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https://www.readbyqxmd.com/read/29027866/magnetic-resonance-imaging-guided-laser-interstitial-thermal-therapy-as-treatment-for-intractable-insular-epilepsy-in-children
#1
M Scott Perry, David J Donahue, Saleem I Malik, Cynthia G Keator, Angel Hernandez, Rohit K Reddy, Freedom F Perkins, Mark R Lee, Dave F Clarke
OBJECTIVE Seizure onset within the insula is increasingly recognized as a cause of intractable epilepsy. Surgery within the insula is difficult, with considerable risks, given the rich vascular supply and location near critical cortex. MRI-guided laser interstitial thermal therapy (LiTT) provides an attractive treatment option for insular epilepsy, allowing direct ablation of abnormal tissue while sparing nearby normal cortex. Herein, the authors describe their experience using this technique in a large cohort of children undergoing treatment of intractable localization-related epilepsy of insular onset...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29023307/interrater-agreement-of-eeg-interpretation-after-pediatric-cardiac-arrest-using-standardized-critical-care-eeg-terminology
#2
Nicholas S Abend, Shavonne L Massey, Mark Fitzgerald, France Fung, Natalie J Atkin, Rui Xiao, Alexis A Topjian
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category...
October 10, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29019042/long-term-outcomes-of-adult-medulloblastoma-patients-treated-with-radiotherapy
#3
Brian De, Kathryn Beal, Kevin C De Braganca, Mark M Souweidane, Ira J Dunkel, Yasmin Khakoo, Stephen W Gilheeney, Lisa M DeAngelis, Paul Menzel, Suchit H Patel, Suzanne L Wolden
Medulloblastoma (MB) is rare in adults and treatment guidelines are consequently not well-established. Few modern series have reported long-term follow-up and treatment sequelae. We examined long-term outcomes of adult MB patients at one institution. Records of 29 consecutive patients (18 male, 11 female) aged ≥ 18 years who received radiotherapy (RT) for primary MB from 1990 to 2016 were reviewed. Median age at diagnosis was 28 years (range 18-72 years). Seventeen patients were standard risk and 12 were high risk...
October 10, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29017082/temporal-lobe-surgery-for-intractable-epilepsy-in-children-what-to-do-with-the-hippocampus
#4
Mony Benifla, Odeya Bennet-Back, Zamir Shorer, Iris Noyman, Rima Bar-Yosef, Dana Ekstein
PURPOSE: Resection of the hippocampus can cause verbal memory decline, especially in the pediatric population. Thus, preservation of the hippocampus can be crucial for the quality of life of children with intractable temporal lobe epilepsy (TLE) who are candidates for epilepsy surgery. We investigated techniques that determine whether the hippocampus is part of the epileptogenic zone and the outcomes of pediatric surgery aimed to spare the hippocampus. METHODS: We accessed data of children with normal hippocampus on MRI, who underwent surgery for medically refractory TLE...
October 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29017081/safety-of-intravenous-lacosamide-in-critically-ill-children
#5
Sarah S Welsh, Nan Lin, Alexis A Topjian, Nicholas S Abend
PURPOSE: Acute seizures are common in critically ill children. These patients would benefit from intravenous anti-seizure medications with few adverse effects. We reviewed the usage and effects of intravenous lacosamide in critically ill children with seizures or status epilepticus. METHODS: This retrospective series included consecutive patients who received at least one dose of intravenous lacosamide from April 2011 to February 2016 in the pediatric intensive care unit of a quaternary care children's hospital, including patients with new lacosamide initiation and continuation of outpatient oral lacosamide...
October 3, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29017073/noninvasive-detection-of-focal-brain-hyperthermia-related-to-continuous-epileptic-activities-using-proton-mr-spectroscopy
#6
Daichi Sone, Naoki Ikegaya, Akio Takahashi, Kaoru Sumida, Miho Ota, Takashi Saito, Yukio Kimura, Hiroshi Matsuda, Noriko Sato
Recent studies using rat models suggested that epileptic discharges (EDs) can induce focal brain hyperthermia, but such ED-related hyperthermia has not been confirmed in humans. We examined hyperthermia of the focus of epilepsy using noninvasive proton magnetic resonance spectroscopy ((1)H-MRS) thermometry. We recruited six pediatric patients with refractory daily seizures, continuous interictal epileptic discharges, and concordant focus lesions on MRI who had undergone comprehensive presurgical exams. (1)H-MRS thermometry calculated the temperatures of the presumed epileptogenic lesions, and we examined the contralateral counterparts in each patient as controls...
