inflammatory syndrome (MIS-C) in children is a febrile illness that has overlapping presentation with other locally prevalent illnesses. Clinicolaboratory profile of children admitted with MIS-C and dengue were compared to understand their presentation at the outset.

Methods: This was a retrospective study of children ≤ 12 y admitted with MIS-C (WHO definition) or laboratory-confirmed dengue between August 2020 and January 2021 at a tertiary center in North India. Read More

Andes Pediatr 2022 Feb 29;93(1):53-58. Epub 2022 Mar 29.

Miller School of Medicine, University of Miami, Miami, Florida, USA.

Introduction: Children with joint hypermobility, postural orthostatic tachycardia syndrome, and orthostatic hypotension report autonomic symptoms such as dizziness, nausea, headaches, and palpitations. It is unclear if there is a pathophysiological link between connective tissue disorders and autonomic symptoms. There is no published data on the prevalence of disorder at the community level. Read More

Front Pediatr 2022 12;10:850819. Epub 2022 Apr 12.

Department of Pediatric Gastroenterology, Nephrology and Metabolic Diseases, Charité Universitätsmedizin Berlin, Berlin, Germany.

Background: Therapeutic apheresis (TA) is based on the principles of either removing dissolved pathogenic substances (e.g., antibodies) from the blood plasma or replacing plasma factors. Read More

Iran J Child Neurol 2022 14;16(2):149-154. Epub 2022 Mar 14.

Department of Pediatrics , School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Posterior reversible encephalopathy syndrome (PRES) has a broad spectrum of clinical presentations and radiological features. Diagnosis of PRES is established based on reversible clinical manifestations and sequential neuroimaging findings. Atypical MRI features include hemorrhage, restricted diffusion or contrast enhancement of lesions, and involvement of the temporal and frontal lobes, brainstem, basal ganglia, corpus callosum, cerebellum, and spine. Read More

Iran J Child Neurol 2022 14;16(2):77-84. Epub 2022 Mar 14.

General Physician, Tehran University of Medical Sciences, Tehran, Iran.

Objective: One-third of epilepsy of children is refractory, and this study was conducted to evaluate the efficacy and adverse events of levetiracetam as add-on therapy in the treatment of refractory epilepsy of children.

Materials & Methods: In this quasi-experimental study, seizures frequency and side effects of 314 children aged 1-14 years with refractory epilepsy were referred to the Pediatric Neurology Clinic of Shahid Sadoughi Medical Sciences University, Yazd, Iran, and treated with levetiracetam for six months, were evaluated.

Results: We evaluated 142 girls and 172 boys with a mean age of 6. Read More

Indian J Hematol Blood Transfus 2022 Apr 25;38(2):366-372. Epub 2021 Aug 25.

Division of Pediatric Hematology, Department of Pediatrics, Kocaeli University, Umuttepe, 41380 Kocaeli, Turkey.

Although congenital erythrocytosis (CE), an inherited disorder, impairs pediatric quality of life, physicians often overlook high hemoglobin (Hgb) levels and its symptoms due to lack of knowledge of age-adjusted pediatric Hgb levels and CE's rarity. In a retrospective, single-center study, data from hospital records of pediatric patients diagnosed with CE were evaluated. Twenty-six patients from 25 families (80. Read More

Pediatr Emerg Care 2022 May 12;38(5):e1266-e1270. Epub 2022 Jan 12.

Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

Objective: Iron deficiency is extremely common in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department; however, patients are rarely screened for this. The objective of this study was to evaluate screening for iron deficiency in adolescents presenting to the emergency department for HMB.

Methods: This is a secondary analysis of a single-center, cross-sectional observational study using retrospective chart review. Read More

J Med Virol 2022 Apr 27. Epub 2022 Apr 27.

Department of Microbiology, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.

Background: Understanding differences in terms of clinical phenotypes and outcomes of COVID-19 compared with influenza is vital to optimize the management of patients and to plan healthcare.Herein,we aimed to investigate the clinical differences and outcomes in hospitalized patients with SARS-CoV-2 and influenza.

Methods: We performed a retrospective study of hospitalized children who were positive for SARS-CoV-2 between March 2020 and March 2021 and for influenza between January 2016 and February 2020 in respiratory samples. Read More

Childs Nerv Syst 2022 Apr 25. Epub 2022 Apr 25.

Department of Pathology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Gwangju, Republic of Korea.

Introduction: Neurofibromatosis type 2 (NF-2) is an inherited disease, linked with abnormalities in the NF-2 gene, which is located on chromosome 22 and involved in merlin production. Many craniospinal tumors are common in individuals with NF-2. We present a case of NF-2 with the rapid symptomatic progression of multiple craniospinal tumors. Read More

Headache 2022 Apr 25. Epub 2022 Apr 25.

