Clinical and Experimental Pediatrics

Original Article

Neurology

Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study

Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius

Clin Exp Pediatr. 2025;68(4):303-310. Published online November 13, 2024

Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.

DOI: https://doi.org/10.3345/cep.2024.01214

Review Article

Neurology

Cerebral organoid research for pediatric patients with neurological disorders

Jin Eun, Jung Eun Lee, Seung Ho Yang

Clin Exp Pediatr. 2025;68(4):269-277. Published online November 28, 2024

Cerebral organoids obtained from human induced pluripotent stem cells are transforming the study of pediatric neurological diseases by providing more accurate models of human brain development and pathology. These advancements have improved pathology modeling and the potential for novel therapeutic approaches despite existing challenges such as reproducibility and vascularization.

DOI: https://doi.org/10.3345/cep.2024.01235

Original Article

Neurology

Evaluation of pediatric migraine triggers: a single-center study

Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee

Clin Exp Pediatr. 2025;68(2):163-169. Published online November 11, 2024

Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management?
Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense.
Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes.

DOI: https://doi.org/10.3345/cep.2024.00738

Instability of revised Korean Developmental Screening Test classification in first year of life

Ji Eun Jeong, You Min Kim, Na Won Lee, Gyeong Nam Kim, Jisuk Bae, Jin Kyung Kim

Clin Exp Pediatr. 2025;68(1):97-103. Published online November 11, 2024

Question: How stable are the revised Korean Developmental Screening Test score classifications in early infancy?
Finding: A significant number of infants improved into the peer and high-level group (≥-1 standard deviations), especially in the gross motor area.
Meaning: The early detection of developmental delay requires a comprehensive medical history, physical and neurological examinations, and repeated developmental screenings.

DOI: https://doi.org/10.3345/cep.2024.00619

Review Article

Neurology

Role of nonpharmacological concussion management in children: systematic review of randomized controlled trials

Andre Marolop Pangihutan Siahaan, Alvin Ivander, Rr. Suzy Indharty, Steven Tandean, Anastasia Grace Milenia Ginting, Masrini Ginting, Felix Khosasi, Elbert

Clin Exp Pediatr. 2024;67(11):569-579. Published online October 28, 2024

The long-term effects of concussion for pediatric patient remains unclear. Children and teenagers do not experience or recover from concussion in the same manner as adults do. Concussions can cause a variety of anatomical and functional alterations. Nonpharmacological approach in pediatric concussion management is an understudied field of research with significant ability to affect prognosis and quality of life. Active rehabilitation and occupational therapy were especially promising.

DOI: https://doi.org/10.3345/cep.2023.01256

Editorial

Neurology

Impact of COVID-19 pandemic on clinical features of benign convulsions with mild gastroenteritis

Jon Soo Kim

Clin Exp Pediatr. 2024;67(9):456-458. Published online March 25, 2024

· The frequency of benign convulsions with mild gastroenteritis (CwG) was not significantly influenced by the pandemic.
· The coronavirus disease 2019 pandemic has further diversified the etiologic enteric viral pathogens of CwG.

DOI: https://doi.org/10.3345/cep.2024.00108

Original Article

Neurology

Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study

Hyejin Na, Sanghoon Lee, Seo Hee Kim, Young Ok Kim

Clin Exp Pediatr. 2024;67(4):213-220. Published online March 19, 2024

Web of Science 2 Crossref 2

Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)?
Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases).
Meaning: The COVID-19 pandemic affected CwG.

