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Kilic MA, Yildiz EP, Kurekci F, Coskun O, Cura M, Avci R, Genc HM. Association of epilepsy with neuroimaging patterns in children with cerebral palsy. Acta Neurol Belg 2024; 124:567-572. [PMID: 37777694 DOI: 10.1007/s13760-023-02385-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 09/07/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES In this study, we examined whether epilepsy and drug-resistant epilepsy are associated with neuroimaging findings in children with cerebral palsy (CP). METHODS Magnetic resonance imaging classification system (MRICS) proposed by Surveillance of Cerebral Palsy in Europe (SCPE) was used for classification of different MRI patterns in patients with cerebral palsy. We reviewed the brain MRI scans and medical records of children with CP who were followed-up in our clinic between 2019 and 2023. Patients were divided into three categories: CP without epilepsy, CP with controlled epilepsy and CP with DRE. MRI patterns were grouped as maldevelopments, predominant white matter injury, predominant gray matter injury, miscellaneous (delayed myelination, cerebral atrophy, cerebellar atrophy, brainstem lesions and calcifications, lesions that were not classified under any other group) and normal according to MRICS of the SCPE. RESULTS There were 325 CP patients. The most common MRI patterns were predominant white matter injury (47.6%) and gray matter injury (23.8%). There was a 1.5-fold reduction in the risk of epilepsy in patients with predominant white matter injury (OR = 1.54, 95% CI 1.23-1.94). In contrast, children in the miscellaneous group had significantly higher risks of epilepsy (p < 0.001), and we were able to determine that miscellaneous findings increased the risk by 1.8 times (OR = 1.77, 95% CI 1.47-2.12). CONCLUSION In conclusion, more than half of the children with CP had epilepsy, 40.7% of whom had DRE. On MRI, miscellaneous findings may indicate a poor prognosis for epilepsy, while predominant white matter injury may indicate a good outcome. Children with CP, especially those with miscellaneous findings on MRI, should be closely monitored for epilepsy development.
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Affiliation(s)
- Mehmet Akif Kilic
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
| | - Edibe Pembegul Yildiz
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Fulya Kurekci
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Orhan Coskun
- Department of Pediatric Neurology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey
| | - Meryem Cura
- Department of Pediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ridvan Avci
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Hulya Maras Genc
- Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Stanbouly D, Asi AM, Ascherman JA, Chuang SK, Kinard B, Melville JC. Are Patients with Syndromic Craniosynostosis at Greater Risk for Epilepsy than Patients with Nonsyndromic Craniosynostosis? World Neurosurg 2024; 181:e45-e54. [PMID: 37327863 DOI: 10.1016/j.wneu.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The aim of this study was to determine whether patients with syndromic craniosynostosis (SCS) are at increased risk for epilepsy relative to patients with nonsyndromic craniosynostosis (NSCS). METHODS A retrospective cohort study was completed using the Kids' Inpatient Database (KID). All patients diagnosed with craniosynostosis (CS) were included. The primary predictor variable was study grouping (SCS vs. NSCS). The primary outcome variable was a diagnosis of epilepsy. Descriptive statistics, univariate analyses and multivariate logistic regression were performed to identify independent risk factors for epilepsy. RESULTS The final study sample included a total of 10,089 patients (mean age, 1.78 years ± 3.70; 37.7% female). 9278 patients (92.0%) had NSCS, and the remaining 811 patients (8.0%) had SCS. A total of 577 patients (5.7%) had epilepsy. Not controlling for other variables, patients with SCS were at increased risk for epilepsy relative to patients with NSCS (OR 2.1, P < 0.001). After controlling for all significant variables, patients with SCS were no longer at increased risk for epilepsy relative to patients with NSCS (OR 0.73, P = 0.063). Hydrocephalus, Chiari malformation (CM), obstructive sleep apnea (OSA), atrial septal defect (ASD), gastro-esophageal reflux disease (GERD) were all independent risk factors (P < 0.05) for epilepsy. CONCLUSIONS Syndromic craniosynostosis (SCS) in itself is not a risk factor for epilepsy relative to NSCS. The greater prevalence of hydrocephalus, CM, OSA, ASD, and GERD, all of which were risk factors for epilepsy, in patients with SCS relative to patients with NSCS likely explains the greater prevalence of epilepsy in SCS relative to NSCS.
