Pediatric neurology
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Pediatric neurology · Oct 2016
ReviewFellowship Training in the Emerging Fields of Fetal-Neonatal Neurology and Neonatal Neurocritical Care.
Neonatal neurocritical care is a growing and rapidly evolving medical subspecialty, with increasing numbers of dedicated multidisciplinary clinical, educational, and research programs established at academic institutions. The growth of these programs has provided trainees in neurology, neonatology, and pediatrics with increased exposure to the field, sparking interest in dedicated fellowship training in fetal-neonatal neurology. ⋯ With consistent implementation, the proposed model has the potential to establish recognized standards of professional excellence for training in the field, provide a pathway toward Accreditation Council for Graduate Medical Education certification for program graduates, and lead to continued improvements in medical and neurological care provided to patients in the neonatal intensive care unit.
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Pediatric neurology · Sep 2016
Case ReportsDiffuse Encephalopathy Associated with Isolated Cerebral Langerhans Cell Histiocytosis.
Langerhans cell histiocytosis is a rare disease of the monocyte-macrophage system. Abnormalities of the hypothalamic-pituitary region are common in individuals with central nervous system involvement. ⋯ Similar MRI findings have rarely been described in the literature. These findings represent part of the broad neuroradiological spectrum of Langerhans cell histiocytosis of the nervous system in children.
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Pediatric neurology · Aug 2016
Double Inversion Recovery Magnetic Resonance Imaging in Identifying Focal Cortical Dysplasia.
Focal cortical dysplasia is commonly recognized in pediatric epilepsy surgery. Despite characteristic radiographic features, focal cortical dysplasia can be subtle on magnetic resonance imaging. Double inversion recovery acquisition suppresses the white matter signal, which may enhance visualization of abnormal features at the gray-white matter interface. We assessed the ability of double inversion recovery to distinguish focal cortical dysplasia from periventricular nodular heterotopia and normal brain. ⋯ Double inversion recovery is sensitive for detection of focal cortical dysplasia with experienced users, particularly when there is consensus agreement. The use of two clinically available magnetic resonance imaging acquisitions-double inversion recovery and another sequence with high specificity such as MPRAGE-would be complementary in the evaluation of lesional epilepsy.
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Pediatric neurology · Jun 2016
Review Case ReportsRethinking the Magnetic Resonance Imaging Findings in Early Rasmussen Encephalitis: A Case Report and Review of the Literature.
We present a child with Rasmussen encephalitis and highlight the pitfalls of diagnosis when magnetic resonance imaging (MRI) is negative for atrophy. We review the literature regarding this issue, introduce the FreeSurfer software as a potential means of noninvasive diagnosis, and discuss methods for prompt and definitive treatment. ⋯ The Bien criteria have poor sensitivity for the diagnosis of Rasmussen encephalitis when the MRI is negative for atrophy. Tissue diagnosis is essential in such instances. We suggest a high clinical index of suspicion and multidisciplinary collaboration between radiology, pathology, and neurosurgery to facilitate a greater emphasis on biopsy followed by hemispherotomy as definitive therapy for individuals with early Rasmussen encephalitis.
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Pediatric neurology · May 2016
Case ReportsThe Use of Magnetic Resonance Spectroscopy in the Evaluation of Pediatric Patients With Seizures.
The objective was to determine if it is useful to routinely add magnetic resonance spectroscopy (MRS) to magnetic resonance imaging (MRI) in the evaluation of seizure in the pediatric patient. Specifically, how often does MRS contribute information to conventional MRI? ⋯ These results suggest that MRS is a useful evaluation tool in addition to MRI for children undergoing imaging for the evaluation of seizures.