DOI: https://doi.org/10.3345/cep.2023.01137

Clinical Note

Neurology

Expanding association between BICD2 variants and brain malformations and associated lissencephaly

Jaeso Cho, Haeryung Kim, Seoungbok Lee, Jihoon G Yoon, HyeJin Kim, Minhye Kim, Seoyun Jang, Woojoong Kim, Soo Yeon Kim, Jong Hee Chae

Clin Exp Pediatr. 2024;67(1):54-56. Published online December 21, 2023

DOI: https://doi.org/10.3345/cep.2023.01095

Original Article

Neurology

Effectiveness of Helmet therapy for infants with moderate to severe positional plagiocephaly

Jeongho Kim, Jina Kim, Kyu Young Chae

Clin Exp Pediatr. 2024;67(1):46-53. Published online December 5, 2023

Web of Science 1 Crossref 1

Question: Is helmet therapy effective for positional plagiocephaly? What factors influence helmet therapy efficacy for positional plagiocephaly?
Finding: Helmet therapy is effective for infants with moderate to severe positional plagiocephaly, and its effectiveness is influenced by age at treatment initiation, severity of head asymmetry, and daily duration of helmet wear.
Meaning: Pediatricians should initiate helmet therapy for positional plagiocephaly sooner, ideally before 9 months of age, to maximize treatment efficacy.

DOI: https://doi.org/10.3345/cep.2023.00626

Need for palliative care from birth to infancy in pediatric patients with neurological diseases

Raffaele Falsaperla, Silvia Marino, Carla Moscheo, Lucia Giovanna Tardino, Simona Domenica Marino, Concetta Sciuto, Piero Pavone, Giovanna Vitaliti, Federica Sullo, Martino Ruggieri

Clin Exp Pediatr. 2023;66(8):350-356. Published online June 14, 2023

Web of Science 2 Crossref 2

Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy?
Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis.
Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required.

DOI: https://doi.org/10.3345/cep.2023.00129

Review Article

Neurology

Gut microbiota affects brain development and behavior

Gun-Ha Kim, Jung-Ok Shim

Clin Exp Pediatr. 2023;66(7):274-280. Published online November 8, 2022

Web of Science 11 Crossref 14

· The gut microbiota can alter a host’s brain development and behavior.
· Gut bacteria communicate with the brain via the microbiota-gut-brain axis.
· Fecal microbial transplantation is a promising treatment strategy for autism spectrum disorder.

DOI: https://doi.org/10.3345/cep.2021.01550

Editorial

Neurology

Understanding the usefulness of electroencephalography source localization

Bo Lyun Lee

Clin Exp Pediatr. 2023;66(5):210-211. Published online April 18, 2023

· Electroencephalography (EEG) records brain activity with high temporal resolution.
· EEG source localization, combined with other functional or structural imaging methods, provides information about brain network and connectivity in clinical neuroscience.
· EEG source localization identifies brain location from electrical current sources in several neuropsychiatric diseases such as epilepsy, attention deficit/hyperactivity disorder, and anxiety disorders.

DOI: https://doi.org/10.3345/cep.2022.01480

Review Article

Neurology

Electroencephalography source localization

Tae-Hoon Eom

Clin Exp Pediatr. 2023;66(5):201-209. Published online December 29, 2022

Web of Science 8 Crossref 10

· Electroencephalography (EEG) directly images the electrical activity of neurons at a higher temporal resolution than other neuroimaging techniques.
· EEG is still widely used in brain function research due to its advantages.
· Forward and inverse problems of EEG analyses require solutions.
· Methods such as the dipole and distributed source models have been introduced.
· Applications of EEG are expanding with the integration of other technologies and large-scale data.

DOI: https://doi.org/10.3345/cep.2022.00962

Pediatric syncope: pearls and pitfalls in history taking

Jung Sook Yeom, Hyang-Ok Woo

Clin Exp Pediatr. 2023;66(3):88-97. Published online February 15, 2023

Crossref 2

An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.

DOI: https://doi.org/10.3345/cep.2022.00451

Editorial

Neurology

Lumbar puncture or not: when does febrile seizure require a neurodiagnostic evaluation?

Seung Soo Kim

Clin Exp Pediatr. 2023;66(2):68-69. Published online December 9, 2022

· A neurodiagnostic evaluation (lumbar puncture, blood tests, electroencephalography, and neuroimaging) is not indicated in most patients with simple febrile seizures.
· A lumbar puncture is indicated when a central nervous system infection is suspected in any patient with febrile seizures.
· Blood tests (glucose, electrolytes, and complete blood count) are indicated in patients with persistent seizure after benzodiazepine treatment, prolonged loss of consciousness, poor general condition, or signs of dehydration.

