A424 Arch Dis Child 2012;97(Suppl 2):A1–A539 Abstracts WHEN SUSPECT PANAYIOTOPOULOS SYNDROME (PS) IN A CHILD WITH CLINICAL DIAGNOSIS OF GASTRIC ESOPHAGUS REFLUX DISEASE (GERD) doi:10.1136/archdischild-2012-302724.1496 C Pacchiarotti, P Parisi, A Ferretti, F Marra, S Bianchi, MP Villa. Sapienza University of Roma, Roma, Italy Panayiotopoulos syndrome is “a benign age related focal seizure dis- order occurring in early and mid-childhood. It is characterized by seizures, often prolonged, with predominantly autonomic symp- toms, and by an EEG that shows shifting and/or multiple foci, often with occipital predominance” (definition of International League Against Epilepsy). In literature the clinical features of PS was frequently mistaken as non-epileptic conditions such as acute encephalitis, syncope, migraine, cyclic vomiting syndrome, motion sickness, sleep disor- der, or gastroenteritis. In our experience during the last 2 years we have observed 4 chil- dren misdiagnosed by clinical history for GERD. Until now PS is underestimated with the consequences of high morbidity and costly mismanagement. These 4 children were referred to general pediatrician at the age of 2–3 years because they started suffering from gastrointestinal emetic symptoms: nausea, retching, and vomiting. The attacks occurred mainly during sleep without sensory-motor clinical signs of seizure. One child also had monthly episodes of severe headache with clinical characteristics of migraine without aura. After a treatment with proton pump inhibitors (PPI) and anti- acid without benefits, according to the literature, they were sent to neurologist for suspection of PS which was confirmed by EEGs occipital features. Because of the importance of the symptomatology, the children have been treated with Lamotrigine with benefit. Conclusions When a child presents symptoms suggestive of GERD but non responding to specific GERD therapy, there is indica- tion to effect an EEG to investigate a PS. THE EFFECT OF SURGERY TIME ON PROGNOSIS IN NEWBORNS WITH MENINGOMYELOCELE doi:10.1136/archdischild-2012-302724.1497 1 MY Oncel, 1 R Ozdemir, 2 G Kahilogulları, 1 S Yurttutan, 3 O Erdeve; 1,4 U Dilmen. 1 Neonatology, Zekai Tahir Burak Maternity Teaching Hospital; 2 Neuorsurgery; 3 Neonatology, Ankara University, Faculty of Medicine; 4 Pediatrics, Yıldırım Beyazıt University, Faculty of Medicine, Ankara, Turkey Background and Aim To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. Methods The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. Results The records of 30 babies were included in the final analy- sis. Overall, the mean gestational age was 37.7±2.7 weeks, with a mean birth weight of 2967±755 g and head circumference of 35.8±3.8 cm. In terms of localization, 46.6% of the meningomy- eloceles were lumbosacral, 40% were lumbar, 10% were thoraco- lumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33±1.2 cm. Newborns underwent surgery on average of 8.2±5.9 days after birth, with an overall mean duration of hospital stay of 30±25.1 days. Patients were divided into two groups based on timing of surgery (group 1, ≤5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). 1496 1497 NEUROFEEDBACK AS A TREATMENT OF TICS IN CHILDREN doi:10.1136/archdischild-2012-302724.1494 1 S Bakhtadze, 1 N Geladze, 1 N Khachapuridze, 2 M Nasrashvili. 1 Tbilisi State Medical University; 2 ’Cito’, Medical Centre, Tbilisi, Georgia Object: Tics are involuntary, sudden, rapid, recurrent, stereotyped motor movements or phonic productions that involve discrete mus- cle groups. Pharmacological treatment was considered as the most effective approach for tics management for many years. In recent period clinicians attempt to use behavioral methods for this purpose. The aim of our study was to use non pharmacological treatment like EEG biofeedback-neurofeedback (NF) for the treatment of tics. Methods We have examined previously non treated 15 children (9 boys and 6 girls) with simple tics (average age 10 years). All chil- dren with complex tics and with other comorbidities were excluded from the study. Tics frequency and severity were assessed by Yale Global Tic Severity Scale (YGTSS). Sensorimotor rhythm (SMR) training was used for NF therapy. 30 session of NF with duration of 30 minutes of each was conducted in every patient. Data were ana- lyzed by SPSS 10.0. ANOVA was used to determine the effect of treatment on YGTSS parameters. Results The ANOVA showed a significant effect of treatment on YGTSS measures (F(1.37)=223.69, MSE=114.735, p<.0001). These evidences suggest that NF significantly improves the severity and frequency of tics. Conclusions Thus effectiveness of SMR training in children with tics is important as the drugs used for the treatment have severe side effects, compliance problems and etc. Cognitive behavioral therapy is effective not only for reducing of tics but also for increas- ing self esteem and social competence as well. ASSESSMENT OF ANTIPYRETICS AS SEIZURE PREVENTING IN FEBRILE CONVULSION doi:10.1136/archdischild-2012-302724.1495 A Mortazavi. Pediatrics, Social Security Organization/Imam Hossein Hospital, Zanjan, Iran Background Febrile seizure is the most common seizure disorder during childhood. Antipyretics has not been shown to prevent sei- zure recurrences. (1) Objectives Some researchers previously studied prophylactic effi- cacy of antipyretics in FC (2–7). Uhari studied synergic effect of antipyretics and BDPs in 1993. our study planned for antipyretics efficacy in FC in IRAN. Methods Our observational, analytical, cross-sectional study was accomplished in over one year from 2009/Nov/23 to 2010/Nov/23. Sample size was 92 patients and sampling method was accidentally. Data collected by interview and analyzed using SPSS statistical software and Kolmogorov-smirnov, Pearson correlation and Regres- sion tests. Results 67 patients (72.8%) had been received antipyretics before seizure occurrences, and 25 patients (27.2%) hadn’t. Antipyretic which had been used composed of one forms of acetaminophen in 62.7%, NSAIDs in 4.5%, and more than one drugs (mixed) in 32.8%.34 patients (50.7%) used antipyretics less than 3 hours, 31 patients (46.3%) in 4–24h and 2 patients (3%) more than 24h before seizure occurrences (FIG-1). (Table-1) shows maximal plasma con- centration and plasma half-life of antipyretics. Approximately 50% of patients received antipyretics in appropriate time, but 25% treated after plasma half-life and remainder didn’t received anti- pyretics before seizure occurrences. Conclusion Preventable effects of antipyretics in FC, is in doubt but the difference between seizure occurrences in treated groups and remainders are not significant. FIG-1: Antipyretic usage time before seizure occurrences. 1494 1495 on June 1, 2020 by guest. Protected by copyright. http://adc.bmj.com/ Arch Dis Child: first published as 10.1136/archdischild-2012-302724.1496 on 1 October 2012. Downloaded from