[Guillain-Barre syndrome in children in 2009-2014 years]. / Zespól Guillain-Barre u dzieci w latach 2009-2014.

INTRODUCTION: Guillain-Barre syndrome (GBS) is an acute polyradiculoneuropathy with a variable clinical presentation and is the most common cause of acute palsy in children. The classic presentation is an acute monophasic, nonfebrile, postinfectious illness manifesting as an ascending flaccid palsy with areflexia. Aim. Analysis of children with GBS in 6 years observation. MATERIAL AND METHODS: In the present study we describe a population of 21 children (19 boys and 2 girls) with GBS hospitalized in the years 2009-2014 in our department. In this group 20 children (95%) had flaccid palsy of limbs, 13 children (62%) had previous respiratory or digestive infections. 17 (81%) children were treated by plasmapheresis, 3 (14%) by intravenous immunoglobulin with good outcome. CONCLUSIONS: For 6 years mechanical ventilation was not used in children with GBS.

[Results of autonomic testing in children with migraine with aura, including visual and sensory]. / Wyniki oceny funkcji autonomicznych u dzieci z migrena z aura wzrokowa i czuciowa.

BACKGROUND: Despite the signs of involvement of autonomic nervous system (ANS) in the pathomechanism of migraine, the significance of its dysfunction was not fully explained. One of parameters serving to establish a balance of both ANS parts is relation of low frequency (LF) to high frequency (HF) heart rate variability (HRV), LF/ HF ratio. HF reflects parasympathetic activity, whereas LF both sympathetic and parasympathetic as well as respiratory rhythm. AIMS: The aims of the study was to establish LF and HF ratio in children with migraine with aura, during rest, passive tilting and also during active standing. Prospective research, approved by Bioethical Commission of Jagiellonian University, Nr KBET/188/B/2011. MATERIAL AND METHODS: The examination was performed in 47 children with migraine with aura during headache-free period (within 31 girls and 16 boys, mean age 14 years) and in 32 children without headaches and syncope (19 female and 13 male volunteers), constituting an age-matched control group. HRV was evaluated during rest, during a 10-min 70 degrees head-up passive tilting and during 3-min active standing test, using Task Force Monitor 3030i/3040i. RESULTS: In all 47 children with migraine with aura head-up tilt test was negative for syncope, however in 4 children (8.5%), postural orthostatic tachycardia syndrome was diagnosed (all of them from a group of 24 children with migraine with sensory aura). In 2 children from the control group head-up tilt-induced syncope (6%), reflecting false positive result (in one of children the second neurocardiogenic syncope occurred). Results of LF/HF ratio did not differ between groups with migraine with aura and controls significantly, whereas they were higher in group of 24 children with migraine with sensory aura during passive tilting. Active standing did not reveal differences of LFIHF ratio between any groups. CONCLUSIONS: Predominance of sympathetic nervous system activity during passive head-up tilt test, as well as more common postural orthostatic tachycardia syndrome in patients with migraine with sensory aura as compared with children with migraine with visual aura and healthy volunteers indicate differential autonomic reactivity. False positive result of passive tilting in healthy children may suggest a higher risk of syncope recurrence. In spite of poor orthostatic tolerance reported by patients with migraine, active standing did not reveal differences between migraine patients and healthy volunteers.

[May neuroimaging findings of a child with multiple sclerosis surprise us? Clinical and radiological observation]. / Czy wynik neuroobrazowania u dziecka ze stwardnieniem rozsianym moze nas zaskoczyc? Spostrzezenie kliniczno-radiologiczne.

BACKGROUND: Multiple sclerosis (MS) is a chronic disorder characterized by presence of demyelinating changes in the central nervous system. The disease most often affects young adults with a female predominance, but the first symptoms can also occur in children. MS symptoms in childhood are characterized by a higher incidence of sensory, cerebellar and brainstem disorders compared to adults. They are frequently multifocal especially in the youngest age groups, requiring differentiation of acute disseminated encephalomyelitis. The diagnosis of MS is based on the 2010 McDonald criteria in both children and adults. Dissemination of disease in space and time documented by either clinical and/or radiological findings is necessary for diagnosis establishment. Additional tests used in MS diagnosis are examination of cerebrospinal fluid and examination of exogenous evoked potentials. CASE REPORT: We describe a case of 11-year-old boy who came to the Department of Pediatric Neurology Chair of Pediatric and Adolescent Neurology Jagiellonian University in Krakow because of severe headache and dizziness, which occurred the day before admission. Neurological examination revealed the presence of balance disorders and signs of the pyramidal tract involvement. Head MRI revealed disseminated demyelinating lesions in typical for MS localization with the presence of one active, gadolinium-enhancing lesion. Examination of cerebrospinal fluid showed oligo-clonal bands. Results of exogenous evoked potentials were normal. The patient received high-dose intravenous (pulse) methylprednisolone therapy with good clinical outcome. At that time the patient did not meet requirements for interferon therapy financed from the state budget because of too young age. CONCLUSIONS: Pediatric-onset MS has a slightly different clinical presentation compared to adult-onset MS. The neuroimaging findings may be sometimes surprising showing a large discrepancy between advanced radiological changes and clinical outcome.

