Sleep Disorders in Traumatic Brain Injury.

Sleep disorders are common after traumatic brain injury (TBI). This study will review the spectrum and proposed mechanisms of TBI-associated sleep disorders and discuss the clinical approach to diagnosis and management of them. Disordered and fragmented sleep with insomnia and daytime sleepiness is very common after TBI.

Reversible posterior leukoencephalopathy syndrome after blood transfusion in a pediatric patient with sickle cell disease.

Background: Children with sickle cell disease are at increased risk for neurological complications. Reversible posterior leukoencephalopathy syndrome is a clinico-radiological syndrome characterized by headache, vomiting, seizures, and visual disturbances along with the radiological findings of posterior leukoencephalopathy.

Case Report: We report a 13-year-old female with sickle cell disease presenting with a headache and two isolated episodes of partial seizures with secondary generalization after blood transfusion.

An uncommon case of pediatric neurobrucellosis associated with intracranial hypertension.

We present the case of a 4-year-old boy who was admitted to hospital with intracranial hypertension, headache, diplopia, papilledema, and a normal brain MRI. Brucella melitensis in the cerebrospinal fluid was confirmed with PCR assay. We believe that neurobrucellosis should be included in the differential diagnosis when headaches persist following brucellosis.

Sleep disorders in children with cancer.

Approximately three-fourths of all pediatric cancer patients will be long-term survivors; however, there can be a steep cost for cancer survivorship. Cancer treatment involves exposure to chemotherapy, surgical intervention, and radiation, which can cause lasting long-term toxicities. Children with brain tumors have the highest prevalence of long-term morbidities.

Sleep-wake patterns of seizures in children with lesional epilepsy.

This study examined diurnal patterns of seizures and their occurrence during wakefulness and sleep in children with lesional focal epilepsy. We reviewed 332 consecutive children with lesional focal epilepsy and video-electroencephalogram monitoring during a 3-year period. Data were analyzed in relationship to clock time, wakefulness/sleep, and seizure localization.

Electroencephalogram monitoring during intracranial surgery for moyamoya disease.

We describe our experience with intraoperative electroencephalography in moyamoya surgery, a method to monitor for ischemic changes during the procedure and to minimize the risk of intraoperative and perioperative stroke. Case records and intraoperative electroencephalography recordings of all patients (n=220) treated with surgical revascularization for moyamoya (pial synangiosis) performed for 14 years (1994-2008) were reviewed. Electroencephalographic slowing occurred in 100 cases (45.

Chronobiology of epilepsy: diagnostic and therapeutic implications of chrono-epileptology.

The combination of chronobiology and epilepsy offers novel diagnostic and therapeutic management options. Knowledge of the interactions between circadian periodicity, entrainment, sleep patterns, and epilepsy may provide additional diagnostic options beyond sleep deprivation and extended release medication formulations. It may also provide novel insights into the physiologic, biochemical, and genetic regulation processes of epilepsy and the circadian clock, rendering new treatment options.

Sleep and epilepsy in children and adolescents.

Epilepsy and sleep disorders are considered by many to be common bedfellows. Several sleep phenomena may occur during nighttime taking a wide variety of forms and which can mimic seizures. Although most seizure sub-types have the potential to occur during sleep or wakefulness, sleep has a well-documented and strong association with specific epilepsy syndromes.

Sleep study abnormalities in children with attention deficit hyperactivity disorder.

The study objective was to describe polysomnographic findings in children with attention deficit hyperactivity disorder (ADHD) with diverse sleep problems. Polysomnographic data were retrospectively analyzed for 33 children (age 3-16 years) with ADHD who had sleep studies performed for diverse sleep complaints. Eight patients (24%) had obstructive sleep apnea, 10 (30%) had periodic limb movements of sleep, 8 (24%) had upper airway resistance syndrome, and 5 (15%) had obstructive hypoventilation.

Narcolepsy and other hypersomnias in children.

Purpose Of Review: We provide an update on the pathogenesis, diagnosis, assessment (clinical and laboratory), and treatment options for children with narcolepsy and other hypersomnias of central origin in order to raise awareness of these diseases and to highlight the clinical findings that should make the pediatrician suspect the diagnosis.

Recent Findings: Narcolepsy is a chronic rapid eye movement sleep disorder. Accumulating evidence indicates that signs of narcolepsy may start during childhood.

Severity of obstructive sleep apnea in children with sickle cell disease.

Objective: To characterize polysomnographic (PSG) findings of children with sickle cell disease (SCD) suspected of having sleep disordered breathing (SDB).

Methods: Families of 100 consecutively referred children with SCD completed the Children's Sleep Habit Questionnaire during a routine visit to identify concerns regarding sleep habits and sleep behavior. Of these, 48 children were identified as displaying behaviors suspicious of SDB.

Spectrum of polysomnographic abnormalities in children with epilepsy.

This study sought to evaluate polysomnographic abnormalities in a cohort of 40 children with epilepsy who underwent a sleep study because of various sleep complaints. Retrospective analyses included polysomnographic variables, antiepileptic drugs, type of epilepsy, and seizure control. The subgroup with epilepsy and obstructive sleep apnea syndrome was compared with 11 children who manifested uncomplicated obstructive sleep apnea syndrome.

The clinical and laboratory assessment of the sleepy child.

