Journal of Pediatric Epilepsy - Volume 2, issue 1

Authors: Lin, Doris D.M. | Gallagher, Anne

Article Type: Other

DOI: 10.3233/PEP-13045

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 1-2, 2013

Authors: Bourel-Ponchel, Emilie | Wallois, Fabrice

Article Type: Review Article

Abstract: Surgery is increasingly proposed as a treatment for children with medically refractory partial epilepsy. The outcome after surgery depends on complete resection of the epileptogenic zone correlates. Despite multimodal preoperative assessment, 40–60% of children require intracranial electroencephalography (EEG) recording. Standard EEG can be easily performed with 20 to 30 electrodes in children of all ages. Increasing the number of electrodes (high-density [HD] EEG) significantly improves the spatial resolution of EEG and allows source localization of the epileptogenic focus. In adults, this technique has been validated for source localization of the epileptic focus and contributes to a better understanding of the …neural networks involved in epilepsy. In this review, we discuss the pediatric specificities of HD EEG and source localization in order to define the value of this technique in the preoperative assessment of children with refractory partial epilepsy. Source localization using HD EEG requires several steps. The first step, elaboration of the head model, must take into account the heterogeneity of skull bone thickness, persistence of the fontanelles in younger infants, and the unknown conductivities of anatomical structures in children. The second step consists of defining the number of electrodes, which depends on the age and cortical gyration of the brain. Finally, after extraction of meaningful information (interictal or ictal features), the third step consists of defining the specific modalities required in pediatric subjects to resolve the inverse problem to determine source localization. Show more

Keywords: High-density EEG, children, epilepsy, source localization, ictal, inter-ictal spikes, seizures

DOI: 10.3233/PEP-13041

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 3-18, 2013

Authors: Mashayekh, Ameneh | Newberg, Andrew

Article Type: Research Article

Abstract: Single photon emission computed tomography (SPECT) and positron emission tomography (PET) offer valuable information for the diagnosis, management, and follow up of patients with seizure disorders. These imaging studies can also contribute to the understanding of the pathophysiology of epilepsy. Intractable epilepsy in children is a serious disorder that has an overwhelming effect on physical, psychological, and social development. Functional imaging with PET and SPECT has been useful in a variety of seizure types and is typically more sensitive compared to anatomic imaging methods such as magnetic resonance imaging for localizing non-lesional seizure foci. SPECT and PET may be useful …in guiding the strategy of implantation in patients submitted to undergo invasive recordings. However, the ability of PET and SPECT to localize a seizure focus may be crucial for tailoring the surgical resection area in patients with intractable seizures. Since most seizure cases begin in childhood, PET and SPECT imaging for seizure disorders is frequently used in this population. In this article, we review the literature on the current uses and indications of PET and SPECT in the study and management of epilepsy in children. Show more

Keywords: SPECT, PET, seizure, pediatric epilepsy, children epilepsy, functional brain imaging, neuroimaging, MRI

DOI: 10.3233/PEP-13038

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 19-31, 2013

Authors: Caruso, Paul A. | Johnson, Jason | Thibert, Ron | Rapalino, Otto | Rincon, Sandra | Ratai, Eva-Maria

Article Type: Review Article

Abstract: This chapter is a practical “why, how to, and when” chapter, written in three parts to address three questions that arise when the epileptologist or neuroimager evaluates a patient with epilepsy. Why do magnetic resonance spectroscopy (MRS)? How to do MRS in the patient with epilepsy? When, that is, in what clinical-imaging setting, can MRS help to diagnose or manage the patient with epilepsy?

Keywords: MRI, MRS, epilepsy, inborn error of metabolism, malformation of cortical development, focal cortical dysplasia, tumor, neoplasm

DOI: 10.3233/PEP-13046

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 33-48, 2013

Authors: Malfait, Domitille | Tucholka, Alan | Lippé, Sarah

Article Type: Review Article

Abstract: Diffusion-weighted magnetic resonance imaging (dMRI) is a unique tool, which allows non-invasive in-vivo assessment of the white matter integrity and characterization of the brain maturation process in normal and abnormal subjects. In this review, we briefly present dMRI techniques and methodologies for non-experts and we describe recent studies investigating the use of dMRI in pediatric epilepsy. The study of white matter connections can guide us in localizing epileptic foci. Moreover, it has been proven sensitive to white matter-invisible lesions, network reorganization, the effects of seizures on the brain network, and the development of lesions in children and adults. Taken …together, the results reviewed here suggest that dMRI is a valuable tool for assessing childhood epilepsy. However, studying dMRI in pediatric population is a challenge due to the high variability between age groups. In the quest for a deeper understanding of childhood epilepsies and brain abnormalities, dMRI protocols should be tested to determine the most sensitive parameters. Show more