Biodegradable Nonwovens with Poultry Feather Addition as a Method for Recycling and Waste Management.

Geotextiles are used for separation, drainage, filtration and anti-erosion protection sealing, as well as to improve plant vegetation conditions. The research objective of this study was to verify the influence of the addition of poultry feathers on accelerating the biodegradation of nonwovens in cultivated soil. The tests were carried out in laboratory conditions and were based on the assessment of weight loss. The experiments confirmed the positive effects of the presence of waste that was rich in keratin on the time required for the biodegradation of the tested materials (the period of biodegradation was 8-24 weeks). Additionally, the influence of the biodegradation of the tested materials on the ecotoxicity was investigated and showed no negative effects on the microbiological activity (106 cfu). The research also included the determination of the carbon to nitrogen ratio of the test medium (blank, 12-14:1; with feather addition, 19-20:1). A statistical analysis revealed a correlation between the mechanical properties and the period of biological decomposition. This research was an important step for the management of poultry feather waste in agricultural applications. The tested materials could be seen an alternative that meets all ecological criteria, which seems to be a golden solution that not only allows the delivery of important nutrients to the soil, but also manages waste in an environmentally safe manner.

Viscoelastic Polyurethane Foam with Keratin and Flame-Retardant Additives.

Viscoelastic polyurethane (VEPUR) foams with increased thermal resistance are presented in this article. VEPUR foams were manufactured with the use of various types of flame retardant additives and keratin fibers. The structure of the modified foams was determined by spectrophotometric-(FTIR), thermal-(DSC), and thermogravimetric (TGA) analyses as well as by scanning electron microscopy (SEM). We also assessed the fire resistance, hardness, and comfort coefficient (SAG factor). It was found that the use of keratin filler and flame retardant additives changed the foams' structure and properties as well as their burning behavior. The highest fire resistance was achieved for foams containing keratin and expanding graphite, for which the reduction in heat release rate (HRR) compared to VEPUR foams reached 75%.

[Arachnoid cysts and epilepsy in children]. / Torbiel pajeczynówki a padaczka u dzieci.

BACKGROUND: At neurodevelopment age arachnoid cysts (ac) are commonly found by accident in neuroimaging examinations performed in the process of differential diagnostics of different diseases, including epilepsy. They are neurodevelopmental disorders which usually develop in the fetal life. Ac are usually supratentorial, less often subtentorial and sporadically interstellar. They are often the only structural lesions of the brain found in the child with epilepsy. There is still lack of univocal statement whether presence of ac determines type of seizures and focal paroxysmal changes in EEG recording. AIM OF THE STUDY: Estimation the association between cyst localization and changes in bioelectric activity in inter seizure EEG recording and type of epileptic seizures observed in children with ac. MATERIAL AND METHODS: Analysis included 14 children out of 35 with found pineal cyst hospitalized in the Department of Pediatric Neurology Chair of Pediatric and Adolescent Neurology in Krakow, in the years 2007-2009. There were 4 girls and 10 boys at the age range from 1 month to 14 years. On the basis of clinical symptoms and EEG results diagnosis of epilepsy was established. RESULTS: Pc were usually localized in the temporal region and posterior cranial fossa and had characteristics of single lesions. In minority of children they were co-occurring with other brain development disorders. In children with pc generalized and polymorphic seizures were dominating and in EEG recording generalized paroxysmal changes. CONCLUSIONS: No association between presence and localization of pc and type of epileptic seizures and characteristics of changes in inter seizure EEG recording was found.

