The administration of rescue medication to children with prolonged acute convulsive seizures in the community: what happens in practice?

This paper presents the findings of a review of existing clinical and non-clinical guidance on the management of children with prolonged acute convulsive seizures (PCS) and the administration of rescue medication in community settings. Findings are based on desk- and web-based research in 6 countries. Published clinical guidelines are mostly limited to the hospital setting and offer few explicit recommendations for community settings.

Apnea as the sole manifestation of a seizure attributable to meningioangiomatosis of the temporal lobe in an infant.

An 8-month-old boy presented with periods of apnea occurring several times daily. Initial clinical and radiologic evaluations could not identify a cause for these episodes. Video electroencephalographic monitoring indicated interictal high-voltage θ and δ activity over the right frontotemporal area.

Cardiac autonomic dysfunction in West syndrome.

Background: West syndrome is an age-dependent epileptic encephalopathy. Autonomic changes are increasingly being recognized in patients with epilepsy: cardiac autonomic function is mediated by sympathetic and parasympathetic efferent activity to the heart and can provide information on the functional state of the autonomic nervous system. The goal of the study is to evaluate the effect of an early epileptic encephalopathy on the autonomic nervous system by measuring heart rate variability.

Successful use of fenfluramine as an add-on treatment for Dravet syndrome.

Purpose: Despite the development of new antiepileptic drugs, Dravet syndrome frequently remains therapy resistant and is a catastrophic epilepsy syndrome. Fenfluramine is an amphetamine-like drug that has been used in the past as a part of antiobesity treatments. Because of the possible cardiac adverse effects (valve thickening, pulmonary hypertension) associated with use of fenfluramine, it was withdrawn from the market in 2001.

Recommendations for the treatment of epilepsy in adult patients in general practice in Belgium: an update.

In 2008, a group of Belgian epilepsy experts published recommendations for antiepileptic drug (AED) treatment of epilepsies in adults and children. Selection of compounds was based on the registration and reimbursement status in Belgium, the level of evidence for efficacy, common daily practice and the personal views and experiences of the authors. In November 2011 the validity of these recommendations was reviewed by the same group of Belgian epilepsy experts who contributed to the preparation of the original paper.

Ring chromosome 20 syndrome: electroclinical description of six patients and review of the literature.

Background: Ring chromosome 20 syndrome is a rare chromosomal disorder.

Methods: In six patients, we focused on the presenting epileptic phenotype, the behavioral and mental problems and the relationship between the ratio of mosaicism and the age at onset of the epilepsy.

Results: All patients presented with pharmacoresistant frontal lobe complex partial seizures.

Plasmon filters and resonators in metal-insulator-metal waveguides.

We present the numerical and experimental demonstration of plasmonic Bragg filters and resonators inside metal-insulator-metal (MIM) waveguides. The presented filters and resonators are fabricated using standard top down lithography methods. The optical bandgap of the integrated Bragg filters is experimentally observed and its optical properties are investigated as a function of the grating pitch and the number of grating periods.

Boosting the figure-of-merit of LSPR-based refractive index sensing by phase-sensitive measurements.

Localized surface plasmon resonances possess very interesting properties for a wide variety of sensing applications. In many of the existing applications, only the intensity of the reflected or transmitted signals is taken into account, while the phase information is ignored. At the center frequency of a (localized) surface plasmon resonance, the electron cloud makes the transition between in- and out-of-phase oscillation with respect to the incident wave.

Long-term cognitive and cardiac outcomes after prenatal exposure to chemotherapy in children aged 18 months or older: an observational study.

Background: Chemotherapy for the treatment of maternal cancers during pregnancy has become more acceptable in the past decade; however, the effect of prenatal exposure to chemotherapy on cardiac and neurodevelopmental outcomes of the offspring is still uncertain. We aimed to record the general health, cardiac function, and neurodevelopmental outcomes of children who were prenatally exposed to chemotherapy.

Methods: We did an interim analysis of a multicentre observational cohort study assessing children who were prenatally exposed to maternal cancer staging and treatment, including chemotherapy.

Within-subject variability during spatial working memory in children with ADHD: an event-related potentials study.

Working memory (WM) dysfunction and increased within-subject variability are known issues in attention deficit/hyperactivity disorder (ADHD) patients. Little is known about the electrophysiological characteristics of this variability. We evaluated behavioral and electrophysiological within-subject variability taking developmental aspects into account in a group of ADHD patients.

Excitation wavelength dependent surface enhanced Raman scattering of 4-aminothiophenol on gold nanorings.

Detailed understanding of the underlying mechanisms of surface enhanced Raman scattering (SERS) remains challenging for different experimental conditions. We report on an excitation wavelength dependent SERS of 4-aminothiophenol molecules on gold nanorings. SERS and normal Raman spectra, combined with well-characterized surface morphology, optical spectroscopy and electromagnetic (EM) field simulations of gold nanoring substrates indicate that the EM enhancement occurs at all three excitation wavelengths (532, 633 and 785 nm) employed but at short wavelengths (532 and 633 nm) charge transfer (CT) results in additional strong enhancements of particular Raman transitions.

KCNQ2 encephalopathy: emerging phenotype of a neonatal epileptic encephalopathy.

