Publications in Pediatric Epilepsy: Using Bibliometrics to Determine Readings in the Field.

Bibliometrics and citation analysis are popular forms of analyzing medical literature based on article impact as determined by the number of citations an article has received from other publications. Many bibliometric studies published within the past 10 years have assembled lists of highly cited papers, top 100 papers, or citation classics of specialties, subspecialties, and specific morbidities. For pediatric epilepsy, there is only 1 study that bibliometrically examines articles in this subspecialty.

Clinical Utility of Transcranial Magnetic Stimulation (TMS) in the Presurgical Evaluation of Motor, Speech, and Language Functions in Young Children With Refractory Epilepsy or Brain Tumor: Preliminary Evidence.

Accurate presurgical mapping of motor, speech, and language cortices, while crucial for neurosurgical planning and minimizing post-operative functional deficits, is challenging in young children with neurological disease. In such children, both invasive (cortical stimulation mapping) and non-invasive functional mapping imaging methods (MEG, fMRI) have limited success, often leading to delayed surgery or adverse post-surgical outcomes. We therefore examined the clinical utility of transcranial magnetic stimulation (TMS) in young children who require functional mapping.

Utility of Epilepsy Surgery in Survivors of Childhood Cancer.

Resection of an epileptogenic focus improves seizure control in patients with drug-resistant epilepsy. There is little data available on usefulness of epilepsy surgery in childhood cancer survivors with drug-resistant epilepsy. To learn about seizure outcome after epilepsy surgery in childhood cancer survivors, we retrospectively reviewed charts of 42 children who were referred to an epilepsy center for surgical evaluation.

Intractable Generalized Epilepsy and Autosomal Dominant Hypocalcemia: A Case Report.

Calcium-sensing receptor gain-of-function mutations are known to cause autosomal dominant hypocalcemia and independently an epilepsy syndrome. We report the unique case of a child with both intractable generalized epilepsy and a chronic abnormality in calcium homeostasis due to a calcium-sensing receptor gene mutation. She is a 16-year-old female who began having staring events around 3 years of age.

Congenital Ocular Neuromyotonia with Partial Third Nerve Palsy.

Purpose: We report the first case of congenital ocular neuromyotonia (ONM) and the results of strabismus surgery for this patient's co-existing cranial nerve (CN) III palsy.

Patients And Method: The patient presented at 18 months with strabismus that had reportedly been present since the time of birth. On exam, she had persistent exotropia (RXT) and hypertropia (RHT) with episodes of esotropia in the right eye that could be evoked by sustained left gaze.

Vagus Nerve Stimulation in Intractable Epilepsy Associated With SCN1A Gene Abnormalities.

Mutations in the SCN1A gene cause a spectrum of epilepsy syndromes. There are 2 syndromes that are on the severe end of this spectrum. The classic severe form, Dravet syndrome, is an epileptic encephalopathy of childhood, causing cognitive decline as well as intractable seizures.

SmartWatch by SmartMonitor: Assessment of Seizure Detection Efficacy for Various Seizure Types in Children, a Large Prospective Single-Center Study.

Introduction: Patients with epilepsy and their caregivers are constantly burdened with the possibility of a seizure and its consequences, such as accidents, injuries, and sudden unexplained death in epilepsy. It is the unpredictable nature of seizures that often affects both patients with seizures and their caregivers, limits independence, and hinders quality of life. There are several types of motion detectors on the market, each with varying degrees of sensitivity.

Clinical Applications of Transcranial Magnetic Stimulation in Pediatric Neurology.

Noninvasive brain stimulation is now an accepted technique that is used as a diagnostic aid and in the treatment of neuropsychiatric disorders in adults, and is being increasingly used in children. In this review, we will discuss the basic principles and safety of one noninvasive brain stimulation method, transcranial magnetic stimulation. Improvements in the spatial accuracy of transcranial magnetic stimulation are described in the context of image-guided transcranial magnetic stimulation.

Diffusion tensor imaging to evaluate commissural disconnection after corpus callosotomy.

Introduction: Corpus callosum transection can prevent propagation of epileptic discharges. If seizures persist after surgery, assessment of the efficacy of the transection requires knowledge that the commissural fibers have been disrupted. We evaluated whether diffusion tensor imaging (DTI) and diffusion tensor fiber tracking can assess the degree of callosal transection and determine which white matter pathways remain intact.

Cerebellar seizures.

Epilepsy, especially with refractory seizures, is thought to arise only from cortical lesions or substrate. The authors report on 2 patients with refractory epilepsy and cerebellar lesions. Depth electrodes were placed within the cerebellar lesions in both patients, and intracranial electroencephalographic recordings showed seizure origin from the cerebellar lesions.

Prospective Study of the Emfit Movement Monitor.

Sudden unexplained death in epilepsy (SUDEP) is associated with generalized tonic-clonic seizures and occurs most often when patients are in bed. There are several seizure detection monitors on the market, but little data are available on the sensitivity and specificity of these devices. We recently tested 2 models of seizure detection alarms with disappointing results.

