Journal of Pediatric Epilepsy - Volume 2, issue 4

Authors: Potvin, Deborah | Nussbaum, Nancy

Article Type: Review Article

Abstract: In considering noninvasive alternatives to the Wada test, reviews of the adult literature on language lateralization have touted the possibilities and promises of functional magnetic resonance imaging for localizing language prior to surgery for intractable epilepsy. However, even as research continues to examine the benefits of pursuing a surgical treatment for intractable epilepsy in young children, the literature on alternative methods of language lateralization remains considerably less developed than the adult literature. In addition to functional magnetic resonance imaging, potential alternative methods include functional transcranical Doppler, magnetoencephalography, near infrared spectroscopy, and dichotic listening. This paper examines current research on the …use of these alternative methods in order to provide an introduction to the clinical possibilities and challenges in using each method with children with the cognitive or behavioral limitations often associated with intractable epilepsy. Show more

Keywords: Epilepsy, dichotic listening, fMRI, fTCD, NIRS, MEG

DOI: 10.3233/PEP-14067

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 215-221, 2013

Authors: Das, Pijush | Bindu, Parayil S. | Bharath, Rose D. | Saini, Jitender S. | Prasad, Chandrajit | Sinha, Sanjib

Article Type: Review Article

Abstract: We analyzed the magnetic resonance imaging (MRI) observations and their clinical correlates in a large cohort of children with epilepsy. This observational study prospectively included 144 children with epilepsy (male/female = 73/71; mean age = 5.87 ± 4.19 yr duration = 2.74 ± 2.79 yr), who were evaluated with cranial MRI and phenotypic data. The seizures types were partial 67; generalized 72, and unclassified five. Ninety-four (65.28%) patients had abnormal MRI findings. The common MRI findings included atrophy in 58 [diffuse 33; focal 25]; signal changes in 61 [T2-weighted hyperintense with T1-weighted hypointense to isointense in 58; T1-weighted hyperintense in …two patients T2-weighted hypointense in one]; and ventriculomegaly in 29. Among 41 children with both computerized tomography and MRI of brain, 10 were normal, while MRI had better delineation in 17 children and concordant in rest 14. Electroencephalography was abnormal in 104 (72.22%). The syndromic subtypes were structural/metabolic (symptomatic) in 95 (acute in eight); unknown (cryptogenic) in 45; and genetic (idiopathic) in six patients. Based on the imaging and other electroclinical features the final diagnosis in the symptomatic subgroup were hypoxic ischemic encephalopathy in 27; developmental malformation in 14; poliodystrophy in 13; leukoencephalopathy in seven; granuloma in seven; tumor in four; ischemic in three; meningoencephalitis in three; Rasmussen’s encephalitis in three; progressive cerebral degeneration in three; chromosomal in two; neurocutaneous in two; developmental in two; and metabolic; gliosis; storage, hippocampal sclerosis, calcification in one each cases. Seizure freedom for >1 yr was noted in 50%. Show more

Keywords: Epilepsy, cause, epilepsy syndrome, MRI, pediatrics, seizures

DOI: 10.3233/PEP-14065

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 223-228, 2013

Authors: Gatta, Michela | Toffoli, Elisa | Spoto, Andrea | Salmaso, Ambra | Canetta, Elisabetta | Toldo, Irene | Battistella, Pier A. | Boniver, Clementina

Article Type: Review Article

Abstract: This study investigates the relationship between temperament and psychopathology in children with idiopathic epilepsy (CWIE). The parents of 42 children between 4 and 12 yr of age with idiopathic epilepsy were administered the Child Behavior Checklist to assess their children’s behavior and the Italian Questionnaires about temperament to assess their temperament. Multiple linear regression analysis was used to compare the results with those of two control groups, one consisting of 62 children (aged 5–12 yr) with primary migraine (CWPM), the other of 74 children (aged 3–11 yr) who underwent neuropsychiatric assessment for emotional distress. The temperamental dimension of inhibition to …novelty was found significant in predicting problems of internalizing behavior in both CWIE and CWPM, while externalizing behavior issues were predicted by the negative emotionality dimension in CWIE and by the inhibition to novelty and motor activity dimensions in CWPM. The results of this study suggest that temperament is one of the predictors of the onset of psycho-behavioral disorders in CWIE. Show more

Keywords: Idiopathic epilepsy, temperament, psychopathology, behavioral problems, childhood

DOI: 10.3233/PEP-14063

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 229-237, 2013

Authors: Kumandas, Sefer | Poyrazoglu, Hatice G. | Per, Huseyin | Kuyucu, Tamer | Gumus, Hakan | Saraymen, Recep

