Continuous electroencephalographic monitoring (CEEG) is useful for detecting nonconvulsive seizures and nonconvulsive status epilepticus in critically ill children. Nonconvulsive status epilepticus is a risk factor for a poor neurological outcome. Background electroencephalographic activity is also helpful for predicting the prognosis. However, CEEG is a labor-intensive monitoring method, so it is important to elucidate the risk factors for nonconvulsive seizures in order to select patients whose CEEG are beneficial. Further research is necessary to clarify whether or not CEEG can improve the prognosis.

  Objective: The Nagasaki Children’s Medical and Welfare Center (hereafter referred to as the center) has been implementing an initiative in which 1-2-week joint parent-child hospitalization (hereafter referred to as parent-child hospitalization), in line with the family’s wishes, are repeated at intervals of approximately 1-3 months, with the aim of promoting at-home support to the children in a phased manner. We introduced specific initiatives for parent-child hospitalization and investigated the impact of parent-child hospitalization on the parents’ awareness. Methods: We measured two indices―the Canadian Occupational Performance Measure (COPM) and parental care confidence―in a total of 59 parents of pediatric patients who were admitted under the parent-child hospitalization initiative between March 2020 and September 2020. Measurements were performed at admission and discharge. Results: In a single round of parent-child hospitalization, an increase in the average level of performance and satisfaction of tasks set at the time of admission and an increase in the average level of parental care confidence (from an average of 3.75 at admission to an average of 4.03 at discharge) were observed. However, even after repeated parent-child hospitalizations, the average level of childcare confidence in terms of “acceptance of the child,” “response to the child,” and “understanding of behavior” did not increase in the long term. Conclusions: Although parent-child hospitalizations, even for short durations of 1-2 weeks, increased the parents’ COPM performance and satisfaction and childcare confidence, our study suggests that the effects are less likely to persist in the long term. Even after the onset/diagnosis, the parents were in an unstable condition, including experiencing feelings of worry and difficulty, highlighting the importance of being conscious about the issues experienced by parents who are providing support at home to their children and addressing them.

  Guillain-Barré syndrome (GBS) is rarely complicated by reversible cerebral vasoconstriction syndrome (RCVS) and cardiomyopathy due to dysautonomia. In this study, we report on a four-year-old girl who initially presented with leg pain. Seven days after the onset of pain, she fell unconscious and experienced respiratory/cardiovascular failure due to Takotsubo cardiomyopathy, and she received ventilator management. She was initially suspected of having vasculitis or encephalomyelitis; therefore, pulse steroids were administered. After ventilator weaning, the patient was diagnosed with muscle weakness that affected the extremities and caused sensory disturbances. Albuminocytologic dissociation and reduced peripheral nerve conduction velocity were observed. The patient was diagnosed with GBS and started on intravenous immunoglobulin therapy 16 days after the onset of pain. Magnetic resonance (MR) imaging of the head revealed extensive cerebral infarction. Further, MR angiography demonstrated reversible irregularities in the cerebral arteries, confirming RCVS. She was able to ambulate 47 days after the onset of pain, and her motor function improved to premorbid levels six months after the onset of pain. RCVS and cardiomyopathy may occur in early-stage GBS, which is difficult to prevent. Therefore, early diagnosis of GBS and careful monitoring while considering the possibility of sudden conditional changes due to autonomic dysfunction can help prevent secondary neurological disorders.