[Sleep paroxysmal events in children in video/polysomnography]. / Napadowe zaburzenia snu u dzieci w wideo/polisomnografii.

BACKGROUND: It is estimated that about 25% of children have sleep disorders, from short problems with falling asleep to severe including primary sleep disorders. Majority of these problems are transitory and self-limiting and usually are not recognized by first care physicians and need education. AIM OF THE STUDY: Analysis of sleep structure at the developmental age and of sleep disorders associated with different sleep phases on the basis of video/polysomnography results. MATERIAL AND METHODS: Literature review and illustration of fundamental problems associated with sleep physiology and pathology, with special attention to paroxysmal disorders. Additionally 4 cases from our own experience were presented with neurophysiological and clinical aspects. RESULTS: Discussion on REM and NREM sleep, its phases and alternating share according to child's age was conducted. Sleep disorders were in accordance with their international classification. Parasomnias, occupying most of the space, were divided in two groups: primary and secondary. Among primary parasomnias disorders associated with falling asleep (sleep myoclonus, hypnagogic hallucinations, sleep paralysis, rhythmic movement disorder, restless legs syndrome) are important. Another disorders are parasomians associated with light NREM sleep (bruxism, periodic limb movement disorder) and with deeper NREM sleep (confusional arousals, somnabulism, night terrors), with REM sleep (nightmares, REM sleep behavior disorder) and associated with NREM and REM sleep (catathrenia, sleep enuresis, sleep talking). Obstructive sleep apnea syndrome and epileptic seizures occurring during sleep also play an important role. Frontal lobe epilepsy and Panayiotopoulos syndrome should be considered in the first place in such cases. Our 4 cases document these diagnostic difficulties, requiring video/polysomnography examination 2 of them illustrate frontal lobe epilepsy and single ones myoclonic epilepsy graphy in children is a difficult technique and requires special device, local and trained personnel. It is crucial in gathering objective data about sleep disorders. SUMMARY: Correct diagnosis of paroxysmal disorders during sleep in children is possible thanks to video/polysomnography, and enables proper management and pharmacotherpy. It enables improvement or cure disorders during the sleep and moreover enables the obtainment of positive changes in child's every day life.

[The pineal cyst in children with different central nervous system diseases]. / Wystepowanie torbieli szyszynki u dzieci diagnozowanych z powodu róznych chorób osrodkowego ukladu nerwowego.

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.

Eslicarbazepine for focal epilepsy and acute intermittent porphyria.

Porphyrias are rare genetic disorders which cause a deficiency in the enzymes involved in the biosynthesis of heme. The treatment of epilepsy in patients with acute intermittent porphyria can be difficult since many anticonvulsants can increase heme synthesis and trigger porphyric attacks. We report a patient with focal epilepsy successfully treated with eslicarbazepine without exacerbation of porphyria.

Composites of Semi-Rigid Polyurethane Foams with Keratin Fibers Derived from Poultry Feathers and Flame Retardant Additives.

Semi-rigid composites of polyurethane foams (SRPUF) modified with the addition of keratin flour from poultry feathers and flame retardant additives were manufactured. Ten percent by mass of keratin fibers was added to the foams as well as halogen-free flame retardant additives such as Fyrol PNX, expandable graphite, metal oxides, in amounts such that their total mass did not exceed 15%. Thermal and mechanical properties were tested. Water absorption, dimensional stability, apparent density and flammability of produced foams were determined. It was found that the use of keratin fibers and flame retardant additives changes the foam synthesis process, changes their structure and properties as well as their combustion process. The addition of the filler made of keratin fibers significantly limits the amount of smoke generated during foam burning. The most favorable reduction of heat and smoke release rate was observed for foams with the addition of 10% keratin fibers and 10% expandable graphite. Systems of reducing combustibility of polyurethane foams using keratin fillers are a new solution on a global scale.

[Children's sleep disturbances in videoelectroencephalography and polysomnography--preliminary data]. / Wstepne wyniki badan wideoelektroencefalograficznych i polisomnograficznych zaburzen snu u dzieci.