Article Type: Review Article

Abstract: West syndrome (WS) is an epileptic syndrome of early childhood. There have been a limited numbers of studies of cerebrospinal fluid (CSF) excitatory amino acid (EAA), nitric oxide (NO), and malondialdehyde (MDA) levels, as well as plasma levels of EAA, and NO, in WS. In this article, CSF EAA, NO, and MDA levels and plasma EAA, NO status, and a determination of the effects of antiepileptic drug therapy on these values were investigated in children with WS. Evaluation of CSF and serum EAA, NO, and MDA levels and of serum EAA and NO levels after 3 mo of antiepileptic drug …therapy revealed a statistically significant decrease in CSF aspartate, glutamate, NO and MDA levels. In conclusion, the decrease in CSF MDA levels in this study is the result of both the decrease in glutamate activity and neuronal damage after controlling seizures with antiepileptic drugs. Show more

Keywords: Excitatory amino acid, nitric oxide and malondialdehyde, West syndrome, treatment

DOI: 10.3233/PEP-14068

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 239-243, 2013

Authors: Chakraborty, Debabrata | Ganguly, Goutam | Ray, Biman K. | Paul, Neelanjana | Roy, Arijit | Pandit, Alak | Senapati, Asit K.

Article Type: Review Article

Abstract: Around 50% of epilepsy begins in childhood or adolescence. Behavioral and cognitive problems are encountered in 20–30% of them. There are only few studies on this subject from India. Aims of the study were to determine the frequency and spectrum of behavioral disorders and cognitive impairment in school going epileptic children (4–15 yr). Patients were selected from the Epilepsy Clinic, Neurology Indoor and Outpatient Department of Bangur Institute of Neurosciences. Children with low intelligence quotient, having medical co-morbidities were excluded. Behavioral impairment was assessed by Childhood Behavior Checklist score. Cognitive impairment was assessed by comparing the rank and attendance of …the student before and after the seizure onset from interview and by modified National Institute of Mental Health and Neurosciences battery scale. Results showed that out of 150 children, 68.70% had generalized and 31.30% had localization related epilepsy. Aggressive and destructive behavior was mostly noted in children in the age group 4–6 yr and those on polytherapy having longer duration and increased frequency of seizure. Overall, cognitive impairment was present in 54% of children and with sustained attention being mostly affected. We concluded in this preliminary observational study that behavioral abnormality was present in 74% epileptic children and 8% of controls; cognitive impairment in the form of ill-sustained attention in 78.75% cases and 0.60% controls. Show more

Keywords: School children, epilepsy, behavioral disorder, cognitive dysfunction

DOI: 10.3233/PEP-14062

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 245-253, 2013

Authors: Hino-Fukuyo, Naomi | Sato, Yuko | Kakisaka, Yosuke | Endo, Wakaba | Kubota, Yuki | Kikuchi, Atsuo | Kobayashi, Tomoko | Haginoya, Kazuhiro | Uematsu, Mitsugu | Numata, Yurika | Doi, Hiroshi | Mori, Masato | Osaka, Hitoshi | Kure, Shigeo

Article Type: Other

Abstract: Treatment of west syndrome in patients with tuberous sclerosis, the relevant effective period and doses of vigabatrin (VGB) to avoid serious side effects still needs further investigation. We report on a Japanese girl who showed good results with a very low dose of VGB. Tonic spasms appeared at 5 mo of age. Adrenocorticotropic hormone therapy resulted in incomplete seizure control. VGB at the lowest practical dose (30 mg/kg/d) showed complete control after 3 d. With reduction of the dose to 10 mg/kg/d, side effects such as hyperactivity, irritability, and sleep disturbances improved. She was seizure-free for the next 6 mo …with an improved developmental quotient. Ophthalmological evaluation revealed no abnormality. The present case illustrates that low-dose VGB therapy (10 mg/kg/d) has fewer side effects and may bring prompt seizure control in west syndrome with tuberous sclerosis. Show more

Keywords: West syndrome, infantile spasms, tuberous screlosis complex, vigabatrin

DOI: 10.3233/PEP-14064

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 255-258, 2013

Authors: Gowda, Vykuntaraju K.N. | Reddy, Bharath | Madivala, Bhaskar V. | Ramaswamy, Premalatha | Gowda, Sarala HS. | Govindraj,

Article Type: Other

Abstract: We report a case of Kearns-Sayre syndrome in 10-year-old boy, who presented with epilepsia partialis continua. Laboratory investigations revealed an elevated creatine kinase, serum lactate and cerebrospinal fluid protein. The subject was treated with multiple antiepileptic medications and megavitamins and the seizures decreased over a period of 2 wk.

Keywords: Kearns-Sayre syndrome, epilepsia partialis continua

DOI: 10.3233/PEP-14066

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 259-261, 2013

Article Type: Other

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 263-265, 2013

Article Type: Other

Citation: Journal of Pediatric Epilepsy, vol. 2, no. 4, pp. 267-268, 2013