Restricted diffusion of the callosal splenium is highly specific for seizures in neonates.

Background: To determine whether restricted diffusion of the callosal splenium is specific for seizure activity in neonates.

Methods: We performed a retrospective chart review of 123 neonates who had a diagnosis of hypoxic ischemic encephalopathy (HIE) who underwent therapeutic cooling and had magnetic resonance imaging (MRI) within the first 10 days of life. The regions examined for injury include the callosal splenium, cortex, deep gray matter, and subcortical white matter.

Does the first hour of continuous electroencephalography predict neonatal seizures?

Objective: Prolonged continuous video-electroencephalography (cEEG) is recommended for neonates at risk of seizures. The cost and expertise required to provide a real-time response to detected seizures often limits its utility. We hypothesised that the first hour of cEEG could predict subsequent seizures.

Optical Flow Estimation Improves Automated Seizure Detection in Neonatal EEG.

Purpose: Existing automated seizure detection algorithms report sensitivities between 43% and 77% and specificities between 56% and 90%. The algorithms suffer from false alarms when applied to neonatal EEG because of the high degree of nurse handling and rhythmic patting used to soothe neonates. Computer vision technology that quantifies movement in real time could distinguish artifactual motion and improve automated neonatal seizure detection algorithms.

Levetiracetam Versus Phenobarbital for Neonatal Seizures: A Randomized Controlled Trial.

Background And Objectives: There are no US Food and Drug Administration-approved therapies for neonatal seizures. Phenobarbital and phenytoin frequently fail to control seizures. There are concerns about the safety of seizure medications in the developing brain.

Rapid Whole Genome Sequencing Has Clinical Utility in Children in the PICU.

Objectives: Genetic disorders are a leading contributor to mortality in the neonatal ICU and PICU in the United States. Although individually rare, there are over 6,200 single-gene diseases, which may preclude a genetic diagnosis prior to ICU admission. Rapid whole genome sequencing is an emerging method of diagnosing genetic conditions in time to affect ICU management of neonates; however, its clinical utility has yet to be adequately demonstrated in critically ill children.

Rapid whole-genome sequencing decreases infant morbidity and cost of hospitalization.

Genetic disorders are a leading cause of morbidity and mortality in infants. Rapid whole-genome sequencing (rWGS) can diagnose genetic disorders in time to change acute medical or surgical management (clinical utility) and improve outcomes in acutely ill infants. We report a retrospective cohort study of acutely ill inpatient infants in a regional children's hospital from July 2016-March 2017.

Neurological Outcomes After Presumed Childhood Encephalitis.

Objective: To evaluate factors during acute presumed childhood encephalitis that are associated with development of long-term neurological sequelae.

Methods: A total of 217 patients from Rady Children's Hospital San Diego with suspected encephalitis who met criteria for the California Encephalitis Project were identified. A cohort of 99 patients (40 females, 59 males, age 2 months-17 years) without preexisting neurological conditions, including prior seizures or abnormal brain magnetic resonance imaging scans was studied.

Epilepsy After Resolution of Presumed Childhood Encephalitis.

Objective: To evaluate factors associated with the development of epilepsy after resolution of presumed childhood encephalitis.

Methods: A total of 217 patients with suspected encephalitis who met criteria for the California Encephalitis Project were identified. Evaluable outcome information was available for 99 patients (40 girls, 59 boys, ages 2 months to 17 years) without preexisting neurological conditions, including prior seizures or abnormal brain magnetic resonance imaging scans.

Acute pediatric encephalitis neuroimaging: single-institution series as part of the California encephalitis project.

Purpose: Diagnosing pediatric encephalitis is challenging because of varied clinical presentation, nonspecific neuroimaging features, and rare confirmation of causality. We reviewed acute neuroimaging of children with clinically suspected encephalitis to identify findings that may correlate with etiology and length of stay.