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Affiliation(s)
- Dani Stanbouly
- Columbia University College of Dental Medicine, New York, New York, USA.
| | - Abdalla M Asi
- Departments of Oral and Maxillofacial Surgery, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Jeffrey A Ascherman
- Thomas S. Zimmer Professor of Reconstructive Surgery, Division of Plastic Surgery, Department of Surgery, Columbia University College of Physicians & Surgeons, New York, New York, USA; Cleft and Craniofacial Team of the Children's Hospital of NewYork-Presbyterian, New York, New York, USA
| | - Sung-Kiang Chuang
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania, School of Dental Medicine, Philadelphia, Pennsylvania, USA; Department of Oral and Maxillofacial Surgery, Good Samaritan Medical Center, Brockton, MA, USA; Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University, School of Dentistry, Kaohsiung, Taiwan; Department of Oral and Maxillofacial Surgery, National University of Singapore, School of Dentistry, Singapore
| | - Brian Kinard
- Department of Oral and Maxillofacial Surgery, Department of Orthodontics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James C Melville
- Departments of Oral and Maxillofacial Surgery and Oral, Head, and Neck Oncology, and Microvascular Surgery, University of Texas Health Sciences Center at Houston, School of Dentistry, Houston, Texas, USA
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3
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Gill JS, Nguyen MX, Hull M, van der Heijden ME, Nguyen K, Thomas SP, Sillitoe RV. Function and dysfunction of the dystonia network: an exploration of neural circuits that underlie the acquired and isolated dystonias. DYSTONIA 2023; 2:11805. [PMID: 38273865 PMCID: PMC10810232 DOI: 10.3389/dyst.2023.11805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Dystonia is a highly prevalent movement disorder that can manifest at any time across the lifespan. An increasing number of investigations have tied this disorder to dysfunction of a broad "dystonia network" encompassing the cerebellum, thalamus, basal ganglia, and cortex. However, pinpointing how dysfunction of the various anatomic components of the network produces the wide variety of dystonia presentations across etiologies remains a difficult problem. In this review, a discussion of functional network findings in non-mendelian etiologies of dystonia is undertaken. Initially acquired etiologies of dystonia and how lesion location leads to alterations in network function are explored, first through an examination of cerebral palsy, in which early brain injury may lead to dystonic/dyskinetic forms of the movement disorder. The discussion of acquired etiologies then continues with an evaluation of the literature covering dystonia resulting from focal lesions followed by the isolated focal dystonias, both idiopathic and task dependent. Next, how the dystonia network responds to therapeutic interventions, from the "geste antagoniste" or "sensory trick" to botulinum toxin and deep brain stimulation, is covered with an eye towards finding similarities in network responses with effective treatment. Finally, an examination of how focal network disruptions in mouse models has informed our understanding of the circuits involved in dystonia is provided. Together, this article aims to offer a synthesis of the literature examining dystonia from the perspective of brain networks and it provides grounding for the perspective of dystonia as disorder of network function.
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Affiliation(s)
- Jason S. Gill
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, TX, United States
| | - Megan X. Nguyen
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
- Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, TX, United States
| | - Mariam Hull
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Meike E. van der Heijden
- Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, TX, United States
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United State
| | - Ken Nguyen
- Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, TX, United States
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United State
| | - Sruthi P. Thomas
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, United States
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, United States
| | - Roy V. Sillitoe
- Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, TX, United States
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United State
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
- Development, Disease Models and Therapeutics Graduate Program, Baylor College of Medicine, Houston, TX, United States
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4
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Gong C, Liu A, Lian B, Wu X, Zeng P, Hao C, Wang B, Jiang Z, Pang W, Guo J, Zhou S. Prevalence and related factors of epilepsy in children and adolescents with cerebral palsy: a systematic review and meta-analysis. Front Pediatr 2023; 11:1189648. [PMID: 37576141 PMCID: PMC10416728 DOI: 10.3389/fped.2023.1189648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Objective To study the worldwide prevalence and associated factors of epilepsy in children and adolescents with Cerebral Palsy (CP) and to analyze the differences between various subgroups. Method We identified all potential studies on the prevalence of epilepsy in children and adolescents with CP from PubMed, Web of Science, and Embase. The search time was from the establishment of the database to November 2022. Randomized effects meta-analysis models were used to calculate the prevalence of epilepsy in CP. Subgroup analysis and meta-regression were utilized to further explore heterogeneity between articles and prevalence disparities between subgroups. The funnel plot and Egger's test were used to investigate potential publication bias. Results Seventy-two articles, comprising 53,969 children and adolescents with CP, were included in this study. The results indicated a total epilepsy prevalence of 38.0% (95% CI: 34.8%-41.2%) in CP. The prevalence of epilepsy was 46.4% (95% CI: 41.4%-51.5%) in clinical sample-based studies and 31.6% (95% CI: 28.7%-34.5%) in population-based studies. Meta-regression demonstrated that the sample source, neonatal seizure, family history of epilepsy, EEG or cranial imaging abnormalities, intellectual/cognitive impairment, and topographical types of CP were heterogeneous contributors to the epilepsy prevalence in CP. Conclusion Approximately one-third of children and adolescents with CP have epilepsy, and the sample source can significantly impact the total prevalence of epilepsy. Neonatal seizures, family history of epilepsy, EEG abnormalities, cranial imaging abnormalities, severe intellectual disability, and quadriplegia may be contributing factors to epilepsy comorbid in CP. Further study is required to verify the strength of these associations with epilepsy. This study aids in identifying the clinical characteristics of young people with CP at risk of developing epilepsy, which may assist clinicians in the early prevention and diagnosis of epilepsy within this population.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=367766, identifier CRD42022367766.