Keywords: Diffusion-weighted MRI, diffusion tensor imaging, MRI, children, epilepsy, surgery

DOI: 10.3233/PEP-13039

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 49-61, 2013

Authors: Noulhiane, Marion | Pinabiaux, Charlotte | Jambaqué, Isabelle | Chiron, Catherine | Hertz-Pannier, Lucie

Article Type: Review Article

Abstract: New non-invasive functional magnetic resonance imaging (fMRI) techniques are deeply changing the exploration of epileptic and functional networks in childhood epilepsies, as well as of the normally developing brain. In this review, we first briefly describe the fMRI methods and the specificity, advantages and limitations of fMRI protocols and studies in pediatric epilepsies. Current fMRI applications in pediatric epilepsies mostly refer to presurgical mapping that can be performed with motor, language or memory tasks, and allows to select patients, tailor resection and sometimes predict postoperative cognitive outcome. Functional connectivity studies are currently emerging from resting state fMRI acquisitions to assess …the possible consequences of epileptic activity on the development of functional long distance networks. Future directions for research applications, especially connectivity analysis, and new developments such as electroencephalography-fMRI, will lead to better comprehensive descriptions of functional brain networks in pediatric epilepsy. Show more

Keywords: Functional magnetic resonance imaging, pediatric epilepsy, cognitive networks, resting state

DOI: 10.3233/PEP-13042

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 63-71, 2013

Authors: Papadelis, Christos | Harini, Chellamani | Ahtam, Banu | Doshi, Chiran | Grant, Ellen | Okada, Yoshio

Article Type: Review Article

Abstract: Magnetoencephalography (MEG) is a noninvasive neuroimaging tool that is increasingly becoming useful for presurgical delineation of epileptogenic zones and eloquent cortex in both lesional and non-lesional pediatric cases. During the past 10 yrs, the use of MEG in pediatric epilepsy research has increased. This paper starts with a review of the use of MEG in pediatric epilepsy. We then describe the protocol used for epilepsy patients at the pediatric MEG facility in Boston Children’s Hospital and present two case studies of intractable epilepsy obtained in our laboratory -cortical dysplasia and tuberous sclerosis complex -to illustrate our methodology in localizing epileptiform …generators. In both cases, we are able to localize generators of interictal spikes in the irritative zone just outside the lesion. We also present results on localization of the somatosensory cortex based on our pediatric MEG system to illustrate the utility of MEG for identification of the eloquent cortex. We complete this review by considering advantages and limitations of MEG in children with epilepsy, its future developments and research applications. Application of MEG in pediatric epilepsy will accelerate during the coming years as different types of pediatric whole-head MEG systems and more advanced data analysis methods become available to the researchers and clinicians. These advances will lead to greater use of MEG as a complement to clinical electroencephalography, with improved noninvasive delineation of the epileptogenic zone. Show more

Keywords: Magnetoencephalography, pediatric epilepsy, tuberous sclerosis complex, cortical dysplasia, pediatric magnetoencephalography systems, human brain development

DOI: 10.3233/PEP-13040

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 73-85, 2013

Authors: Gallagher, Anne

Article Type: Review Article

Abstract: Near infrared spectroscopy (NIRS) is a noninvasive neuroimaging technique that is highly suitable for pediatric populations due to its many advantages. In past decades, research on clinical applications and technical development of NIRS software and equipment has significantly increased, leading to greater use in children with epilepsy, especially for presurgical assessment. In this review, the NIRS signal and data acquisition are first described. Then, clinical applications in pediatric epilepsy, including the characterization and prediction of seizures, presurgical language mapping and epileptogenic zone localization, and detection of postsurgical cerebral reorganization are presented. Advantages and limitations of using NIRS in children with …epilepsy are also discussed. Finally, potential developments and research applications for NIRS in the pediatric population with epilepsy are proposed. Show more

Keywords: Near infrared spectroscopy, children, epilepsy, presurgical assessment, language mapping, epileptic focus localization, noninvasive neuroimaging

DOI: 10.3233/PEP-13044

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 87-92, 2013

Authors: Stafstrom, Carl E.

Article Type: Book Review

DOI: 10.3233/PEP-13043

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 93-94, 2013

Article Type: Other

DOI: 10.3233/PEP-13047

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 1, pp. 95-95, 2013