DOI: https://doi.org/10.3345/cep.2022.01081

Original Article

Neurology

Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review

Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga

Clin Exp Pediatr. 2023;66(1):38-45. Published online November 30, 2022

Web of Science 3 Crossref 3

· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.

DOI: https://doi.org/10.3345/cep.2022.01102

Editorial

Neurology

Increasing our understanding of rotavirus-induced central nervous system manifestations

Jon Soo Kim

Clin Exp Pediatr. 2022;65(11):536-537. Published online May 6, 2022

Web of Science 3 Crossref 3

· Diverse clinicoradiological features of central nervous system (CNS) complications in rotavirus infection can be identified with the rapid and wide use of various brain magnetic resonance imaging protocols.
· An increased understanding of the various pathophysiological mechanisms of rotavirus-induced CNS manifestations will enable precise management in the future.

DOI: https://doi.org/10.3345/cep.2022.00395

Review Article

Neurology

Rotavirus infection-associated central nervous system complications: clinicoradiological features and potential mechanisms

Kyung Yeon Lee

Clin Exp Pediatr. 2022;65(10):483-493. Published online February 7, 2022

Web of Science 10 Crossref 12

∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children.
∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy.
∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain.

DOI: https://doi.org/10.3345/cep.2021.01333

Update on benign convulsions with mild gastroenteritis

Yeong Seok Lee, Ga Hee Lee, Young Se Kwon

Clin Exp Pediatr. 2022;65(10):469-475. Published online December 27, 2021

Web of Science 7 Crossref 10

∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing.
∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary.
∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear.

DOI: https://doi.org/10.3345/cep.2021.00997

Neonatal seizures: diagnostic updates based on new definition and classification

Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee

Clin Exp Pediatr. 2022;65(8):387-397. Published online April 4, 2022

Web of Science 8 Crossref 10

· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.

DOI: https://doi.org/10.3345/cep.2021.01361

Original Article

Neurology

Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database

Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae

Clin Exp Pediatr. 2022;65(6):312-319. Published online December 9, 2021

Web of Science 7 Crossref 10

Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.

DOI: https://doi.org/10.3345/cep.2021.01417

Review Article

Neurology

Recent trends of healthcare information and communication technologies in pediatrics: a systematic review

Se young Jung, Keehyuck Lee, Hee Hwang

Clin Exp Pediatr. 2022;65(6):291-299. Published online December 15, 2021

Web of Science 11 Crossref 7

· The innovation of healthcare information communication technology (ICT) was accelerated with the adoption of electronic health records (EHRs).
· Telemedicine currently has no technical barriers.
· EHRs and personal health records are being connected, and mobile/wearable technologies are being integrated into them.
· Conventional rule-based clinical decision support systems have already been implemented and used in EHRs and PHRs. Artificial intelligence/machine learning improves precision and accuracy.

DOI: https://doi.org/10.3345/cep.2020.01333

Big data analysis and artificial intelligence in epilepsy – common data model analysis and machine learning-based seizure detection and forecasting

Yoon Gi Chung, Yonghoon Jeon, Sooyoung Yoo, Hunmin Kim, Hee Hwang

Clin Exp Pediatr. 2022;65(6):272-282. Published online November 26, 2021

Web of Science 7 Crossref 9

· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care.
· Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection.
· Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting.

DOI: https://doi.org/10.3345/cep.2021.00766

Editorial

Neurology

Cerebrospinal fluid biomarkers in various pediatric neurologic diseases

Jeongho Lee

Clin Exp Pediatr. 2022;65(2):81-82. Published online January 6, 2022

Web of Science 1 Crossref 1

Cerebrospinal fluid (CSF) has many important biomarkers that are commonly analyzed in pediatric neurologic diseases, including central nervous system infection and inflammation. Neurologic disease in pediatrics is difficult to diagnosis, there are challenges in developing CSF profiles. Some biomarkers are expected to help differential diagnosis.