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Affiliation(s)
- Chao Gong
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Annan Liu
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Beibei Lian
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Xixi Wu
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Pei Zeng
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Chaoli Hao
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Bobo Wang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
| | - Zhimei Jiang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
- Jiamusi University Affiliated No.3 Hospital, Jiamusi, China
| | - Wei Pang
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
- Jiamusi University Affiliated No.3 Hospital, Jiamusi, China
| | - Jin Guo
- College of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
- Jiamusi University Affiliated No.3 Hospital, Jiamusi, China
| | - Shaobo Zhou
- School of Science, Faculty of Engineering and Science, University of Greenwich, Medway Campus Central Avenue, Chatham Maritime, Kent, England
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5
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Cooper MS, Mackay MT, Dagia C, Fahey MC, Howell KB, Reddihough D, Reid S, Harvey AS. Epilepsy syndromes in cerebral palsy: varied, evolving and mostly self-limited. Brain 2023; 146:587-599. [PMID: 35871494 DOI: 10.1093/brain/awac274] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 06/25/2022] [Accepted: 07/08/2022] [Indexed: 11/12/2022] Open
Abstract
Seizures occur in approximately one-third of children with cerebral palsy. This study aimed to determine epilepsy syndromes in children with seizures and cerebral palsy due to vascular injury, anticipating that this would inform treatment and prognosis. We studied a population-based cohort of children with cerebral palsy due to prenatal or perinatal vascular injuries, born 1999-2006. Each child's MRI was reviewed to characterize patterns of grey and white matter injury. Children with syndromic or likely genetic causes of cerebral palsy were excluded, given their inherent association with epilepsy and our aim to study a homogeneous cohort of classical cerebral palsy. Chart review, parent interview and EEGs were used to determine epilepsy syndromes and seizure outcomes. Of 256 children, 93 (36%) had one or more febrile or afebrile seizures beyond the neonatal period and 87 (34%) had epilepsy. Children with seizures were more likely to have had neonatal seizures, have spastic quadriplegic cerebral palsy and function within Gross Motor Function Classification System level IV or V. Fifty-six (60%) children with seizures had electroclinical features of a self-limited focal epilepsy of childhood; we diagnosed these children with a self-limited focal epilepsy-variant given the current International League Against Epilepsy classification precludes a diagnosis of self-limited focal epilepsy in children with a brain lesion. Other epilepsy syndromes were focal epilepsy-not otherwise specified in 28, infantile spasms syndrome in 11, Lennox-Gastaut syndrome in three, genetic generalized epilepsies in two and febrile seizures in nine. No epilepsy syndrome could be assigned in seven children with no EEG. Twenty-one changed syndrome classification during childhood. Self-limited focal epilepsy-variant usually manifested with a mix of autonomic and brachio-facial motor features, and occipital and/or centro-temporal spikes on EEG. Of those with self-limited focal epilepsy-variant, 42/56 (75%) had not had a seizure for >2 years. Favourable seizure outcomes were also seen in some children with infantile spasms syndrome and focal epilepsy-not otherwise specified. Of the 93 children with seizures, at last follow-up (mean age 15 years), 61/91 (67%) had not had a seizure in >2 years. Children with cerebral palsy and seizures can be assigned specific epilepsy syndrome diagnoses typically reserved for normally developing children, those syndromes commonly being age-dependent and self-limited. Compared to typically developing children with epilepsy, self-limited focal epilepsy-variant occurs much more commonly in children with cerebral palsy and epilepsy. These findings have important implications for treatment and prognosis of epilepsy in cerebral palsy, and research into pathogenesis of self-limited focal epilepsy.
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Affiliation(s)
- Monica S Cooper
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
| | - Mark T Mackay
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
| | - Charuta Dagia
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Michael C Fahey
- Department of Paediatrics, Monash University, Melbourne, