Randomised controlled trial of the use of an educational board game in neonatology.

BACKGROUND: Games have been used in healthcare education to encourage active learning. AIM: To investigate whether an educational board game which had been developed in the speciality of neonatology could influence the learning experience of medical students during their neonatal attachment. METHOD: A randomised controlled trial of using the game was conducted amongst 67 student participants. RESULTS: The average final assessment score was 4.15 points higher in the group of students that played the game compared to the control group (95% CI-0.88-9.17; p = 0.09). The game was well received by the students. CONCLUSION: Although we cannot conclude firmly that the game produces an effect on learning, this study suggests that educational games should be investigated further in the delivery of undergraduate learning in specialities where exposure is brief.

Sulthiame in refractory paediatric epilepsies: an experience of an 'old' antiepileptic drug in a tertiary paediatric neurology unit.

PURPOSE: Sulthiame is an old antiepileptic drug primarily used in a few European countries for the treatment of benign epilepsy of childhood with central temporal spikes. Other studies suggest that it might be effective in children and adults with a range of refractory seizure types. METHODS: A retrospective case note review was undertaken to evaluate the efficacy and safety of sulthiame as adjunctive therapy in children with refractory epilepsies. RESULTS: Twenty patients (10 female) were evaluated, aged 10.7 (range 2.1-17) years. The median duration of treatment with sulthiame was 18 (range 2-37) months. Fifty five percent of patients showed at least a 50% reduction in seizure frequency and two patients were seizure-free at the end of follow-up. Patients with focal seizures responded best. Seven patients reported side effects, leading to withdrawal of the drug in two (10%). CONCLUSION: Sulthiame was reasonably effective and well-tolerated in a heterogeneous group of 20 children with refractory epilepsies. Although an 'old' antiepileptic drug it should be considered in a similar population.

A novel presentation of inappropriate antidiuretic hormone secretion in Leigh syndrome with the myoclonic epilepsy and ragged red fibers, mitochondrial DNA 8344A>G mutation.

A 17-month-old infant presented with a 2-week history of lethargy, anorexia, and an abnormal respiratory pattern on a previous 4-month history of hypotonia and gross motor delay, suggesting a clinical phenotype of Leigh syndrome. The patient experienced no epileptic seizures. Biochemical investigations were normal other than showing evidence of inappropriate secretion of antidiuretic hormone, and cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the cervical cord and lower brain stem. Initial screening investigations for a mitochondrial cytopathy were negative. Muscle histochemistry demonstrated reduced staining of cytochrome c oxidase but no ragged red fibers. Blood and muscle-derived DNA demonstrated a high level (92% and 82%, respectively) of the m.8344A>G mutation seen in patients with the mitochondrial cytopathy, ''myoclonic epilepsy with ragged red fibers on muscle biopsy.'' This infant's early presentation including inappropriate antidiuretic secretion due to presumed renal salt loss and rapid course appears to be unique to this mutation.