DOI: https://doi.org/10.3345/cep.2021.01445

Review Article

Neurology

Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients

Seh Hyun Kim, Soo Ahn Chae

Clin Exp Pediatr. 2022;65(2):56-64. Published online August 23, 2021

Web of Science 6 Crossref 8

· Pediatric cerebrospinal fluid (CSF) components have been extensively evaluated as biomarkers of various neurologic diseases.
· Several promising candidate CSF biomarkers, including Tau, glial fibrillary acidic protein, neuron-specific enolase, S100β, and interleukins, have been studied in pediatric patients with seizure disorders, central nervous system infections, inflammation, tumors, hypoxic-ischemic encephalopathy, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus.
· Circulating microRNAs in the CSF are a promising class of biomarkers for various neurological diseases.

DOI: https://doi.org/10.3345/cep.2021.00241

Worldwide national intervention of developmental screening programs in infant and early childhood

Seunghyo Kim

Clin Exp Pediatr. 2022;65(1):10-20. Published online September 30, 2021

Web of Science 16 Crossref 17

∙ Prevalence rate of developmental disabilities has been reported from 8% to 15% and its rate is increasing worldwide.
∙ The critical period of intervention for developmental delay is before the child reaches 3 years of age.
∙ All primary care pediatricians should conduct developmental surveillance and screening tests to infants and children at scheduled visits. Through this, they are liable for providing early identification and timely intervention.

DOI: https://doi.org/10.3345/cep.2021.00248

Editorial

Neurology

Recent studies are focus on the new treatments for hypoxicischemic encephalopathy (HIE) and long-term outcomes in later childhood and adolescence in children with a history on HIE

Eun Sook Suh

Clin Exp Pediatr. 2021;64(12):628-629. Published online September 30, 2021

Neonatal encephalopathy is the most important reason for morbidity and mortality. The early detection of neonate with high risk for hypoxic ischemic encephalopathy (HIE) and treatment are important for prevent long term complication. Hypothermia is currently standard treatment option for HIE. Several clinical studies have been performed due to improve the long term outcome. New therapeutic options including xenon, allopurinol, erythropoietin, topiramate will help to reduce neuropsychiatric disability.

DOI: https://doi.org/10.3345/cep.2021.00822

Review Article

Neurology

Cognitive outcomes in late childhood and adolescence of neonatal hypoxic-ischemic encephalopathy

Bo Lyun Lee, Hannah C. Glass

Clin Exp Pediatr. 2021;64(12):608-618. Published online May 24, 2021

Web of Science 39 Crossref 40

∙ Cognitive impairments occur in children with hypoxic-ischemic encephalopathy (HIE) even without neuromotor deficits.
∙ Therapeutic hypothermia has improved neurodevelopmental outcomes of children with HIE; however, 40% of children remain at risk of death/disability or cognitive impairments necessitating the development of adjunctive neuroprotective therapies.
∙ Long-term follow-up until adolescence is required to identify cognitive dysfunction.
∙ A pattern of watershed injury on brain imaging is associated with poor cognitive outcomes.

DOI: https://doi.org/10.3345/cep.2021.00164

Recent update on reading disability (dyslexia) focused on neurobiology

Sung Koo Kim

Clin Exp Pediatr. 2021;64(10):497-503. Published online March 2, 2021

Web of Science 5 Crossref 6

·Neurobiological studies using functional brain imaging have uncovered the reading pathways, brain regions involved in reading, and neurobiological abnormalities of dyslexia.
·An accurate diagnosis and timely specialized intervention are important in children with dyslexia. When national infant development screening tests have been conducted as in Korea, if a language developmental delay and early predictors of dyslexia are detected, the progression to dyslexia should be carefully observed and early intervention provided.

DOI: https://doi.org/10.3345/cep.2020.01543

Is it really a seizure? The challenge of paroxysmal nonepileptic events in young infants

Seung Yeon Jung, Joon Won Kang

Clin Exp Pediatr. 2021;64(8):384-392. Published online September 18, 2020

Web of Science 1 Crossref 4

Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential...

DOI: https://doi.org/10.3345/cep.2020.00451

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