One-Stage, Limited-Resection Epilepsy Surgery for Bottom-of-Sulcus Dysplasia.

Objective: To determine whether 1-stage, limited corticectomy controls seizures in patients with MRI-positive, bottom-of-sulcus dysplasia (BOSD).

Methods: We reviewed clinical, neuroimaging, electrocorticography (ECoG), operative, and histopathology findings in consecutively operated patients with drug-resistant focal epilepsy and MRI-positive BOSD, all of whom underwent corticectomy guided by MRI and ECoG.

Results: Thirty-eight patients with a median age at surgery of 10.

Clinical seizure manifestations in the absence of synaptic connections.

We report a child with a history of temporal-parietal-occipital disconnection for epilepsy secondary to posterior quadrantic dysplasia who developed recurrent and prolonged bouts of distress and autonomic disturbance associated with EEG and PET evidence of status epilepticus confined to his disconnected cortex. These bouts were refractory to antiseizure medications but resolved following resection of the disconnected cortex. In the absence of synaptic connections, we hypothesise that his seizure-related symptoms were mediated either by neurochemical transmission in preserved vascular and lymphatic channels or by ephaptic transmission to trigeminal nerve fibres in overlying dura, producing symptoms akin to migraine.

Focal cortical hypermetabolism in atypical benign rolandic epilepsy.

Objective: Atypical benign rolandic epilepsy (BRE) is an underrecognized and poorly understood manifestation of a common epileptic syndrome. Most consider it a focal epileptic encephalopathy in which frequent, interictal, centrotemporal spikes lead to negative motor seizures and interfere with motor and sometimes speech and cognitive abilities. We observed focal cortical hypermetabolism on PET in three children with atypical BRE and investigated the spatial and temporal relationship with their centrotemporal spikes.

Intrinsic epileptogenicity of cortical tubers revealed by intracranial EEG monitoring.

Objective: We sought to identify intracranial EEG patterns characteristic of epileptogenic tubers and to understand the contribution of perituberal cortex.

Methods: Twenty-three intracranial EEG monitoring studies were reviewed from 17 children aged 1.3-7.

Preventing hospital-associated infection: MRSA.

By understanding the preventive strategies associated with reducing HA-MRSA transmission, the medical-surgical nurse can impact mortality rates and health care costs. He or she should model and enforce adherence to prevention strategies, such as hand hygiene, contact isolation, and other evidence-based strategies.

Long-term follow-up of febrile infection-related epilepsy syndrome.

Purpose: Febrile infection-related epilepsy syndrome (FIRES) is an increasingly recognized epileptic syndrome that presents with multifocal refractory status epilepticus in previously normal children and evolves into a chronic, refractory, focal epilepsy with associated cognitive and behavioral difficulties. Herein we describe the features of the chronic epilepsy and critically review evidence for the etiology of this syndrome.

Methods: Seven patients with FIRES were studied.

Temporoparietooccipital disconnection in children with intractable epilepsy.

Object: Temporoparietooccipital (TPO) disconnection is described mainly in children with diffuse posterior quadrant lesions and concordant electroencephalography (EEG) findings. The authors report on 16 children who underwent TPO surgery, including 4 with no definite epileptogenic lesion and 8 with generalized electroclinical manifestations.

Methods: The authors conducted a retrospective review of clinical, neuropsychological, EEG, imaging, and histopathological data in 16 children with intractable epilepsy who underwent TPO disconnection and/or resection at their center between December 1998 and March 2010.