CPK-BB (CK-BB) isoenzyme is an intracellular enzyme released in various neurologic conditions, including central nervous system (CNS) infections. Activity of CK-BB in cerebrospinal fluid (CSF) was determined in 80 children by electrophoresis and densitometry. The possible correlation between CNS infection and CK concentrations was assessed. Significantly elevated concentrations of CK activity (P <0.01) in the CSF were found in children with bacterial meningitis as compared with children with either aseptic meningitis or normal CSF findings. The data suggest the possibility of utilizing CSF CK activity to differentiate between bacterial and viral meningitis in situations where a routine CSF examination is inconclusive.

We describe two children who presented with an acute encephalopathy preceded by a prodromal illness. The disease was marked by an active phase of coma or confusion with abnormal motor movements, followed by a recovery phase with a rapid return of motor function and a gradual improvement in speech and social behavior. No cause was found. These may be additional representative cases of a new syndrome of encephalopathy which is characterized by a distinctive course and a relatively good prognosis.

Between 1987 and 1990, seven children presented with acute cerebellar symptoms and serologic evidence suggestive of recent varicella infection. The neurological symptoms lasted for 1 to 3 weeks. Symptoms resolved spontaneously in all patients without residual signs or symptoms during a 2- to 3-year follow-up.

zure occurred on the following day, and again phenytoin was started at a dose of 3 mg/kg/day. Within 8 hours, the girl developed urinary retention. The blood level of phenytoin was 27 ~,~/mL. The patient was alert on the days of retention. On day 3, when she voided spontaneously, she was also able to pass stool. She had not experienced similar periods of urinary retention in the past. She had not received any other medications during the period of retention. On the 10th day, phenytoin therapy was discontinued, and the urinary retention resolved. At that time, the blood hydantoin level was 17 ~tg/mL. We performed several studies to rule out other possible causes of the urinary retention. Repeated urinalyses and urinary cultures were negative. Carbon dioxide cytometry was done for urodynamic evaluation using a transurethral catheter, while simultaneous pelvic floor electromyograph readings were made using perianal surface electrodes; all findings were normal. Phenytoin was changed to acetaz