PDF File - Mahidol University

382
Abstracts
ities have become available for treating the mobility
problems associated with cerebral palsy. Although the benefits
conferred by certain treatments are clear, other management
options are more controversial. In addition to
conventional orthopaedic surgery and physiotherapy,
multi-level surgery, intramuscular botulinum injections,
selective dorsal rhizotomy, intrathecal baclofen, targeted
training and sophisticated orthoses all have their advocates.
Less orthodox strategies too, such as hyperbaric oxygen,
cranial osteopathy and lycra suits have been in vogue. Cerebral
palsy is a heterogeneous condition and it might be legitimately
argued that its management should be highly
individualised. For professionals in the field however there
is now a bewildering choice of treatment options available in
many countries, with only scant guidelines about the criteria
of choice. Our lack of full understanding of some of the basic
concepts of neuromuscular function such as tone and spasticity
has contributed to some of this confusion and this has
been made worse by the lack of universally acceptable
‘outcome measures’ for comparing different treatment techniques.
Gait analysis has been shown to be useful in the child
with hemiplegia, diplegia and mild quadriplegia (less so with
ataxic and dyskinetic cerebral palsy), not only for determining
intervention, but also in its use of measuring outcomes in
a range of therapeutic options. It is however a very expensive
academic outcome tool and other less technical procedures
have been developed in recent years for determining
outcome. Tools such as gross motor function measure
(GMFM), paediatric evaluation of disability inventory
(PEDI), etc., have the major advantage of being performed
at home by trained therapists but all such tools lack some
versatility. Individual treatment options will be discussed,
including the criteria currently available, which help us to
make individual decisions about individual children.
WS-1-6
Treatment of 140 cerebral palsied children based on
combination of traditional Chinese medicine and
Western medicine
X.-J. Zhou, N.-X. Zhuang, S.-Q. Zheng, T. Chen, Y.-F. Luo
The Children’s Hospital, Zhejiang University School of
Medicine, Hang Zhou, China
Objective: To investigate the effective approaches and
practicable plan for the rehabilitation on childhood cerebral
palsy. Methods: Cerebral palsied children received multiple
therapy based on age, type and status of cerebral palsy,
including preparation of traditional Chinese medicine,
scalp acupuncture, body acupuncture, point-injection therapy,
auricular-plaster therapy, massage and pressing points,
manipulation, physiotherapy, occupational therapy, etc.
And they not only were handled in hospital, but also at
home. Results: The majority of cerebral palsied children
got progress on motor and social adaptation capacity.
There were highly significant differences on motor and
adaptive capacity between before and after treatment by
signed rank test (P , 0:01). Conclusion: It is a pattern of
rehabilitation suitable for the Chinese children with cerebral
palsy that is based on combination of traditional Chinese
medicine and Western medicine, rehabilitation in hospital
and at home. If the pattern of treatment can be better implement
and carried out, the most of cerebral palsied children
will be rehabilitated effectively.
WS-2
Epilepsy
WS-2-1
The clinically efficacy of midazolam on childhood status
epilepticus
Q.-K. Huang, M. Zhao, J.-C. Gu
Department of Pediatrics, Shanxian Central Hospital,
Shandong, China
The purpose of this study was to explore the safety and
efficacy of midazolam in the treatment of childhood status
epilepticus. Forty-three patients with status epilepticus (41
with convulsive status epilepticus and two with epilepsia
partialis continua) were treated from June 1997 to June
2001. The underly disease was idiopathic status epilepticus
in 35 patients and symptomatic status epilepticus in eight
patients. They were divided randomly into the treatment
group and control group. During the study, the pulse, respiration,
blood pressure were monitored. The treatment group
included 22 cases (12 boys and ten girls) aged 8 months–12
years. The midazolam was given in a dose of 0.05–0.2 mg/kg
bolus for the patients with continuous seizures, and 3–15 mg/
kg per min infusion for those who had frequent seizures. The
seizure ceased 10 min to 4 h after the administration of midazolam,
and no comp1ication occurred. The control group
included 21 cases (11 boys and ten girls) aged 10 months–
12 years diazepam, phenobarbital, lidocain and thiopentone
was given sequentially. The seizure ceased 15 min–42 h after
the first anticonvulsant administration. In control group, the
case with seizure continuous for 42 h that died of underlying
disease, three patients need intubating and assisted ventilation
because of respiration suppresion. The time interval
from midazolam administration to seizure ceased was significantly
shorter than that of control group (Rank test
P , 0:05). It is concluded that midazolam is safe and effective
in treating the childhood status epilepticus.
WS-2-2
Five children with frontal lobe epilepsy
J. Li, H.-B. Zhang
Jinan Children Hospital, Jinan, China
We report five children (four male and one female; age is
22 days, 5, 6, 8 and 8 years, respectively) with frontal lobe