Prospective Study of 2 Bed Alarms for Detection of Nocturnal Seizures.

For parents of children with epilepsy, seizures occurring in sleep are a major concern. Risk factors for sudden unexplained death in epilepsy patients include being in bed and generalized tonic-clonic seizures. A device for detecting nocturnal seizure activity would be valuable.

Passive language mapping with magnetoencephalography in pediatric patients with epilepsy.

Object: Functional mapping is important for determining surgical candidacy and also in epilepsy surgery planning. However, in young children and uncooperative patients, language mapping has been particularly challenging despite the advances in performing noninvasive functional studies. In this study the authors review a series of children with epilepsy who underwent language mapping with magnetoencephalography (MEG) while sedated or sleeping, to determine receptive language localization for presurgical evaluation.

Mesial temporal sclerosis in a cohort of children with SCN1A gene mutation.

Mesial temporal sclerosis is uncommon in childhood but has been associated with febrile status epilepticus. SCN1A gene mutations are linked to multiple epilepsy syndromes with patients frequently presenting with prolonged febrile seizures. After observing mesial temporal sclerosis in a child with SCN1A gene mutation, we retrospectively reviewed magnetic resonance imaging (MRI) findings in all patients with SCN1A gene mutation identified between 2005 and 2010.

Rapid infusion of a loading dose of intravenous levetiracetam with minimal dilution: a safety study.

Intravenous antiepileptic drugs are required in patients needing urgent treatment or unable to take oral medication. The safety of intravenous levetiracetam has been established in prospective studies of adult epilepsy and healthy participants. The authors performed a prospective, single-center study to evaluate the safety of a rapid loading dose of intravenous levetiracetam.

A case that is not for the faint of heart.

A 5-year-old was admitted after an episode of loss of consciousness and an episode of convulsive activity. Information that aids in differentiating seizures and syncope is discussed.

Pediatric extratemporal epilepsy presenting with a complex auditory aura.

Introduction: Ear plugging (placing fingers in or covering the ears) is a clinical seizure semiology that has been described as a response to an unformed, auditory hallucination localized to the superior temporal neocortex. The localizing value of ear plugging in more complex auditory hallucinations may have more involved circuitry. We report on one child, whose aura was a more complex auditory phenomenon, consisting of a door opening and closing, getting louder as the ictus persisted.

Benign rolandic epilepsy -- perhaps not so benign: use of magnetic source imaging as a predictor of outcome.

The purpose of this study was to evaluate children with benign rolandic epilepsy, a childhood epilepsy characterized by centrotemporal/rolandic spike-wave discharges with infrequent partial seizures that may secondarily generalize. Recently, some investigators have questioned whether benign rolandic epilepsy is indeed "benign" or whether long-term cognitive outcome may be adversely affected. We initiated an ongoing study to identify children with benign rolandic epilepsy.

Pediatric experience with sudden unexplained death in epilepsy at a tertiary epilepsy center.

Sudden unexplained death in epilepsy is rare in children, and few studies report risk factors. We reviewed our experience with 17 cases of sudden unexplained death in epilepsy to determine risk factors in children. The charts of all patients with onset of epilepsy at less than age 18 years who suffered sudden unexplained death in epilepsy between August 1992 and April 2004 at our epilepsy center were retrospectively reviewed.

Childhood mesial temporal sclerosis.

The prevalence and clinical characteristics of mesial temporal sclerosis have not been well studied in children. All brain magnetic resonance imaging (MRI) reports of children less than 14 years of age were reviewed from two tertiary institutions. A 52-month period from one institution and a 37-month period from the other were reviewed.

Right-sided vagus nerve stimulation as a treatment for refractory epilepsy in humans.

Purpose: We present three children who underwent right-sided vagus nerve stimulation (R-VNS). This treatment option for people with refractory epilepsy has not been described in children.

Methods: We reviewed our database of >350 patients implanted with vagus nerve stimulators and now describe our experience in three patients with R-VNS for the treatment of intractable seizures.

Magnetic resonance imaging detection of mesial temporal sclerosis in children.

The objective of this study was to investigate the prevalence and clinical characteristics of mesial temporal sclerosis as diagnosed by brain magnetic resonance imaging in children. A total of 390 consecutive brain magnetic resonance imaging studies in children were reviewed for evidence of mesial temporal sclerosis. Subsequently, the magnetic resonance imaging scans and charts of patients with mesial temporal sclerosis were reviewed and their clinical details were evaluated.

The ketogenic diet: adolescents can do it, too.

Purpose: To determine both the efficacy of and compliance with the ketogenic diet in the adolescent population.

Methods: A retrospective study of 45 patients, aged 12-19 years, consecutively enrolled in a ketogenic diet program from 1994 to 2002, was performed. Thirty-seven patients were from The Johns Hopkins Medical Institutions; eight were from The University of Texas at Houston.