To the Editor.—
I read with interest the report in the Archives by Schoenberg et al (34:511-512, 1977) of a 7-year-old girl with moyamoya disease who had seizures and headache, which the authors state is a rare phenomenon. I think some comment is warranted.Analysis of a series of 111 patients by Nishimoto and Takeuchi1 resulted in their finding that convulsions and headaches were relatively common. Of 73 patients younger than 16 years old, seizures were an initial symptom in 15 and the primary reason for seeking medical attention in all but one of these. In a single year at Duke, I cared for four children in whom this diagnosis was proved. Seizure was the initial symptom in one girl who experienced prolonged focal convulsions at the ages of 13 and 22 months, two years prior to the development of repeated ischemic events at the age of 4 years.
Sunder TR. Moyamoya Disease. Arch Neurol. 1979;36(1):59–60. doi:10.1001/archneur.1979.00500370089031
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