Pediatric neurology
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Pediatric neurology · Feb 2015
ReviewNeurodevelopmental outcome after extreme prematurity: a review of the literature.
Advances in obstetric and neonatal medical care and assisted reproductive technology have increased the rates of preterm birth, decreased preterm mortality rates, and lowered the limit of viability. However, morbidity in survivors, including neurodevelopmental disabilities, has increased, especially in extremely preterm infants born at ≤25 weeks' gestation. A better understanding of the prevalence and patterns of adverse neurodevelopmental outcomes in extremely preterm infants is important for patient care, counseling of families, and research. ⋯ Infants who are born at ≤25 weeks' gestation, especially those born at 22 and 23 weeks' gestation, have a very low likelihood of surviving little or no impairment. Nearly half of surviving extremely premature infants have significant neurodevelopmental disabilities on short- and long-term follow-up. Instituting early intervention programs, providing family support, and establishing special educational school programs can pay high dividends and lead to brighter futures and, hence, help improve neurodevelopmental outcome of preterm infants.
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Pediatric neurology · Feb 2015
Post-traumatic epilepsy in children-experience from a tertiary referral center.
Post-traumatic epilepsy after a traumatic brain injury occurs in 10%-20% of children. Unfortunately, a biomarker that could provide prognostic information about both post-traumatic epilepsy and cognitive development is lacking. In this first of a series of studies, we have reviewed and analyzed clinical variables in children following traumatic brain injury to understand the epidemiologic and clinical characteristics of post-traumatic epilepsy in our urban population. ⋯ This study demonstrates a need for biomarkers in children following traumatic brain injury to reliably evaluate the risk of post-traumatic epilepsy.
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Pediatric neurology · Jan 2015
Susceptibility-weighted imaging helps to discriminate pediatric multiple sclerosis from acute disseminated encephalomyelitis.
Susceptibility-weighted imaging is a relatively new magnetic resonance imaging sequence that can identify lesions of multiple sclerosis in adults. This study was designed to determine if susceptibility-weighted imaging is a useful discriminator between children who develop multiple sclerosis and children with monophasic acute disseminated encephalomyelitis. ⋯ Susceptibility-weighted imaging may be a useful technique in differentiating acute disseminated encephalomyelitis from multiple sclerosis at initial presentation.
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Pediatric neurology · Jan 2015
Neurocognitive function in children after anterior temporal lobectomy with amygdalohippocampectomy.
We assessed the postoperative neurocognitive function after temporal lobectomy in children with temporal lobe epilepsy. ⋯ Temporal lobectomy in children did not provoke a significant decline in intelligence or memory function. Early surgical treatment in children with intractable seizures of temporal lobe origin may result in better neurocognitive outcomes.
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Pediatric neurology · Jan 2015
ReviewThe expanding spectrum of neurological phenotypes in children with ATP1A3 mutations, Alternating Hemiplegia of Childhood, Rapid-onset Dystonia-Parkinsonism, CAPOS and beyond.
ATP1A3 mutations have now been recognized in infants and children presenting with a diverse group of neurological phenotypes, including Rapid-onset Dystonia-Parkinsonism (RDP), Alternating Hemiplegia of Childhood (AHC), and most recently, Cerebellar ataxia, Areflexia, Pes cavus, Optic atrophy, and Sensorineural hearing loss (CAPOS) syndrome. ⋯ The phenotypic spectrum of ATP1A3-related neurological disorders continues to expand beyond the distinct yet overlapping phenotypes in patients with AHC, RDP, and CAPOS syndromes. ATP1A3 mutation analysis is appropriate to consider in the diagnostic algorithm for any child presenting with episodic or fluctuating ataxia, weakness or dystonia whether they manifest persistence of neurological symptoms between episodes. Additional work is needed to better identify and classify affected patients and develop targeted treatment approaches.