Headache is one of most common chief complaints of pediatric patients in emergency departments (ED). In this study, the character, duration, strength and location of headaches, as well as the results of brain imaging studies, were recorded. Seventy-four children (34 boys, 40 girls) visiting the ED of major hospitals in Cheongju were enrolled from October 1, 2013 to September 30, 2014. Ages of the children ranged from 3 to 18 years, with the mean age being 13 years. Four of them (5.4%) had trauma-related headaches. There were 34 migraines (45.9%), 27 tension headaches (36.5%), 3 secondary headaches (4.1%), 2 seizure-related headaches (2.7%), 1 headache with hydrocephalus (1.4%), 1 concussion (1.4%), and 1 headache with subdural hematoma (1.4%). The highest number of patients, 31 (41.9%), had symptoms for less than two hours, while 11 pediatric patients (14.9%) had symptoms for 2-4 hours, and the third-largest group, 10 patients (13.5%), had symptoms between 24 and 72 hours. Twenty-nine patients (39.2%) had one headache per month, 20 patients (27.0%) had 1 to 14 headaches per month, and 4 patients (5.4%) had more than 15 headaches per month. Children with migraine took a nonsteroidal anti-inflammatory drugs (NSAID, 34 patients; 45.9%), acetaminophen (19 patients; 25.7%), and Topiramate (1 patient; 1.4%). Average strength of headache was 7.37 ± 1.79. There were 23 children (31.1%) with headaches in the parieto-temporal area, 16 children (21.6%) in the occipital area, 9 children (12.2%) in the frontal area, 4 children (5.4%) in the global area, and 6 children (8.1%) in an uncertain location. There were 31 children (41.9%) with pulsating headaches, 18 children (24.3%) with squeezing headaches, 5 children (6.8%) with stabbing headaches, and 11 children (14.9%) with headaches of an uncertain nature. Thus, we suspect children visiting the ED had severe headaches.
Guillain-Barre´ syndrome (GBS) is an acute inflammatory demyelinating polyneuropathy most commonly characterized by rapidly progressive, essentially symmetric weakness and areflexia. This study examined clinical symptoms of clinical variants of GBS through a cerebrospinal fluid (CSF) study, nerve conduction (NCV) study, treatment, and prognosis. There were 16 children with GBS who visited our hospital from January 2011 to December 2013. Guillen-Barre´-like syndromes with transient synovitis were noted in three children. Clinical variants of GBS with acute demyelinating encephalomyelitis were observed in one child. Previous infections were noted in 16 children with Guillen-Barre´-like syndrome. There were ascending infections in 16 cases. Fifteen children showed symmetric infections, and one showed asymmetric infection. In NCV, slow waves were noted in two cases. We treated using intravenous immunoglobulin (IVIG) in four cases, IVIG with steroid in two, cases and supportive care in 10 (62.5%) cases. Five children treated with IVIG and 10 with supportive care management were completely improved.Our study suggests that supportive care is effective as a treatment for clinical variants of GBS. Further study is necessary for more patients.