Objective: KCNQ2 and KCNQ3 mutations are known to be responsible for benign familial neonatal seizures (BFNS). A few reports on patients with a KCNQ2 mutation with a more severe outcome exist, but a definite relationship has not been established. In this study we investigated whether KCNQ2/3 mutations are a frequent cause of epileptic encephalopathies with an early onset and whether a recognizable phenotype exists.

The "why" and "how" of JointICA: results from a visual detection task.

Since several years, neuroscience research started to focus on multimodal approaches. One such multimodal approach is the combination of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). However, no standard integration procedure has been established so far.

Integrity of the inferior longitudinal fasciculus and impaired object recognition in children: a diffusion tensor imaging study.

Aim:   In this study, we explored the integrity of the inferior longitudinal fasciculus (ILF) by means of diffusion tensor imaging tractography in children with visual perceptual impairment, and more specifically, object recognition deficits, compared with typically developing children.

Methods:   Eleven individuals (nine males, two females; mean age 7 y 8 mo; range 3 y 5 mo-13 y) were assessed with the L94 visual perceptual battery after assessment of performance age. In all participants, an ophthalmological evaluation was carried out.

Is there a common neuroanatomical substrate of language deficit between autism spectrum disorder and specific language impairment?

Discussion of an overlap between specific language impairment (SLI) and autism spectrum disorder (ASD) is on going. The most intriguing overlap between both phenotypes is the similarity in the observed language deficits described in SLI and a subgroup of ASD with co-occurring linguistic impairment, ASD-LI. Examining whether a similar neuroanatomical substrate underlies this phenotypical linguistic overlap, we studied the white matter microstructural properties of the superior longitudinal fascicle (SLF) of 19 ASD-LI adolescents (mean age 13.

Development of an electronic decision tool to support appropriate treatment choice in adult patients with epilepsy--Epi-Scope(®).

Background: Given the continuous knowledge progression and the growing number of available antiepileptic drugs (AEDs), making appropriate treatment choices for patients with epilepsy is increasingly difficult. While published guidelines help for separate clinical aspects, patients with a combination of specific characteristics may escape proper guidance. This study aimed to determine the appropriateness of AEDs for particular clinical variables and to offer treatment recommendations for adult patients with epilepsy in a user-friendly format for practicing neurologists.

Screening for cerebral visual impairment: value of a CVI questionnaire.

The objective of the study was to investigate the screening utility of a questionnaire for cerebral visual impairment (CVI) by correlating the questionnaire with diagnostic tools such as the L94, the Test of Visual Perceptual Skills - Revised and the Visual Perception subtask of the Beery test of VisuoMotor Integration.The questionnaire consisted of 46 items, exploring different characteristics of CVI. We consecutively recruited 91 children.

Autonomic effects of refractory epilepsy on heart rate variability in children: influence of intermittent vagus nerve stimulation.

Aim: Vagus nerve stimulation (VNS) is a therapeutic option for individuals with refractory epilepsy. Individuals with refractory epilepsy are prone to dysfunction of the autonomic nervous system. Reduced heart rate variability is a marker of dysfunction of the autonomic nervous system.

Specific magnetic isolation for direct detection of HPV16.

Finding a suitable DNA purification system is vital for the success of many PCR based diagnostic tests. This report demonstrates the value of magnetic beads in combination with real-time PCR for the sequence-specific isolation and detection of episomal HPV16 DNA. In order to maximize the isolation, two purification procedures were evaluated.

Temperature determination of resonantly excited plasmonic branched gold nanoparticles by X-ray absorption spectroscopy.

The fields of bioscience and nanomedicine demand precise thermometry for nanoparticle heat characterization down to the nanoscale regime. Since current methods often use indirect and less accurate techniques to determine the nanoparticle temperature, there is a pressing need for a direct and reliable element-specific method. In-situ extended X-ray absorption fine structure (EXAFS) spectroscopy is used to determine the thermo-optical properties of plasmonic branched gold nanoparticles upon resonant laser illumination.

Visual perception in preterm children: what are we currently measuring?

Over the past two decades, cerebral visual impairment has been recognized as a principal deficit in preterm children, and in particular those with cerebral palsy. We review the current knowledge of visual processing deficits in these children, and provide an overview of the tools for assessing cerebral visual impairment. Commercially available instruments are usually directed at evaluating visuospatial skills rather than detecting object recognition difficulties.

Specific cell targeting with nanobody conjugated branched gold nanoparticles for photothermal therapy.

Branched gold nanoparticles are potential photothermal therapy agents because of their large absorption cross section in the near-infrared window. Upon laser irradiation they produce enough heat to destroy tumor cells. In this work, branched gold nanoparticles are biofunctionalized with nanobodies, the smallest fully functional antigen-binding fragments evolved from the variable domain, the VHH, of a camel heavy chain-only antibody.

Clinical practice: the treatment of acute convulsive seizures in children.

An adequate early treatment of a long-lasting convulsive seizure is critical in reducing potential morbidity, and in particular, brain damage. In pre-hospital settings the use of benzodiazepines should become standard. Nowadays, rectal diazepam is used frequently, but midazoloam and lorazepam are becoming more popular, both being given either intranasally or orally.