INTRODUCTION: Correlation between sleep and epilepsy is one of the most basic issues of pediatric neurology. VideoEEG nad polysomnography play an important role in diagnostic process of seizures occuring during sleep, epileptic seizures as well as parasomnic episodes. AIM: In this paper videoEEG and polysomnography assessment in diagnosis paroxysmal sleep events in children was done. MATERIAL AND METHODS: 25 sleep registrations were performed, videoEEG was performed in 23 children with the age limit of 5 years, and two 8-years-old children underwent total polysomnographic examinations. RESULTS: Examination during sleep time enabled to establish diagnosis of epilepsy in 18/25 children, in 2 children suspicion of epilepsy was made and in 5 epilepsy was excluded. Positive video results were found in 18/25 children and in 7 no clinical symptoms were recorded. Paroxysmal EEG activity was registered in 16 children, in 5 it was abnormal and in 4 it was within normal limits. Frontal epileptic seizures were observed in two children with simultaneous pathological changes in EEG, and in 1 of them in polysomnographic recording. CONCLUSIONS: VideoEEG and polysomnographic examinations in children during sleep are helpful in defining seizure types and parasomnias.

[Rehabilitation outcome in children with cranial trauma and hypoxaemia of the brain]. / Wyniki usprawniania dzieci po ciezkich urazach czaszkowo-mózgowych i niedotlenieniu mózgu.

BACKGROUND: Traumatic brain injury is one of the most common causes of children's disability and death. AIM OF THE STUDY: The goal of this study was to present the effects of improvement treatment in patients who suffered various types of brain trauma, to discuss their motor functions as well as the emotional state and behavioural disturbances. One of the aims was also to present complications which took place reagardless of complex rehabilitation. MATERIAL AND METHODS: In this study we describe the state of 5 patients. The patients were assessed with the Ashworth and RLAS scales before and after the complex rehabilitation. The programme of rehabilitation was designed individually for each patient depending on his RLAS score. The complications developed after 6 months of treatment are described. RESULTS: In one case only- in a girl with hemiparesis- the state of nearly independent motor functioning was achieved. The other patients are bedridden or dependent on a second person when moving in a wheelchair. The girl with hempiparesis and another girl with spastic quadriparesis remain in the best verbal contact. Both of them however present with profound cognitive, emotional and behavioural deficits. The other patients are unable to reach any verbal communication. Because of swallowing problems some of the patients had feeding tube or tracheostomy performed. Each patient had an individually designed rehabilitation programme. CONCLUSIONS: The outcome of rehabilitation treatment in patients with profound traumatic brain injury is very individual. The best outcome was achieved in a girl with hemiparesis who suffered brain injury in a car accident, and worse in children after brain hypoxaemia.

Evolution of high-sensitivity troponin-T and echocardiography parameters in patients undergoing high efficiency on-line hemodiafiltration versus conventional low-flux hemodialysis.

BACKGROUND AND OBJECTIVES: On-line hemodiafiltration (HDF) has been associated with better inflammatory markers profile and survival than low-flux hemodialysis (HD). This study aimed at determining the effect of HDF vs HD on hs-TnT and echocardiography parameters evolution at one year follow-up. METHOD: Patients were randomized from 2007 to 2013 to HD or HDF in accordance with the CONvective TRAnsport STudy protocol initially as part of the Montreal cohort and subsequently as part of a local cohort. Pre-dialysis hs-TnT were analyzed at baseline and 1-year follow-up. RESULTS: A total of 54 HDF patients and 59 HD patients were included. At baseline, median hs-TnT value was 49 ng/L (IQR 31-89) in the HDF group vs. 60 ng/L (36-96) in the HD group (p = 0.370). At one year follow-up, median hs-TnT remained stable in the HDF group (p = 0.707 vs. baseline), but significantly increased to 62 ng/L (40-104) in the HD group (p = 0.021 vs. baseline). The median variation (delta) in hs-TnT values was -3 ng/L (IQR -7-+8) in the HDF group vs. +8 ng/L (-5 -+25) in the HD group (p = 0.042). In the HDF group, LVEF increased from 60.0% (IQR 55.0-65.0) at baseline to 65.0% (60.0-65.5) at 1-year follow-up (p = 0.040) whereas it remained stable in the HD group (LVEF of 60.0% [IQR 55.0-65.0] at baseline and 65.0% [55.0-65.0] at 1-year follow-up [p = 0.312]). CONCLUSIONS: High-efficiency HDF is associated with stability in hs-TnT values, whereas low-flux HD is associated with significant increase in hs-TnT levels.

Improved Thermal Insulating Properties of Renewable Polyol Based Polyurethane Foams Reinforced with Chicken Feathers.

