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Background Pediatric epilepsy is associated with various comorbidities. It is known that children with epilepsy have a compromised health-related quality of life (QOL) and may be affected across physical, psychological, social, and educational domains. Aims and Objectives (1) To study QOL in children with epilepsy from private and public outpatient departments, (2) study various risk factors affecting QOL, and (3) compare risk factors between groups. Methods Sample consisted of 400 and 201 children aged 5 to 18 years from private and public settings with epilepsy taking antiepileptic drugs (AEDs) for at least 6 months. Structured case record form was used to collect data on sociodemographic, clinical, and treatment parameters. QOL was measured by the Pediatric Quality of Life Inventory (PedsQL) questionnaire (in the local language). Adverse effects were monitored by Pediatric Epilepsy Side Effects Questionnaire (PESQ). Univariate regression analysis was performed on the data (p < 0.005). Results Overall PedsQL score was 67.21 ± 29.391 and 78.66 ± 9.161 in private and public settings, respectively (p = 0.000). QOL was affected significantly by age of the child, educational and economic background of the caregivers, age at the onset of epilepsy, seizure frequency, duration of treatment, number of drugs, presence of comorbidities, intelligence quotient (IQ) levels of children, and PESQ score in both the groups. Total PESQ score was 18.63 ± 17.02 and 7.69 ± 10.646 in private and public settings, respectively (p = 0.000). Conclusions Children with epilepsy have a compromised QOL. Risk factors relating to QOL are numerous. Educational and economic status of caregivers plays a significant role in awareness of the problem. AbstractKeywords ► quality of life ► adverse effects ► pediatric epilepsy ► private and public tertiary care centers Int

Patients with Friedreich's ataxia (FA) are at an increased risk of developing diabetes mellitus and glucose intolerance. Diabetes usually develops many years after the initial presentation. We report an 8-year-old girl who initially presented with diabetic ketoacidosis and was treated as a case of insulin-dependent diabetes mellitus. Around a year later, she developed gait problems and ataxia. Cardiac involvement was detected on echocardiography. Genetic testing confirmed the diagnosis of FA. FA should be a diagnostic consideration in children presenting with diabetes and neurological issues, even with early presentation of the former. Early occurrence of diabetes and rapid progression of ataxia in this patient needs a better understanding of underlying genetic mechanisms.

Acute encephalopathy with biphasic seizures and reduced diffusion (AESD) is a syndrome of encephalopathy characterized by biphasic seizures and altered consciousness in the acute stage followed in the subacute stage by restricted diffusion in the subcortical white matter on magnetic resonance imaging. The etiology of AESD has been attributed to viral infection like influenza A and human herpes virus 6. The exact pathogenesis of AESD is uncertain. Here we report a case of AESD, diagnosed based on clinicoradiological correlation.

Phospholipase A2-associated neurodegeneration (PLAN) comprises of three disorders with overlapping presentations. The most common of these is classical or infantile-onset phospholipase A2-associated neurodegeneration, also known as infantile neuroaxonal dystrophy (INAD). Only 1 case of INAD has been reported from India till now. We report two genetically confirmed patients seen at a tertiary care pediatric hospital. Both these patients presented with infantile onset of neuroregression. We believe that INAD is underrecognized and underreported from India.