October 6, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#7
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28989169/moyamoya-disease-in-an-18-month-old-female-caucasian-complicated-by-cerebral-hyperperfusion-syndrome-following-indirect-revascularization
#8
James Murchison, John M Wilson, Coby Ray, Jessica Ginsberg, Laszlo Nagy
BACKGROUND Cerebral hyperperfusion syndrome is a rare complication of indirect revascularization due to moyamoya disease, but has not been reported previously in the pediatric population. We present a case of an 18-month-old girl with moyamoya disease that was treated with bilateral pial synangiosis and had complications consistent with cerebral hyperperfusion syndrome. This case report discusses the pathophysiological mechanisms involved in cerebral hyperperfusion in moyamoya syndrome. CASE REPORT An 18-month-old female Caucasian presented with seizures and weakness of the left side...
October 9, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28987645/tumefactive-demyelinating-lesions-tdls-a-case-series-of-clinicoradiological-features
#9
Rajendra Singh Jain, Ibraheem Khan, Kapil Kandelwal, Tushar Desai
OBJECTIVE: Diagnosis of tumefactive demyelination lesions (TDLs) is challenging to neurophysician, neuroradiologist or neurosurgeon. Our objective in this study was to analyze clinicoradiological features of TDLs. PATIENTS AND METHOD: A retrospective analysis with prospective follow-up of 11 cases of TDLs was performed. Study was conducted in the neurology department of a tertiary care centre of North-West India from August 2014 to March 2017. MRI of brain and cervical spine with contrast, visual evoked potential, oligoclonal bands, serum anti-AQP4 antibody and MRS performed in most of the patients...
September 29, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28977297/initial-clinical-presentation-in-cases-of-inborn-errors-of-metabolism-in-a-reference-children-s-hospital-still-a-diagnostic-challenge
#10
Andressa Romão, Priscila Endlich Alves Simon, José Eduardo Coutinho Góes, Louise Lapagessede Camargo Pinto, Roberto Giugliani, Gisele Rozone de Luca, Francisca Ligia Cirilo Carvalho
OBJECTIVE: To assess the initial clinical presentation of confirmed cases of inborn errors of metabolism (IEM) at a reference facility for pediatric care. METHODS: Cross-sectional, observational and descriptive study with data collection of outpatients, from January 2009 to December 2013. Inclusion criterion: referral to IEM investigation. Exclusion criterion: prior diagnosis of IEM. Analyzed variables: identification data; status of diagnostic investigation; family history of IEM; initial clinical presentation, laboratory abnormalities related to the hypothesis of IEM...
July 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28973391/postoperative-epileptic-seizures-in-children-is-the-brain-incision-a-risk-factor
#11
Luca Massimi, Domenica Battaglia, Federico Bianchi, Simone Peraio, Elisabetta Peppucci, Concezio Di Rocco
BACKGROUND: Postoperative seizures (PSs) after neurosurgical operations are common but little is known about the role of surgical brain incision on their genesis. This topic has not been addressed so far. OBJECTIVE: To verify if the corticotomy affects the risk of PSs and postoperative epilepsy (PE) in children. METHODS: One hundred forty-three consecutive pediatric cases operated on for supratentorial lesions at the same institution in the last 15 yr have been retrospectively reviewed by dividing them into group A, 68 children who required brain corticotomy mainly for hemispheric tumors, and group B, 75 children treated through extracortical approaches mainly for suprasellar and optic tumors...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28963933/functional-surgery-in-pediatric-drug-resistant-posterior-cortex-epilepsy-electro-clinical-findings-cognitive-and-seizure-outcome
#12
A Sierra-Marcos, M C Fournier-Del Castillo, J Álvarez-Linera, M Budke, M García-Fernández, M A Pérez-Jiménez
PURPOSE: Epilepsies originated from the occipital, parietal and/or the posterior edge of the temporal lobe are grouped together into posterior cortex epilepsy (PCE). Our objective was firstly to describe electro-clinical and imaging findings in the presurgical evaluation of children with PCE, and secondly to identify potential factors associated with surgical and cognitive outcomes. METHOD: From the total of patients referred to the Epilepsy Monitoring Unit of 'Hospital Universitario Niño Jesús' from 2003 to 2016, 55 had drug-resistant PCE...
September 22, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28957722/relationship-between-iron-deficiency-anemia-and-febrile-seizures-in-children-a-systematic-review-and-meta-analysis
#13
Byung Ok Kwak, Kyungmin Kim, Soo-Nyung Kim, Ran Lee
PURPOSE: The association between iron deficiency anemia (IDA) and febrile seizures (FS) during childhood is inconclusive due to inconsistent results reported in different studies. We performed a systematic review and meta-analysis to determine an association between IDA and FS in children. METHODS: We searched PubMed, EMBASE, and Cochrane Library databases for studies published up to August 2015 using the following key words: ["iron deficiency" OR "iron status"] AND ["febrile seizure" OR "febrile convulsion"] AND ["pediatric" OR "infant" OR "child"]...
