65 results match your criteria: "First Seizure Pediatric Perspective"

Health Care System Costs Associated With Surgery and Medical Therapy for Children With Drug-Resistant Epilepsy in Ontario.

Neurology

March 2022

From the Institute of Health Policy, Management and Evaluation (E.W., A.G., G.T., B.H.S.) and Leong Centre for Healthy Children (A.G.), University of Toronto; Diagnostic Imaging (E.W.), Division of Neurology (E.W., O.C.S.), Neurosciences and Mental Health (L.D., O.Y.), Division of Pediatric Medicine (A.G.), and Department of Neurosurgery (J.R.), Hospital for Sick Children; ICES (E.W., A.G., B.H.S.); Toronto Health Economics and Technology Assessment (THETA) Collaborative (G.T., B.H.S.), University Health Network; and Public Health Ontario (B.H.S.), Toronto, Ontario, Canada.

Background And Objectives: Improvement in seizure control after epilepsy surgery could lead to lower health care resource use and costs, but it is uncertain whether this could offset the high costs related to surgery. This study aimed to evaluate phase-specific and cumulative long-term health care costs of surgery compared to medical therapy in children with drug-resistant epilepsy from the health care payer perspective.

Methods: Children who were evaluated for epilepsy surgery and treated with surgery or medical therapy from 2003 to 2018 at the Hospital for Sick Children in Toronto were identified from chart review and linked to their health administrative databases in Ontario, Canada.

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Background: Status epilepticus (SE) is a serious condition disproportionately affecting Sub-Saharan African (SSA) countries. Little is known about healthcare provider experiences. This study investigated the healthcare provider perspective of SE care.

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Patients with TLE are prone to tolerance to antiepileptic drugs. Based on the perspective of molecular targets for drug resistance, it is necessary to explore effective drug resistant genes and signaling pathways for the treatment of TLE. We performed gene expression profiles in hippocampus of patients with drug-resistant TLE and identified ROCK2 as one of the 20 most significantly increased genes in hippocampus.

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"The First Thousand Days" Define a Fetal/Neonatal Neurology Program.

Front Pediatr

August 2021

Division of Pediatric Neurology, Department of Pediatrics, Fetal/Neonatal Neurology Program, Emeritus Scholar Tenured Full Professor in Pediatrics and Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, United States.

Gene-environment interactions begin at conception to influence maternal/placental/fetal triads, neonates, and children with short- and long-term effects on brain development. Life-long developmental neuroplasticity more likely results during critical/sensitive periods of brain maturation over these first 1,000 days. A fetal/neonatal program (FNNP) applying this perspective better identifies trimester-specific mechanisms affecting the maternal/placental/fetal (MPF) triad, expressed as brain malformations and destructive lesions.

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Background And Purpose: Individualized anti-epileptic drug (AED) selection in patient with epilepsy is crucial. However, there is no unified opinion in treating patients with drug resistant epilepsy (DRE). This survey aimed to make a consolidate consensus with epileptologists' perspectives of the treatment for Korean DRE patients by survey responses.

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Children's understanding of epilepsy: A qualitative study.

Epilepsy Behav

July 2021

Usher Institute, The University of Edinburgh, UK; Muir Maxwell Epilepsy Centre, Centre for Clinical Brain Sciences, The University of Edinburgh, UK; Department of Paediatric Neurosciences, Royal Hospital for Sick Children, Edinburgh, UK; Child Life and Health, MRC Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK.

Purpose: To use a qualitative research approach to determine children's understandings of epilepsy and their epilepsy treatment.

Methods: Children aged 7-16 years with physician-confirmed active epilepsy (i.e.

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In 2005, twork for herapy in are pilepsies (NETRE)-was initiated in order to share treatment experiences among clinicians in patients with rare epilepsies. Here we describe the structure of the rapidly growing NETRE and summarize some of the findings of the last 15 years. NETRE is organized in distinct groups (currently >270).

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Introduction: Antiepileptic drugs (AEDs) are the mainstay of epilepsy treatment. Over the past 20 years, a number of new drugs have been approved for National Health Service (NHS) use on the basis of information from short-term trials that demonstrate efficacy. These trials do not provide information about the longer term outcomes, which inform treatment policy.

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The object of this study was to extensively characterize a region of periventricular nodular heterotopia (PVNH) in an epilepsy patient to reveal its possible neurocognitive functional role(s). The authors used 3-T MRI approaches to exhaustively characterize a single, right hemisphere heterotopion in a high-functioning adult male with medically responsive epilepsy, which had manifested during late adolescence. The heterotopion proved to be spectroscopically consistent with a cortical-like composition and was interconnected with nearby ipsilateral cortical fundi, as revealed by fiber tractography (diffusion-weighted imaging) and resting-state functional connectivity MRI (rsfMRI).

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Epilepsy is associated with a significantly increased risk of developing depressive disorder during adolescence. On the other hand, depression is highly detected in adolescents with epilepsy. These findings highlight the importance of early identification and proper management of comorbid depression in adolescent age.

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Background: Epilepsy is one of the commonest neurological conditions affecting women of reproductive age. Epilepsy management during pregnancy is a clinical conundrum, requiring a balance between seizure control and risk minimization for the women with epilepsy (WWE) as well as for their fetuses. The objective of this comprehensive review is to explore the reproductive health challenges of WWE in sub-Saharan Africa (SSA) and ways to address them.

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Moving beyond sodium valproate: choosing the right anti-epileptic drug in children.

Expert Opin Pharmacother

August 2019

Pediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Opthalmology, Genetics, Maternal and Child's Health, University of Genoa, Genoa , Italy.

: Sodium valproate is a widely used anti-epileptic drug with a broad spectrum of activity and mechanism of action. It has consequently been the first-line drug for most seizure types in children for the past fifty years. A wide range of side effects come along with these exceptional properties, including teratogenicity and neuro-cognitive impairments in offspring.

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Malformations of cortical development: New surgical advances.

Rev Neurol (Paris)

March 2019

Department of Neurosurgery, Hospices Civils de Lyon, Neurology & Neurosurgery Hospital Pierre Wertheimer, 59, boulevard Pinel, 69003 Lyon, France; Faculty of medicine Claude Bernard, University of Lyon, 69003 Lyon, France; Inserm U1028, CNRS 5292, NEUROPAIN team, Lyon Neuroscience Research Center, 69003 Lyon, France.

Epilepsy related to malformations of cortical development is frequently drug resistant or requires heavy medication, therefore surgery is key in their management. The role of stereotactic surgery has recently changed the diagnosis and treatment of focal cortical dysplasias (FCD), hypothalamic hamartomas (HH) and periventricular nodular heterotopias (PNH). In HH, radiosurgery using Gammaknife leads to 60 % of seizure control and is associated with excellent neuropsychological results without significant endocrine function impairment.

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Surgical techniques: Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC).

Seizure

April 2020

Department of Neurosurgery, Neurology & Neurosurgery Hospital Pierre Wertheimer, Hospices Civils de Lyon, France; University of Lyon, Faculty of medicine Claude Bernard, Lyon, France; NEUROPAIN team, Lyon Neuroscience Research Center, INSERM U1028, CNRS, 5292, Lyon, France.

Stereoelectroencephalography-guided radiofrequency-thermocoagulation (SEEG-guided RF-TC) consists of coupling SEEG investigation with RF-TC stereotactic lesioning directly through the recording electrodes. In this systematic review the surgical technique, indications, and outcomes are described. Maximum accuracy is reached when a frame-based procedure with a robotic assistance and a per-operative vascular X-ray imaging are performed.

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Background: Febrile seizure is the most common childhood neurological disorder, is an important health problem with potential short- and long-term complications, also leading to economic burden and increased parental anxiety about fevers and seizures occurring in their children. There are no routine recommendation to detect etiological causes of FS for neurological perspective, further knowledge about the etiological causes of FS in children will support preventive measures and follow-up strategies. The aim of this study is to evaluate the percentage of respiratory viruses in children with FS.

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Background: The link between the protocadherin-19 (PCDH19) gene and epilepsy suggests that an unusual form of X-linked inheritance affects females but is transmitted through asymptomatic males. Individuals with epilepsy associated with mutations in the PCDH19 gene display generalized or focal seizures with or without fever sensitivity. The clinical manifestation of the condition ranges from mild to severe, resulting in intellectual disability and behavioural disturbance.

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New-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES): State of the art and perspectives.

Epilepsia

April 2018

Department of Pediatric Neurology, Centre de Reference Epilepsies Rares, Necker-Enfants Malades Hospital, Inserm U1129, Imagine Institute, Paris Descartes University, Paris, France.

