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Yamaguchi Y, Torisu H, Kira R, Ishizaki Y, Sakai Y, Sanefuji M, Ichiyama T, Oka A, Kishi T, Kimura S, Kubota M, Takanashi J, Takahashi Y, Tamai H, Natsume J, Hamano S, Hirabayashi S, Maegaki Y, Mizuguchi M, Minagawa K, Yoshikawa H, Kira J, Kusunoki S, Hara T. A nationwide survey of pediatric acquired demyelinating syndromes in Japan. Neurology 2016; 87:2006-2015. [PMID: 27742816 PMCID: PMC5109945 DOI: 10.1212/wnl.0000000000003318] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 07/28/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the clinical and epidemiologic features of pediatric acquired demyelinating syndromes (ADS) of the CNS in Japan. METHODS We conducted a nationwide survey and collected clinical data on children with ADS aged 15 years or younger, who visited hospitals between 2005 and 2007. RESULTS Among 977 hospitals enrolled, 723 (74.0%) responded to our inquiries and reported a total of 439 patients as follows: 244 with acute disseminated encephalomyelitis (ADEM), 117 with multiple sclerosis (MS), 14 with neuromyelitis optica (NMO), and 64 with other ADS. We collected and analyzed detailed data from 204 cases, including those with ADEM (66), MS (58), and NMO (10). We observed the following: (1) the estimated annual incidence rate of pediatric ADEM in Japan was 0.40 per 100,000 children (95% confidence interval [CI], 0.34-0.46), with the lowest prevalence in the north; (2) the estimated prevalence rate of MS was 0.69 per 100,000 children (95% CI, 0.58-0.80), with the lowest prevalence in the south; (3) NMO in Japan was rare, with an estimated prevalence of 0.06 per 100,000 children (95% CI, 0.04-0.08); and (4) the sex ratio and mean age at onset varied by ADS type, and (5) male/female ratios correlated with ages at onset in each ADS group. CONCLUSIONS Our results clarify the characteristic clinical features of pediatric ADS in the Japanese population.
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Affiliation(s)
- Y Yamaguchi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Torisu
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
| | - R Kira
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Ishizaki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Sakai
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Sanefuji
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Ichiyama
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - A Oka
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Kishi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Kimura
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Kubota
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Takanashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Takahashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Tamai
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Natsume
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Hamano
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Hirabayashi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - Y Maegaki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - M Mizuguchi
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - K Minagawa
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - H Yoshikawa
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - J Kira
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - S Kusunoki
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | - T Hara
- From the Department of Pediatrics (Y.Y., H. Torisu, R.K., Y.I., Y.S., M.S., T.H.) and Department of Neurology, Neurological Institute (J.K.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Pediatrics (H. Torisu), Fukuoka Dental College Medical and Dental Hospital, Fukuoka; Department of Pediatrics (T.I.), Yamaguchi University Graduate School of Medicine, Ube; Department of Pediatrics (A.O.), Kyorin University School of Medicine, Hachioji; Department of Pediatrics (T.K.), Tokyo Women's Medical University, Tokyo; Department of Child Development Pediatrics (S. Kimura), Kumamoto University Graduate School, Kumamoto; Division of Neurology (M.K.), National Center for Child Health and Development, Tokyo; Department of Pediatrics (J.T.), Kameda Medical Center, Kamogawa; National Epilepsy Center (Y.T.), Shizuoka Institute of Epilepsy and Neurological Disorders, Shizuoka; Department of Pediatrics (H. Tamai), Osaka Medical College, Takatsuki; Department of Pediatrics (J.N.), Nagoya University Graduate School of Medicine, Nagoya; Department of Neurology (S. Hamano), Saitama Children's Medical Center, Saitama; Department of Neurology (S. Hirabayashi), Nagano Children's Hospital, Azumino; Division of Child Neurology (Y.M.), Faculty of Medicine, Tottori University, Yonago; Department of Developmental Medical Sciences (M.M.), Graduate School of Medicine, The University of Tokyo; Department of Pediatrics (K.M.), Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo; Department of Pediatric Neurology (H.Y.), Nagaoka Habilitation and Medical Center for Severely Handicapped Children, Nagaoka; and Department of Neurology (S. Kusunoki), Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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