September 15, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28944533/parents-spend-an-average-of-nine-hours-a-day-providing-palliative-care-for-children-at-home-and-need-to-maintain-an-average-of-five-life-saving-devices
#14
P Lazzarin, B Schiavon, L Brugnaro, F Benini
AIM: This Italian study investigated home-based palliative care for young children and how long it took parents to meet their needs. METHODS: The study population consisted of 33 families with a child under the responsibility of the Veneto Regional Center for Pediatric Palliative Care, northern Italy, who needed medical support in at least two of the following areas: respiratory, feeding, pain and seizures. RESULTS: The children had a mean age of 6...
September 25, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28943819/evaluation-of-safety-in-exceeding-maximum-adult-doses-of-commonly-used-second-generation-antiepileptic-drugs-in-pediatric-patients
#15
Mindl M Messinger, Sunita N Misra, Gary D Clark, Shannon M DiCarlo
OBJECTIVE: Pediatric patients often require larger doses of antiepileptic drug (AED) than adults in order to attain therapeutic serum concentrations and/or achieve seizure control. Safety and efficacy data are often extrapolated from adult literature; hence, optimal dosage may only be determined anecdotally or based on expert opinion. With limited pediatric dosing guidelines, milligrams per day that are based on weight may exceed the maximum adult dose. The primary objective of this study is to evaluate the safety of exceeding maximum doses as specified by the US Food and Drug Administration or manufacturers of commonly used AEDs in pediatric patients...
July 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28941387/management-protocols-for-status-epilepticus-in-the-pediatric-emergency-room-systematic-review-article
#16
REVIEW
Cheuk C Au, Ricardo G Branco, Robert C Tasker
OBJECTIVE: This systematic review of national or regional guidelines published in English aimed to better understand variance in pre-hospital and emergency department (ED) treatment of status epilepticus. SOURCES: Systematic search of national or regional guidelines (January 2000 to February 2017) contained within PubMed and Google Scholar databases, and article reference lists. The search keywords were status epilepticus, prolonged seizure, treatment, and guideline...
September 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28929415/pediatric-neurocysticercosis
#17
REVIEW
Pratibha Singhi, Arushi Gahlot Saini
Neurocysticercosis is the most common helminth infection of nervous system in humans caused by the encysted larvae of Taenia solium. It is a major cause of epilepsy in tropical areas and the most common cause of focal-onset seizures in North Indian children. Children with neurocysticercosis have pleomorphic manifestations depending on the location, number and viability of the cysts and host response. In endemic areas, neurocysticercosis should be clinically suspected in any child with recent-onset seizures, headache or focal motor deficits where there is no other suggestion of an underlying neurological disorder...
September 20, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28928561/periprocedural-management-of-vein-of-galen-aneurysmal-malformation-patients-an-11-year-experience
#18
Ajay Prasad Hrishi, Karen Ruby Lionel
CONTEXT: The vein of Galen aneurysmal malformation (VGAM) is a rare arteriovenous malformation where a dilated median prosencephalic vein provides a low-resistance conduit for intracerebral blood flow resulting in high-output cardiac failure, severe pulmonary hypertension, with or without central nervous system symptoms secondary to hydrocephalus, in the neonatal and pediatric population. AIM: This study aims to analysis of the anesthetic management of this unique subset of patients with VGAM...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926844/atypical-presentation-of-a-pediatric-cerebellar-ganglioglioma
#19
Richard Bram, Roberta J Seidman, David Chesler
BACKGROUND/AIMS: Gangliogliomas (GGs) are rare central nervous system tumors occurring primarily in the supratentorial compartment with infratentorial instances most often involving the brain stem. Infratentorial GGs typically present with signs and symptoms of increased intracranial pressure (ICP), cranial nerve deficits, or focal cerebellar findings; rarely, these tumors have been associated with focal seizures. METHODS: In this report, we describe an atypical presentation of a cerebellar GG in a 20-month-old male who initially presented with syncope and emesis in the absence of electrographic evidence of seizures, radiographic evidence of hydrocephalus, or elevated ICP...
September 20, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28922267/the-1-year-follow-up-clinic-for-neonates-and-children-after-respiratory-extracorporeal-membrane-oxygenation-support-a-10-year-single-institution-experience
#20
Suzan Kakat, Maura O'Callaghan, Liz Smith, Raymond Hreiche, Deborah A Ridout, Jo Wray, Timothy Thiruchelvam, Katherine L Brown, Aparna U Hoskote
OBJECTIVES: To establish the effectiveness of a "1-year extracorporeal membrane oxygenation follow-up clinic" and to characterize any neurodevelopmental concerns identified. DESIGN: Single-center retrospective cohort of respiratory extracorporeal membrane oxygenation survivors over 10 years. SETTING: Nationally commissioned center for neonatal and pediatric (> 28 d of life) respiratory extracorporeal membrane oxygenation. PATIENTS: Children attending the follow-up clinic 1 year after receiving respiratory extracorporeal membrane oxygenation between 2003 and 2013...
September 15, 2017: Pediatric Critical Care Medicine
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