EPILEPSY IN CHILDREN – CLINICAL AND SOCIAL ASPECTS pptx

EPILEPSY IN CHILDREN – CLINICAL AND SOCIAL ASPECTS Edited by Željka Petelin Gadže Epilepsy in Children – Clinical and Social Aspects Edited by Željka Petelin Gadže Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access articles distributed under the Creative Commons Non Commercial Share Alike Attribution 3.0 license, which permits to copy, distribute, transmit, and adapt the work in any medium, so long as the original work is properly cited. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published articles. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Dragana Manestar Technical Editor Teodora Smiljanic Cover Designer Jan Hyrat Image Copyright dusan964, 2011. Used under license from Shutterstock.com First published August, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Epilepsy in Children – Clinical and Social Aspects, Edited by Željka Petelin Gadže p. cm. ISBN 978-953-307-681-2 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Ethiology and Pathogenesis of Epilepsy: Data from Research 1 Chapter 1 Polymicrogyria: A Clinical and Experimental Approach to Epilepsy 3 Tomoyuki Takano Chapter 2 Sequential Prefrontal Lobe Volume Changes in Epileptic Patients with Continuous Spikes and Waves During Slow Sleep 13 Hideaki Kanemura and Masao Aihara Part 2 Clinical Presentation of Epilepsy and Epileptic Syndromes of Childhood 25 Chapter 3 Neonatal Seizures 27 Isam AL-Zwaini Chapter 4 Epileptic Encephalopathy Syndromes in Infancy 47 Raidah Albaradie Chapter 5 The Lessons from Angelman Syndrome for Research and Management 59 Karine Pelc, Guy Cheron and Bernard Dan Part 3 Therapy of Epilepsy: Medicamentous and Surgical Approach 77 Chapter 6 Novel Neuroprotective Strategies and Targets of Intervention in Epilepsy 79 Ryan D. Readnower, Laurie M. Davis and Patrick G. Sullivan VI Contents Chapter 7 Zonisamide – An Overview 93 Sowmini Raman, Lakshmi Narasimhan Ranganathan and Sridharan Ramaratnam Chapter 8 Practical Use of the Ketogenic Diet in Childhood Epilepsy 105 Da Eun Jung and Heung Dong Kim Chapter 9 Epilepsy Surgery in Children 115 Vera Cristina Terra, Américo C Sakamoto and Hélio Rubens Machado Chapter 10 Corpus Callosotomy in Pediatric Intractable Epilepsy: Microsurgical Technique Implication and Variation 133 Eun Kyung Park and Dong-Seok Kim Part 4 Social Aspects of Epilepsy 145 Chapter 11 Childhood Age Epilepsy and Family 147 Cicek Hocaoglu and Ayse Koroglu Chapter 12 Health-Related Quality of Life in Children and Adolescents with Epilepsy: A Systematic Review 161 Dejan Stevanovic, Ivana Tadic and Tanja Novakovic Chapter 13 Frontal Lobe Epilepsies: Neuropsychological and Behavioral Consequences in Children 187 Chiara Vago, Sara Bulgheroni, Silvana Franceschetti and Daria Riva Chapter 14 Physiotherapy for Children with Cerebral Palsy 213 Mintaze Kerem Günel Preface Epilepsy is a neurological condition that accompanies mankind probably since its inception. About 400 years before Christ, the disease was already known by Hippocrates, who wrote the book “On The Sacred Disease”, in which he refuted the idea that the upheaval was the work of spirits and wisely related it to the brain. This concept was not fully accepted until modern era (John Hughlings Jackson, 1873). Classically, epilepsy is defined as a chronic condition characterized by an enduring propensity to generate seizures, which are paroxysmal occurring episodes of abnormal excessive or synchronous neuronal activity in the brain. According to WHO epilepsy accounts for about 1% of the total burden of disease worldwide, about the same as breast cancer in women and lung cancer in men. Out of all brain disorders, epilepsy is the one that offers a unique opportunity to understand normal brain functions as derived from excessive dysfunction of neuronal circuits, because the symptoms of epileptic seizures are not the result of usual loss of function that accompanies many disease that affect the brain. I am therefore extremely honoured to present this book. The 15 very interesting chapters of the book cover various fields in epileptology – they encompass the etiology and pathogenesis of the disease, clinical presentation with special attention to the epileptic syndromes of childhood, principles of medical management, surgical approaches, as well as social aspects of the disease. Author Takao dedicated the chapter to the clinical and experimental investigations