In the present work, sustainable rigid polyurethane foams (RPUF) reinforced with chicken feathers (CF) were prepared and characterized. The bio-based polyol used to formulate the foams was obtained from castor oil. This investigation reports the influence of the chicken feathers fibers as reinforcement of RPUF, on water absorption, thermal, mechanical and morphological properties (field-emission scanning electron microscope-FESEM) and thermal conductivity on water-blown biofoams. It was found that the biofoams improved thermal insulating properties when CF was added. The addition of CF to foams provided lower heat flux density to the biofoams obtaining bio-based materials with better insulation properties. The results obtained in this study proved that the incorporation of CF to RPUF modified the cell structure of the foams affecting their physical and mechanical properties, as well as functional properties such as the heat transmission factor. These biofoams containing up to 45% of bio-based materials have shown the potential to replace fully petroleum-based foams in thermal insulation applications.

[Neuroboreliosis with motoric disturbations in the developmental age]. / Neuroborelioza z zaburzeniami ruchowymi w wieku rozwojowym.

BACKGROUND: Neurological symptoms develop in 10-20% of children suffered borreliosis (LD). AIM OF THE STUDY: It was a presentation of motoric disturbances of neuroboreliosis in children. MATERIAL AND METHODS: Children with neuroborreliosis and other neurological diseases were admitted to the University hospital during 2005-2007. Of these 13 patients, there were 9 males and 4 females, ranging in age between 3-17 years. Neurological diagnostic was performed using ELISA Biomedica kit and western blot bands. A 2-6 week sequential treatment with either iv ceftazidime or amoxicillin and oral doxycycline or amoxicillin was provided. Children were monitored regularly during the next 4-36 months. RESULTS: The 13 children with neuroborreliosis constitute 0.5% of the pediatric neurology department's patients. The clinical manifestation of LD were usual and unusual from patient to patient. They included four cases of facial nerve paralysis (with bilateral paralysis in one case), in three cases transverse myelitis and in a single case, hemiparesis, and oculomotor nerve paresis. In 9/13 children motoric disturbances of neuroboreliosis was diagnosed indeed. The antibiotic treatment was successful in 6 patients and only partially effective in 3 children with facial nerve paralysis. CONCLUSION: The most common symptoms of neuroborreliosis in children was motoric dysfunction.

[Clinical manifestation of neoplasm cerebri in children hospitalized in pediatric neurology department]. / Manifestacja kliniczna nowotworów mózgowia wsród dzieci hospitalizowanych w klinice neurologii dzieciecej.

BACKGROUND: Brain tumors are the second most common malignancy of childhood, following leukemia. Cause factor of some brain tumors is suggested by genetic predisposition. AIM OF THE STUDY: It was a correlation between early symptoms of the brain tumor and its histology, localization and MR imaging. MATERIAL AND METHODS: 13 children, aged 3 to 16 years, took part in this study. MR imaging was performed in all of them. 6 children were operated with histological examination of tumor tissue. RESULTS: The most common first clinical symptom of tumors were epileptic seizure in 6 children and headache in 7. The most frequent tumor was supratentorial glioma. CONCLUSIONS: In pediatric neurology department were hospitalized older children with brain tumors. In most of them headache and epileptic seizures occured.

[Results of control MRI examinations performed due to radiological indication--preliminary report]. / Wyniki powtórnych badan MR mózgu u dzieci wykonywanych ze wskazan radiologicznych--doniesienie wstepne.

INTRODUCTION: MR is very important examination of central nervous system in children in the evaluation of differences dependent of sex and age as well as in the diagnostics. Radiological indications are important in many cases to perform a control study, to evaluate a dynamic changes or to establish the diagnosis. THE AIM: The aim of this study was to examine the results of control MRI examination in children with neurologic syndromes. MATERIAL AND METHODS: In the year 2006 control MRI was performed in 22 cases since it was advised after previous MRI examinations in children hospitalized in the Department of Pediatric Neurology UJ CM in Kraków. The group of children aged 4-18 years (mean 12 years) consisted of 14 boys and 8 girls. The commonest clinical diagnoses were epilepsy, encephalopathies, hemiparesis, cranial neuropathies, headache, anizocoria, vertigo, paraparesis and NF I. RESULTS: Repeated MRI in 14 children did not revealed significant changes, independently from clinical changes. In 3 patients positive changes or regres of pathological foci were observed within the subarachnoid hemorrhage. In 3 children MRI revealed progressive changes, within in the child with NFI, and in patient with pyramidolextrapyramidal syndrome which progressed from hemiparesis to quadriplegia and also in a child with disseminated symptoms, such as ataxia, piramidal syndrome and cranial nerve palsies. In 2 other children the repeated MRI helped to establish the final diagnosis. The evolution of neuroradiological changes in the first child with the history of hemiparesis indicated ischemia as a cause of neurological syndrome. The other patient with cranial neuropathies of VII, VIII and XII nerves associated with intellectual impairment was diagnosed with CADASIL only with the help of control MRI examination. CONCLUSIONS: In 9% children the second MRI which helped to analyze evolution of changes was important to establish the final diagnosis. The control MRI examination in 64% children did not revealed significant changes independently of clinical changes, such as recovery or aggravation of symptoms, what explains the decision to repeat MR examination in unclear cases.

