The misuse and abuse of fentanyl patches for chronic pain have been frequently reported. Such reports show side effects ranging from asymptomatic to death However, there are no reports on brain and neurological damages resulting from oral ingestion of such patches. Thus, we would like to report on this subject.

Mirror movements (MMs) refer to involuntary movements in one limb that are performed simultaneously with voluntary movements in the other limb Although MMs are observed in normal children aged < 10 years when the corpus callosum is maturing, pathological MMs may be noted in patients who have experienced cerebral infarction, Parkinson's disease, tumors, or vertebral trauma Here, we report a 9-year-old boy with a germinoma in the right basal ganglia presenting with only MMs in the ipsilateral hand without other neurological problems.

Purpose: Although 1p36 deletion syndrome is the most common terminal deletion syndrome, unexplained phenotypic variability still occurs. We aimed to delineate the phenotype of this syndrome in detail and to characterize the phenotype-genotype correlation. Methods: We retrospectively reviewed 15 patients diagnosed with 1p36 deletion syndrome confirmed by chromosomal microarray. Results: All 15 patients revealed delayed attainment of motor milestones and speech. Seven patients (46.7%) never walked alone and only two (13.3%) could express a simple two-word sentence. They all showed subsequent intellectual disability. Two patients with large deletions of both distal and proximal critical regions of the 1p36 region shared severe intellectual disability with Rett syndrome-like behavioral features. Seizures, although frequent (73.3%), were well-controlled except in one patient with infantile spasms. Facial dysmorphism (92.9%) and ventricular mild dilatation with corpus callosum anomaly (46.7%) were common. Heart problems were identified in 14 patients, including structural abnormalities and/or functional problems associated with the gene encoding PR domain-containing protein 16. Two patients developed severe cardiac dysfunction requiring heart transplantation in their late teens. One patient with a 400 Kb deletion partly overlapping with the gene encoding calmodulin-binding transcription activator 1 did not have facial dysmorphism and presented with mild developmental delay and ataxic gait. One patient had a choledochal cyst, which was resected due to neonatal cholestasis. Conclusion: Although the phenotype of 1p36 deletion syndrome is quite consistent with previous reports, additional manifestations such as certain behavioral features, ataxic gait, and severe cardiac dysfunction at an early age should be considered.

Ketogenic diets are high in fat, low in carbohydrates, and contain an adequate amount of protein. In addition to the classic ketogenic diet, three...

Purpose: Mutations in the cyclin-dependent kinase-like 5 (CDKL5) gene are associated with epileptic encephalopathy and severe cognitive impairment. We aim to characterize the association between this gene and treatment efficacy. Methods: We retrospectively analyzed 10 patients who were treated at Severance Children's Hospital for epileptic encephalopathy who were subsequently diagnosed with a CDKL5 mutation using next-generation sequencing. Results: Electroencephalography (EEG) results showed generalized pattern abnormalities in 60% (6/10) of patients with CDKL5 mutations. We analyzed the effects of three treatments, namely antiepileptic drugs (AEDs), ketogenic diet (KD), and steroids. A more than 50% reduction in seizures was observed in 12% (1/8) of patients treated with clobazam. KD treatment proved ineffective in most cases. In addition, a more than 50% reduction in seizures was observed in 57% (4/7) of patients treated with steroids. EEG analysis of patients treated effectively with steroids revealed that 75% (3/4) showed hypsarrhythmia and 25% (1/4) showed focal epileptiform. Conclusion: In this study, as in other studies, AEDs and KD did not effectively control seizures in most patients with a CDKL5 mutation. However, steroid therapy reduced the frequency of seizures in patients who also exhibited hypsarrhythmia. This suggests that steroid treatment is helpful in cases of hypsarrhythmia with CDKL5 mutations.

Rotavirus is an important cause of severe gastroenteritis in infants and children. Generally, rotavirus infections are self-limiting benign diseases but occasionally can cause a wide range of neurological manifestations, including benign febrile or afebrile convulsions, meningoencephalitis, cerebellitis, and lethal encephalitis or encephalopathy However, it is unclear how rotavirus can affect the central nervous system without direct invasion.

is a pivotal year of this journal to mark a new path. After full discussion with the key committees of the Korean Child Neurology Society, we have decided to make a tremendous change in the scope of the journal. It is our intention to transform the Journal of the Korean Child Neurology Society into an international, open access journal called Annals of Child Neurology, which is to publish up-to-date, high-quality, basic and clinical research papers, relevant review articles, alongside letters to editors. The journal covers a variety of different topics ranging from epidemiology, etiologies, pathophysiology, brand-new or changing diagnostic procedures and management of neurologic, neuropsychiatric, neurodevelopmental conditions to all other related conditions. Any closely connected or relevant papers will be appreciated and will make a substantial contribution to the success of this journal.