in polymicrogyria, that were reviewed with special reference to the epileptogenicity of this malformation. The cortical hyperexcitability in polymicrogyria may be reduced by the inhibitory neuronal network constructed by a population of aberrantly migrating inhibitory interneurons, which are mobilized from the ganglionic eminence during the development of polymicrogyria. Authors Kanemura and Aihara wrote about epileptic patients with continuous spikes and waves during slow sleep, in which mentioned electroencephalographic findings were associated with frontal lobe growth disturbance. They state that seizures and paroxysmal anomaly durations may be influenced by prefrontal lobe growth, which relates to neuropsychological problems. Authors Isam et al wrote the chapter about neonatal seizures. Neonatal seizures are common and the incidence is variable according to age and maturity of the neonate, X Preface weight and the severity of the underlying condition. It has been estimated that the incidence rate of clinical seizures varies from 1.1 to 8.6 per 1000 live births. No period carries the danger of seizures to the individual person like the first four weeks of life, because of immaturity of the brain cells that are more vulnerable to injury and because of wide range of factors that might cause seizures in this period. Neonatal seizures tend to be brief, because immature neurons are unable to sustain repetitive activity for a long period of time, and to be focal or multifocal. It requires immediate evaluation because of the variable conditions that might insult developing and vulnerable neurons of neonate, some of which might endanger the life of neonate. Some time seizures might be the first and probably the only manifestations of underlying significant dysfunction of the central nervous system of the newborn infant. Furthermore, these seizures are sometimes difficult to be diagnosed clinically, resulting in delaying treatment and worsening of short and long term prognosis. There is still a great debate about pathophysiology, clinical classification, electroencephalographic (EEG) significance and treatment of neonatal seizures. Chapter by authors Dan, Pelc et al is dedicated to patients with Angelman syndrome, that, compared to many other neurodevelopmental disorders, has the remarkably high risk for epilepsy. In particular, early-childhood onset of refractory epilepsy with atypical absences and myoclonic seizures with predisposition to developing non- convulsive status epilepticus is a common presentation. This may be due to propensity to hypersynchronous neuronal activity, which might be related to abnormal GABA- mediated transmission due to lack of UBE3A expression, or other factors. On the one hand, non-epileptic stereotyped or paroxysmal events (including motor or behavioural manifestations) may lead to overdiagnosis. On the other hand, the epileptic nature of relatively subtle manifestations such as absences, myoclonias or non-convulsive status epilepticus may be under-recognised in the context of behavioural and motor features. The neurocognitive effects of seizures are difficult to evaluate. There is a major need for evidence on which to base rational treatment. A diagnostic scheme for patients with epileptic seizures and with epilepsy proposed by ILAE Commission (2001) newly adopted the concept of “epileptic encephalopathy” as one of the new key terms. It is defined as a condition in which epileptiform abnormalities are believed to contribute to the progressive disturbance in cerebral function, but this definition may be ambiguous. Authors Raidah et al state that the proposal include 8 syndromes: early myoclonic encephalopathy, Ohtahara syndrome, West syndrome, Dravet syndrome, myoclonic status in non-progressive encephalopathies, Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and epilepsy with continuous spike-waves during slow-wave sleep. To these syndromes, the migrating partial seizures in infancy and severe epilepsy with multiple independent spike foci may be reasonably added. In the chapter authors concentrate on the epileptic encephalopathies that occur only in infancy. The frontal lobes of the brain constitute more than a third of the human cerebral cortex and are characterized by a complex functional organization supporting higher level [...]