Patients with neurological disorders are at high risk of developing osteoporosis, as they possess multiple risk factors leading to low bone mineral density. Such factors include inactivity, decreased exposure to sunlight, poor nutrition, and the use of medication or treatment that can cause lower bone mineral density such as antiepileptic drugs, ketogenic diet, and glucocorticoids. In this article, mechanisms involved in altered bone health in children with neurological disorders and management for patients with epilepsy, cerebral palsy, and Duchenne muscular dystrophy regarding bone health are reviewed.

Guillain-Barré syndrome (GBS) is a group of clinical syndromes involving acute polyneuropathy secondary to an immune-mediated process. Although affected children generally tend to have a good prognosis, a small subset of children experience residual symptoms that require lengthy and costly rehabilitation. Therefore, we aimed to describe the clinical findings of children with GBS and to investigate factors associated with their outcomes. Methods: A retrospective study was conducted of previously healthy children ≤18 years of age diagnosed with GBS and admitted to Pusan National Children's Hospital between 2009 and 2018. Results: Of the 38 patients included in the study (23 boys [60.5%]; median age, 4.3 years [interquartile range, 2.8 to 9.7 years]), 28 (73.7%) fully recovered without any residual symptoms, while 10 (26.3%) had residual symptoms more than 6 months after the onset of GBS. The presence of autonomic dysfunction and a ≥50% decrease in compound muscle action potential (CMAP) amplitude from the lower limit of normal were associated with functional deficits at 6 months. Age, sex, type of antecedent illness, cranial nerve involvement, the need for mechanical ventilation, and the subtype of GBS were not significantly associated with functional outcomes. Post-gadolinium enhancement of nerve roots was seen in 71.1% of patients on initial spine magnetic resonance imaging (MRI). Conclusion: Contrast enhancement of nerve roots on MRI was the most helpful initial finding for diagnosing GBS. The presence of autonomic dysfunction and a ≥50% decrease in CMAP from the lower limit of normal were poor prognostic factors for functional outcomes.

Purpose: Epilepsy is one of the most common neurological disorders in both adults and children. After detailed history-taking, electroencephalography (EEG) is the most important investigation in the evaluation of epilepsy patients. Polyspikes, defined as a sequence of two or more spikes, are among the findings that can be seen on EEGs of epilepsy patients, but the literature on their significance in focal epilepsy patients is scarce. Therefore, in the current study, we investigated the significance of polyspikes on EEG in childhood focal epilepsy. Methods: A retrospective analysis was conducted of data from children who were diagnosed with focal epilepsy and received anti-seizure medications at Pusan National University Children’s Hospital. Results: Among the 1,125 children included in this study, 468 (41.6%) showed interictal polyspikes on their EEGs. In the multivariate analysis, only the presence of brain magnetic resonance imaging (MRI) abnormalities was significantly associated with the presence of interictal polyspikes on EEGs. Among patients with brain MRI abnormalities, localized polyspikes were significantly associated with focal cortical dysplasia, while multifocal polyspikes were significantly associated with perinatal insults (hypoxic-ischemic encephalopathy and destructive encephalomalacia). Conclusion: Focal epilepsy patients with interictal polyspikes were more likely to have a structural etiology. Furthermore, patients with localized polyspikes were more likely to have focal cortical dysplasia as the structural etiology, while patients with multifocal polyspikes were more likely to have perinatal insults as the structural etiology. This study demonstrates that focal polyspikes can be used as markers of the possible presence of a structural etiology in routine practice.