A quality improvement initiative to improve folic acid supplementation counseling for adolescent females with epilepsy.

Objective: We designed a quality improvement (QI) project to improve rates of documented folic acid supplementation counseling for adolescent females with epilepsy, consistent with a quality measure from the American Academy of Neurology and American Epilepsy Society. Our SMART aim was to increase the percentage of visits at which folic acid counseling was addressed from our baseline rate of 23% to 50% by July 1, 2020.

Methods: This initiative was conducted in female patients ≥12 years old with epilepsy who were prescribed daily antiseizure medication and were seen by the 13 providers in our Neurology QI Program.

Assessing seizure burden in pediatric epilepsy using an electronic medical record-based tool through a common data element approach.

Objective: Improvement in epilepsy care requires standardized methods to assess disease severity. We report the results of implementing common data elements (CDEs) to document epilepsy history data in the electronic medical record (EMR) after 12 months of clinical use in outpatient encounters.

Methods: Data regarding seizure frequency were collected during routine clinical encounters using a CDE-based form within our EMR.

Video Ambulatory EEG in Children: A Quality Improvement Study.

Purpose: We implemented a video ambulatory EEG (VA-EEG) Program as an alternative to inpatient video EEG monitoring for some patients given potential benefits related to quicker access, greater convenience, and lower cost. To evaluate the newly initiated program, we performed a quality improvement study to assess whether VA-EEG yielded studies with interpretable EEG and video quality that generated clinically beneficial data.

Methods: This was a single-center prospective quality improvement study.

Interrater and Intrarater Agreement in Neonatal Electroencephalogram Background Scoring.

Purpose: Many neonates undergo electroencephalogram (EEG) monitoring to identify and manage acute symptomatic seizures. Information about brain function contained in the EEG background data may also help predict neurobehavioral outcomes. For EEG background features to be useful as prognostic indicators, the interpretation of these features must be standardized across electroencephalographers.

Targeted treatment of migrating partial seizures of infancy with quinidine.

Migrating partial seizures of infancy is an early onset epileptic encephalopathy syndrome that is typically resistant to treatment. The most common cause is a gain of function mutation in the potassium channel KCNT1. The antiarrhythmic drug quinidine is a partial antagonist of KCNT1 and hence may be a candidate drug for treatment of this condition.

Engrailed2 modulates cerebellar granule neuron precursor proliferation, differentiation and insulin-like growth factor 1 signaling during postnatal development.

Background: The homeobox transcription factor Engrailed2 (En2) has been studied extensively in neurodevelopment, particularly in the midbrain/hindbrain region and cerebellum, where it exhibits dynamic patterns of expression and regulates cell patterning and morphogenesis. Because of its roles in regulating cerebellar development and evidence of cerebellar pathology in autism spectrum disorder (ASD), we previously examined an ENGRAILED2 association and found evidence to support EN2 as a susceptibility gene, a finding replicated by several other investigators. However, its functions at the cell biological level remain undefined.

Frequency analysis of kinematics of racing wheelchair propulsion.

The purpose of this study was to describe the frequency content of racing wheelchair propulsion motion data. The selection of the filter corner frequency in previous kinematic analyses of manual wheelchair propulsion was commonly based on gait literature. An estimate of the frequency separating the signal and the noise was determined to make recommendations for low-pass digital filters.

User assessment of manual wheelchair ride comfort and ergonomics.

Objective: To examine wheelchair-user perceived ride comfort during propulsion and to compare the ride comfort of ultralight and lightweight manual wheelchairs. An ultralight wheelchair is defined as having a high degree of adjustability, whereas a lightweight wheelchair has minimal adjustability.

Design And Participants: Repeated measures design of a sample of 30 community-dwelling manual wheelchair users evaluating 7 different manual wheelchairs over an activities of daily living course.