... pharmacologically distinguished by four agonists: NMDA, amino-3-hydroxy-5methylisoxazoleproprionic acid (AMPA), kainate, and quisqualate Electrical kindling stimulation in prenatal freeze lesion rat revealed the significant prolonged after discharges in both of the cortex and hippocampus, the early development of hippocampal kindling, 8 Epilepsy in Children – Clinical and Social Aspects and the spontaneous... volumes in a patient with CSWS using three-dimensional (3D) magnetic resonance imaging (MRI) (Kanemura et al., 2009) However, the data cannot be 14 Epilepsy in Children – Clinical and Social Aspects generalized to all CSWS cases because the investigation included evaluation of only one case Many unanswered questions remain with regard to CSWS, such as its clinical significance, pathophysiology and treatment... common in children with epilepsy is the 20 Epilepsy in Children – Clinical and Social Aspects disruptive behavioral disorder group: ADHD, oppositional defiant disorder, and conduct disorder ADHD is described in approximately two thirds of the reported cases (Boel & Casaer, 1989; Guerrini et al., 1998) Hyperactivity and oppositional behaviors are highly associated Aggressiveness, deficits in relatedness and. .. (HRQOL) in children and adolescents with epilepsy over 12 past years The affected domains, predictors, and impacts on HRQOL of specific and non-specific treatments were reviewed Previous reviews evaluated methodological issues in HRQOL assessment, components of theoretical model, and determinants of HRQOL in pediatric epilepsy Based on the findings and evidence found, it could be concluded that children and. .. with cerebral palsy Epilepsy affects 1-2% of children In childhood, epilepsy is more common in the first year of life, and its incidence decreases progressively with increasing age, affecting approximately 100 children per 100,000 births in the first year of life, 40 children for every 100,000 births in subsequent years, and approximately 20 individuals per 100,000 adolescents In 75% of these cases,... psychosocial intervention, or the use of psychotropic medication Our study demonstrated that clinical seizures and EEG discharges responded well to a benzodiazepine such as CLB when combined with VPA in four of 5 patients The study by Liu et al has demonstrated a dramatic improvement in the clinical findings and occurrence of the CSWS phenomenon with administration of low-dose benzodiazepines in a cohort... arrangement in the cortical plate and intermediate zone, lacking the vimentin-positive radial glial fibers (arrow) B: Cortical infolding mimicking microgyria (arrow) 5 days after ibotenate injection Hematoxylin-eosin staining C: Cerebral cortex illustrating the histogenetic development of the microgyria After the radial glial fibers were damaged (small arrows), its corresponding area within the cortical... syndromes associated with partial or generalized seizures, occurring during sleep, as well as atypical absences when awake Thus, the five patients described in this report had clinical features that were consistent with the criteria proposed for CSWS 18 Epilepsy in Children – Clinical and Social Aspects Many CSWS children develop severe cognitive and language deterioration that is unresponsive to medical... patient’s quality of life and relationship with the family are examined, in few ones problems belonging to family members that result from epilepsy are pointed Clinicians should consider both neurological and psychosocial factors, including the family system, when treating psychopathology in children with epilepsy The chapter by Stevanovic et al systematically reviewed synthesizing different studies that... results are in agreement with these findings Patients with CSWS require regular and prolonged clinical and EEG follow-up The same disorder that causes seizures may also have the potential to limit intellectual development in many patients People with learning disabilities represent an important subgroup within the population of patients with epilepsy On the other hand, the interface between epilepsy and behavior . EPILEPSY IN CHILDREN – CLINICAL AND SOCIAL ASPECTS Edited by Željka Petelin Gadže Epilepsy in Children – Clinical and Social Aspects Edited by Željka Petelin. arterial vascular beds, occurring between the 20th and 24th week of gestation. This would lead to intracortical Epilepsy in Children – Clinical and Social Aspects 4 laminar necrosis with delayed. Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Epilepsy in Children – Clinical