Excessive sleepiness is defined as sleepiness that occurs in a situation when an individual would usually be expected to be awake and alert. Hypersomnia is characterized by recurrent episodes of excessive daytime sleepiness (EDS) or prolonged nighttime sleep, which affects the everyday life of the patient. Clinical surveys have reported that EDS is a complaint observed in up to 68% of normal high school children, with a negative impact in academic achievement and extracurricular activity.

Polysomnographic findings in children with headaches.

Although previous studies suggested a relationship between headache and sleep disturbances, polysomnographic findings in children with headache are rarely described. We investigated polysomnographic findings in children with headaches, and correlated them with headache type and severity, body mass index, and medical treatment. Analysis of polysomnographic findings of 90 children with migraine (60), chronic migraine (11), tension headache (6), and nonspecific headache (13) indicated that sleep-disordered breathing was more frequent among children with migraine (56.

Zonisamide: review of pharmacology, clinical efficacy, tolerability, and safety.

Background: Zonisamide (ZNS), a sulphonamide derivative, is a new-generation anticonvulsant with multiple potential mechanisms that contribute to its antiepileptic efficacy and may also explain its as yet incompletely assessed utility for non-seizure disorders such as headaches, neuropathic pain, and weight loss.

Objective: A review of the pharmacokinetics, pharmacodynamics, evidence for efficacy in different seizure types and non-seizure conditions, adverse effects, and tolerability of ZNS is presented.

Methods: A review of all manuscripts published in the English literature on ZNS was performed in preparing this manuscript.

Detection of cortical arousals in children using frontal EEG leads in addition to conventional central leads.

Study Objective: This study was designed to assess the efficacy of using Fz as an additional electrode in screening arousals during polysomnography in children.

Methods: Polysomnograms from 24 children were randomly selected from a sleep-study database of children from different diagnostic categories. Of the children whose polysomnograms selected, 5 were normal, 5 had severe obstructive sleep apnea syndrome, 5 had mild obstructive sleep apnea syndrome, 5 had snoring, and 4 had periodic limb movement disorder.

The adverse effects of antiepileptic drugs in children.

Efficacy of antiepileptic drugs (AEDs) are often equivalent, hence selection of an AED is often determined by the adverse effects (AEs). The development of neurocognitive AEs is almost inevitable with use of AEDs, especially in high-risk groups. Teratogenesis with major or minor malformations is of great concern during the first trimester of pregnancy, but an increasing body of information suggests that potential neurocognitive developmental delay may also occur with use of AEDs in the latter part of pregnancy.

A survey of public awareness, understanding, and attitudes toward epilepsy in Greece.

Purpose: To assess familiarity, understanding, and attitude toward epilepsy in Greece and identification of negative predictive factors.

Methods: A 19-item questionnaire was administered to 750 adults. The magnitude of social stigma toward epileptic people with epilepsy was measured with a quantitative scale of social rejection.

Benign partial epilepsy in infancy: myth or reality?

Purpose: Benign partial epilepsy in infancy (BPEI) was first described by Watanabe in 1987. The aim of this study is to describe a series of infants from the United States to characterize this entity further.

Methods: Among patients with the diagnosis of epilepsy followed up at our institution between 2002 and 2004, those satisfying the criteria for BPEI were included in a retrospective study.

Achieving sleep state during EEG in children; sequence of activation procedures.

Objective: Interictal epileptiform discharges are often enhanced with attainment of sleep during an EEG. Hyperventilation (HV) during an EEG is often followed by drowsiness. However, the effect of intermittent photic stimulation (IPS) on awake/sleep state is unclear.

Efficacy and safety of zonisamide monotherapy in a cohort of children with epilepsy.

The aim of this study was to evaluate the efficacy and safety of zonisamide monotherapy in a cohort of children and adolescents with various types of epilepsy. Retrospective review of charts of our institution from 2001 through 2004 identified 69 children (19 males and 50 females, mean age 13.2 years) with epilepsy on zonisamide monotherapy.

Tacrolimus induced subacute cerebellar ataxia.

Tacrolimus is a macrolide immunosuppressant that is widely used in transplant surgery. Both mild and major neurologic side effects have been reported in patients receiving tacrolimus. Reversible posterior leukoencephalopathy syndrome is one of the major tacrolimus induced neurologic side effects.

Comparison of three treatment regimens of natural surfactant preparations in neonatal respiratory distress syndrome.

Unlabelled: The aim of the study was to compare the treatment regimen of three natural surfactants of different extraction and formulation (Alveofact [Surfactant A = SA], Poractant [Surfactant B = SB] and Beractant [Surfactant C = SC]) in neonatal respiratory distress syndrome (RDS). Premature infants of /=0.3 were randomly assigned to receive at least two doses of SA, SB or SC (100 mg/kg per dose).

Skin-prick test findings in atopic asthmatic children: a follow-up study from childhood to puberty.

In a prospective cohort study we investigated the course of allergic sensitization from childhood to puberty in a group of children with atopic asthma. An attempt was made to correlate the findings with the persistence of asthma. A total of 150 children with atopic asthma established at 7 years of age were evaluated when 8-10 years of age.

Levels of soluble ICAM-1 in premature and full-term neonates with infection.

Background: Infection in the neonatal period is an extremely serious condition and diagnosis is difficult. C-reactive protein (CRP) is widely used as a marker of infection; however, its usefulness is limited in the early phase. The role of soluble intracellular adhesion molecule-1 (sICAM-1), an adhesion molecule, has been examined in recent studies as an early marker of neonatal infection with controversial results.