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Objective: This case-control study examines if measures of subjective and objective (actigraphic) sleep difficulties mediate alterations in amygdalar connectivity in adolescents with migraine compared to healthy adolescents.

Background: Adolescents with migraine have different functional connectivity of the amygdala compared to individuals without migraine. Sleep is often disturbed in adolescents with migraine, and could contribute to the alterations in functional connectivity. Read More

Front Pediatr 2022 8;10:785735. Epub 2022 Apr 8.

Third Xiangya Hospital, Central South University, Changsha, China.

In China, a 9-year-old boy was transferred to the hospital with fever, vomiting, and headache. The disease rapidly deteriorated into vague consciousness. Applying conventional clinical examinations such as blood and cerebrospinal fluid (CSF) tests, the diagnosis of bacterial meningoencephalitis was first drawn, and expectant treatments were adopted immediately. Read More

Biomolecules 2022 04 8;12(4). Epub 2022 Apr 8.

Department of Clinical and Experimental Medicine, Section of Pediatrics, University of Pisa, 56126 Pisa, Italy.

Long Coronavirus disease-19 (COVID-19) refers to the persistence of symptoms related to the infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). This condition is described as persistent and can manifest in various combinations of signs and symptoms, such as fatigue, headache, dyspnea, depression, cognitive impairment, and altered perception of smells and tastes. Long COVID-19 may be due to long-term damage to different organs-such as lung, brain, kidney, and heart-caused by persisting viral-induced inflammation, immune dysregulation, autoimmunity, diffuse endothelial damage, and micro thrombosis. Read More

Pediatr Infect Dis J 2022 Apr 6. Epub 2022 Apr 6.

From the Department of Pediatrics, Spirito Hospital, Azienda Sanitaria Locale, Pescara, and.

A 3.8-year-old Italian girl presenting with high fever and headache developed a decrease in the state of consciousness, apneas, bradycardia thus requiring intensive care and mechanical ventilation. Sandfly fever due to Cyprus virus, previously not reported in a child, outside an endemic area, must be included in the differential diagnosis of acute encephalopathy with apparently no explanation from the usual laboratory work-up. Read More

Am J Emerg Med 2022 Jun 1;56:396.e5-396.e8. Epub 2022 Apr 1.

Michigan State University College of Human Medicine, Grand Rapids, MI, USA; Spectrum Health Medical Group, Grand Rapids, MI, USA. Electronic address:

Spinal arteriovenous malformations (sAVM) are abnormally developed spinal blood vessels with an increased risk of hemorrhage. Current literature regarding sAVMs is sparse and describes classic presentations in very young children or adults. We report a unique case of a sAVM in an adolescent patient. Read More

Int J Rheum Dis 2022 Apr 18. Epub 2022 Apr 18.

Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Background: Biological disease-modifying antirheumatic drugs (bDMARDs) are treatment options for refractory juvenile idiopathic arthritis (JIA) cases which cannot be afforded by the majority. Tofacitinib is a novel Janus kinase inhibitor, which is reported to be a cost-effective oral alternative to biologics. This prospective observational study was carried out to observe the efficacy and safety of tofacitinib in refractory polyarticular course JIA patients. Read More

Front Neurol 2022 31;13:861345. Epub 2022 Mar 31.

Maternal-Infantile and Urological Science Department, Sapienza University of Rome, Rome, Italy.

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric patients is usually characterized by fever, dry cough, and fatigue, or is asymptomatic and rarely presents with pneumonia. On the other hand, cerebral venous sinus thrombosis (CVST) could be a neurological sequela of the prothrombotic state triggered by coronavirus disease 2019 (COVID-19) both in adults and children.

Case Report: We present a case of a 15-year-old male child who was obese and had mild neurocognitive impairment. Read More

Pediatr Rheumatol Online J 2022 Apr 15;20(1):29. Epub 2022 Apr 15.

Pediatric Rheumatology, Pediatrics, University of Chicago Medicine, Chicago, USA.

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that typically affects multiple organs and can lead to potentially fatal complications. Central nervous system (CNS) involvement in SLE is common, especially in children, and can present nonspecifically with various neuropsychiatric manifestations, described as neuropsychiatric SLE (NPSLE). Chronic headache is a common feature of NPSLE, secondary to increased intracranial pressure (also called pseudotumor cerebri (PTC)) due to inflammation or medication. Read More

Neurology 2022 Apr 13. Epub 2022 Apr 13.

Child & Adolescent Headache Program, University of California, San Francisco, UCSF Benioff Children's Hospital.

Background: Children and adolescents with chronic migraine who have continuous headache may have high levels of headache-related disability but have largely been excluded from clinical trials. Understanding patient-valued treatment outcomes may facilitate future study design.

Objective: To identify patient-valued outcome measures for headache preventive treatments among adolescents with continuous headache due to chronic migraine and their parents. Read More