Radiological assessment of the breast following enhancement with Macrolane: Managing the challenges.

Macrolane VRF®, a biodegradable, stabilized hyaluronic acid gel, was used for breast enhancement 2008-2012. Similar to permanent implants, the presence of Macrolane gel may interfere with interpretation of mammography. This short communication aims to provide a guide to the appearance of Macrolane on radiology examination (including mammography, ultrasound and magnetic resonance imaging) and aid selection of the most appropriate imaging modality to facilitate breast examination in women who have undergone Macrolane breast enhancement.

[Cranial neuropathies in children]. / Neuropatie czaszkowe u dzieci.

BACKGROUND: Cranial nerves damages are very important in clinical neuropediatry. Differential diagnosis is very complicated and difficult because of variety of cranial nerves and causes of neuropathies. Functional senses disturbances, and also motor, sensory and vegetative disorders are caused by neuropathies. Paretic symptoms are commonly diagnosed, but also sometimes isolated cranial nerves pareses are seen. THE AIM OF THE STUDY: was to recall the value of differential diagnosis in cranial neuropathies for early assessment of very complicated diseases of the head and neck and for early proper therapy. METHODS: The causes of neuropathies are performed into 10 tables, others causes are described in the paper. Congenital and genetic factors of cranial neuropathies and their clinical effects are discussed. The authors described also acquired local and systemic neuropathies in the aspect of diagnostic and therapeutic possibilities. The specific signs of cranial nerves damages are also performed. CONCLUSION: Deepening of knowledge in the aspect of etiopathogenesis and clinical signs of cranial neuropathies combined with new therapeutic methods should improve the proper follow up of these disorders.

[Paranasal sinus involvement in children with central nervous system disease]. / Zajecie zatok przynosowych u dzieci z chorobami osrodkowego ukladu nerwowego.

BACKGROUND: Paranasal sinus involvement in the developmental age can be clinically uncharacteristic, and therefore it is commonly diagnosed accidentally with other diseases. Not all cases of such sinusitis need otolaryngologic treatment. THE AIM OF THE STUDY: Was to assess the real prevalence of sinus involvement imaging in head MR scans diagnosed in children with neurological diseases and to describe the need of laryngological therapy in these cases. MATERIAL AND METHODS: During the period of 16 months (01.2005-04.2006) 393 MR imaging was done in children hospitalized in the Department of Child Neurology, Jagiellonian University. The study was performed in 77 children with MRI changes, aged between 1,5 to 18 years old. The MR imaging (SE T1, FSET2, PD, FLAIR, IR T1, 3 and 5 mm thickness of layers in frontal, horizontal, sagittal surfaces) were performed on 1.5 T Signa Horizon HiSpeed General Electric machine. EEG, videoEEG, ophtalmologic, laryngologic, dentist's, neuropsychologic, analytic, immunologic and biochemical assessment were done. The MRI results were analyzed by otolaryngologist, and they were compared with basic neurologic diagnosis and treatment. RESULTS: Sinus involvement was diagnosed in 20% of children with neurologic diseases. In 77 children were found 125 pathologic changes, predominated (91%) by mucosal edema. In over half of the study group there were no correlation of the sinus changes and neurologic diagnosis. In 62% of children in this group none type of treatment was used, in 20% of patients the antiinflammatory therapy and in 18% the sinusotomy was proposed. CONCLUSIONS: In most of the children with neurologic diseases and with paranasal sinus involvement diagnosed in MRI, the laryngologic treatment was not necessary, however 38% cases needed it.