Methods: Imaging of 141 children with clinically suspected encephalitis as part of The California Encephalitis Project from 2005 to 2012 at a single institution was reviewed to compare the extent of neuroimaging abnormalities to patient age, gender, length of stay, and unknown, possible, or confirmed pathogen.

The role of continuous electroencephalography in childhood encephalitis.

Background: Seizures are a known complication of encephalitis. We sought to determine the incidence of seizures and the relative utility of routine and continuous electroencephalography in children with suspected encephalitis.

Methods: Records from all 217 children (ages 0-20 years, enrolled 2004-2011) from our institution who had diagnostic samples sent to the California Encephalitis Project were reviewed.

Hippocampal volume and memory performance in children with perinatal stroke.

Background: Pediatric neurologists and neonatologists often are asked to predict cognitive outcome after perinatal brain injury (including likely memory and learning outcomes). However, relatively few data exist on how accurate predictions can be made. Furthermore, although the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children.

The anatomy of amnesia: neurohistological analysis of three new cases.

The most useful information about the anatomy of human memory comes from cases where there has been extensive neuropsychological testing followed by detailed post-mortem neurohistological analysis. To our knowledge, only eight such cases have been reported (four with medial temporal lobe damage and four with diencephalic damage). Here we present neuropsychological and post-mortem neurohistological findings for one patient (NC) with bilateral damage to the medial temporal lobe and two patients (MG, PN) with diencephalic damage due to bilateral thalamic infarction and Korsakoff's syndrome, respectively.

Single-item memory, associative memory, and the human hippocampus.

We tested recognition memory for items and associations in memory-impaired patients with bilateral lesions thought to be limited to the hippocampal region. In Experiment 1 (Combined memory test), participants studied words and then took a memory test in which studied words, new words, studied word pairs, and recombined word pairs were presented in a mixed order. In Experiment 2 (Separated memory test), participants studied single words and then took a memory test involving studied word and new words.

Item memory, source memory, and the medial temporal lobe: concordant findings from fMRI and memory-impaired patients.

We studied item and source memory with fMRI in healthy volunteers and carried out a parallel study in memory-impaired patients. In experiment 1, volunteers studied a list of words in the scanner and later took an item memory test and a source memory test. Brain activity in the hippocampal region, perirhinal cortex, and parahippocampal cortex was associated with words that would later be remembered (item memory).

Intact visual perception in memory-impaired patients with medial temporal lobe lesions.

A recent proposal that structures of the medial temporal lobe support visual perception in addition to memory challenges the long-standing idea that the ability to acquire new memories is separable from other cognitive and perceptual functions. In four experiments, we have put this proposal to a rigorous test. Six memory-impaired patients with well characterized lesions of either the hippocampal region or the hippocampal region plus additional medial temporal lobe structures were assessed on difficult tests of visual perceptual discrimination.

The neuroanatomy of remote memory.

In humans and experimental animals, damage to the hippocampus or related medial temporal lobe structures severely impairs the formation of new memory but typically spares very remote memory. Questions remain about the importance of these structures for the storage and retrieval of remote autobiographical memory. We carried out a detailed volumetric analysis of structural brain images from eight memory-impaired patients.

Quantifying medial temporal lobe damage in memory-impaired patients.

Studies of memory-impaired patients will be most useful when quantitative neuroanatomical information is available about the patients being studied. Toward that end, in the case of medial temporal lobe amnesia, protocols have been developed from histological material that identify the boundaries of relevant structures on magnetic resonance images. Because the size of these structures varies considerably in the normal population, some correction for overall brain size is usually employed when calculating volume measurements.

Impaired visual and odor recognition memory span in patients with hippocampal lesions.

In a recent study, rats with hippocampal lesions performed as well as did unoperated rats on an olfactory memory span task, performing approximately 80% correct even when the span length reached 24 odors. This finding seems potentially at odds with demonstrations that memory-impaired patients typically fail tasks in which large amounts of information must be retained. Accordingly, we have assessed recognition memory span performance for line drawings of objects, designs, and odors in amnesic patients with damage thought to be limited to the hippocampal region.