Shaken baby syndrome masquerading as apparent life threatening event.

A variety of diseases and disorders can present as an acute life-threatening event among which shaken baby syndrome has been recently recognized. A high index of suspicion along with an ophthalmologic evaluation and cranial imaging helps to identify this form of child abuse, which needs multidisciplinary management.

Cerebral gigantism with West syndrome.

A case of cerebral gigantism (Sotos syndrome) with West syndrome in a one-year-old male child is reported. The case had a large stature, typical facies and neurodevelopmental delay along with infantile spasms, which were refractory to treatment with valproate and clonazepam.

Newer antiepileptic drugs and non surgical approaches in epilepsy.

Newer antiepileptic drugs (AEDs) have helped the management of about one third of children with epilepsy who are refractory to primary AED(s). Vigabatrin and lamotrigine are being used as first line drugs for infantile spasms and Lennox Gestaut syndrome (LGS) respectively. Most of the others are, as of now, used as add-on drugs with specific indications. The ketogenic diet has been used successfully in some children with LGS. Steroids have a clear role in infantile spasms. Efficacy of immunoglobulins is mainly anecdotal. Physicians should familiarise themselves with the efficacy, pharmacokinetics and side effects of these drugs and ensure their rational use.

Public awareness, understanding & attitudes toward epilepsy.

The public awareness, understanding and attitudes towards epilepsy were evaluated in a north Indian population in 1992 by personal interview method. The study revealed that 92 per cent of the respondents had read or heard about epilepsy. More than 55 per cent knew someone and had seen a case of seizure. Eighty five per cent of the respondents were not aware of the cause of epilepsy or had wrong beliefs. Eighteen and 15 per cent thought epilepsy to be a hereditary disorder and a form of insanity respectively. About 40 per cent of the respondents felt that children with epilepsy should not be sent to school and also objected to their children's contact with epileptics at school or at play. Two-thirds of the respondents objected to their children marrying a person who had ever had epilepsy. Twenty per cent were ignorant about the manifestation of epilepsy and an equal number were unable to recommend any therapy in case their relatives or friends had epilepsy. Fifty seven per cent did not know what kind of first aid should be given during the epileptic attack. Although the awareness of epilepsy among Indian people was comparable to that of individuals in Western countries, the attitudes of the Indians were much more negative. Better educated people belonging to higher occupational groups were less prejudiced against social contact and schooling of their children with epileptic children compared to low educational and occupational groups.

Maternal attitudes towards spastic cerebral palsy.

Attitudes of 120 mothers of spastic children aged 2-12 yrs were assessed by using Mother's Attitude Scale. Attitudes of mothers towards spastics were highly influenced by the severity of handicap and IQ of the child (r < 0.74). Mother's education, family income, occupational status, type of habitat had significant but low correlation with her attitudes (0.23 to 0.35). Age, sex of the child and type of family did not influence attitudes. Study group mothers (rural or urban) have better attitudes towards spasticity compared to control group mothers. This difference was more discernible among mothers belonging to age group below 30 years of age. The study emphasizes the necessity of constant counselling of mothers so that their attitudes may improve and help in more effective care of the child.