Article Synopsis
  • The First International NORSE and FIRES Symposium aimed to raise awareness and enhance research on new-onset refractory status epilepticus (NORSE) and febrile infection-related epilepsy syndrome (FIRES), sharing insights and strategies to improve patient care.
  • Standardized definitions for these conditions are necessary to facilitate communication and the creation of registries and biobanks, with a call to study both childhood and adult onset as a unified group.
  • Current research suggests a potential postinfectious mechanism and emphasizes the need for early recognition methods, with mixed results for treatments but some promise shown by the ketogenic diet.
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Purpose: Clinical trials of antiepileptic drugs frequently measure outcomes of seizure control, which demonstrate efficacy. Yet, functional status, quality of life, and long-term treatment effects reflecting effectiveness are scarcely assessed. We sought to use a consensus method to help identify which outcome criteria key stakeholders consider should be used to measure effectiveness in trials of antiepileptic treatments for children.

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Epileptogenic networks in nodular heterotopia: A stereoelectroencephalography study.

Epilepsia

December 2017

Inserm, Institut de Neurosciences des Systèmes (INS), Aix Marseille Univ, Marseille, France.

Objective: Defining the roles of heterotopic and normotopic cortex in the epileptogenic networks in patients with nodular heterotopia is challenging. To elucidate this issue, we compared heterotopic and normotopic cortex using quantitative signal analysis on stereoelectroencephalography (SEEG) recordings.

Methods: Clinically relevant biomarkers of epileptogenicity during ictal (epileptogenicity index; EI) and interictal recordings (high-frequency oscillation and spike) were evaluated in 19 patients undergoing SEEG.

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Importance: Incorporating combination vaccines, such as the measles-mumps-rubella-varicella (MMRV) vaccine, into immunization schedules should be evaluated from a benefit-risk perspective. Use of MMRV vaccine poses challenges due to a recognized increased risk of febrile seizures (FSs) when used as the first dose in the second year of life. Conversely, completion by age 2 years of measles, mumps, rubella, and varicella immunization may offer improved disease control.

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Immunotargeting relapsed or refractory precursor B-cell acute lymphoblastic leukemia - role of blinatumomab.

Onco Targets Ther

July 2017

Department of Pediatric Hematology and Oncology, University Children's Hospital, University of Tübingen, Tübingen, Germany.

Patients with refractory or relapsed (R/R) acute lymphoblastic leukemia (ALL) have a dismal prognosis of around 5% long-term survival when treated with cytotoxic chemotherapy and allogenic stem cell transplantation. T-cell immunobased strategies open up new therapeutic perspectives. Blinatumomab is the first of a new class of antibody constructs that was labeled bispecific T-cell engager (BiTE): it consists of two single chain variable fragment connected with a flexible linker, one side binding CD3, the other CD19.

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Acute postasphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a "dream revisited". In this review, a historical perspective is provided from the first reported use of therapeutic hypothermia for brain injuries in antiquity, to the present day.

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Background: The management of drug-resistant epilepsy in children with Tuberous Sclerosis Complex (TSC) is challenging because of the multitude of treatment options, wide range of associated costs, and uncertainty of seizure outcomes. The most cost-effective approach for children whose epilepsy has failed to improve with first-line medical therapy is uncertain.

Methods: A review of MEDLINE from 1990 to 2015 was conducted.

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Families' experiences of living with pediatric epilepsy: A qualitative systematic review.

Epilepsy Behav

July 2016

Muir Maxwell Epilepsy Centre, University of Edinburgh, Sylvan Place, EH9 1UW, UK; Child Life and Health, University of Edinburgh, Sylvan Place, EH9 1UW, UK.

Living with epilepsy in childhood has implications for the child and their family beyond the physical effects associated with epileptic seizures. Qualitative research has emerged, aiming to deliver a greater depth of understanding of the experiences of living with epilepsy from the perspectives of children with epilepsy, their parents, and their siblings. This review of qualitative research had three aims: first, to synthesize the demographic and epilepsy profiles of research participants in eligible studies in order to provide a clear picture of who are included and excluded when studying families' experiences; second, to present and discuss the methodological concerns and implications of research involving children with epilepsy; and third, to synthesize the findings arising from qualitative research with families in order to identify common themes across all relevant studies to date.

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Role of glyoxalase I gene polymorphisms in late-onset epilepsy and drug-resistant epilepsy.

J Neurol Sci

April 2016

Institute of Neurology, Guangdong Medical University, Zhanjiang, Guangdong 524001, China. Electronic address:

Background: Recent studies indicate that increased expression of glyoxalase I (GLO1) could result in epileptic seizures; thus, this study further explored the association of GLO1 with epilepsy from the perspective of molecular genetics.

Material And Methods: GLO1 single nucleotide polymorphisms (SNPs; rs1130534, rs4746 and rs1049346) were investigated in cohort I (the initial samples: 249 cases and 289 controls). A replication study designed to confirm the positive findings in cohort I was performed in cohorts II (the additional samples: 130 cases and 191 controls) and I+II.

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