Navegando por Palavras-chave "pediatric epilepsy"

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    Paradoxical ictal EEG lateralization in children with unilateral encephaloclastic lesions
    (John Libbey Eurotext Ltd, 2009-09-01) Garzon, Eliana [UNIFESP]; Gupta, Ajay; Bingaman, William; Sakamoto, Americo C. [UNIFESP]; Luders, Hans; Cleveland Clin Fdn; Universidade Federal de São Paulo (UNIFESP); Univ Hosp Cleveland
    Background. Describe an ictal EEG pattern of paradoxical lateralization in children with unilateral encephaloclastic hemispheric lesion acquired early in life. Methods. of 68 children who underwent hemispherectomy during 2003-2005, scalp video-EEG and brain MRI of six children with an ictal scalp EEG pattern discordant to the clinical and imaging data were reanalyzed. Medical charts were reviewed for clinical findings and seizure outcome. Results. Age of seizure onset was 1 day-4 years. the destructive MRI lesion was an ischemic stroke in 2, a post-infectious encephalomalacia in 2, and a perinatal trauma and hemiconvulsive-hemiplegic syndrome in one patient each. Ictal EEG pattern was characterized by prominent ictal rhythms with either 3-7 Hz spike and wave complexes or beta frequency sharp waves (paroxysmal fast) over the unaffected (contralesional) hemisphere. Scalp video-EEG was discordant, however, other findings of motor deficits (hemiparesis; five severe, one mild), seizure semiology (4/6), interictal EEG abnormalities (3/6), and unilateral burden of MRI lesion guided the decision for hemispherectomy. After 12-39 months of post-surgery follow up, five of six patients were seizure free and one has brief staring spells. Conclusion. We describe a paradoxical lateralization of the EEG to the good hemisphere in children with unihemispheric encephaloclastic lesions. This EEG pattern is compatible with seizure free outcome after surgery, provided other clinical findings and tests are concordant with origin from the abnormal hemisphere.
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    Surgically amenable epilepsies in children and adolescents: clinical, imaging, electrophysiological, and post-surgical outcome data
    (Springer, 2005-07-01) Terra-Bustamante, V. C.; Fernandes, RMF; Inuzuka, L. M.; Velasco, T. R.; Alexandre, V; Wichert-Ana, L.; Funayama, S.; Garzon, E.; Santos, A. C.; Araujo, D.; Walz, R.; Assirati, J. A.; Machado, H. R.; Sakamoto, A. C.; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
    Background and purpose: A large number of patients with epilepsy in the pediatric population have medically intractable epilepsy. in this age group seizures are usually daily or weekly, and response to antiepileptic therapy is poor, especially for those with neurological abnormalities and symptomatic epilepsies. However, several authors have already demonstrated similarly favorable long-term post-surgical seizure control when comparing pediatric and adult populations. in this article we aim to report the experience of the Ribeirao Preto Epilepsy Surgery Program in pediatric epilepsy surgery. Patients and methods: We analyzed 107 patients with medically intractable epilepsy operated on between July 1994 and December 2002, considering age at surgery, seizure type, pathological findings, and seizure outcome. All data were prospectively collected according to protocols previously approved by the institution ethics committee. Results: We analyzed a total of 115 operations performed in 107 patients. There was no difference in sex distribution. Complex partial seizures occurred in 31.4% of the patients, followed by tonic seizures (25.9%), focal motor seizures (15.4%), and infantile spasms (13.3%). the most common etiologies were cortical developmental abnormalities (25.2%), tumors (16.8%), mesial temporal sclerosis (15.9%), Rasmussen syndrome (6.5%), and tuberous sclerosis (6.5%). Overall post-surgical seizure outcome showed 67.2% of the patients within Engel classes I and II, reaching 75.0% when patients with callosotomies were excluded. Conclusions: Post-surgical seizure control in the pediatric population is similar to that in adult patients, despite the fact that epilepsies in this age group are more frequently of extratemporal origin, suggesting that surgery should be considered in children as soon as intractability is determined.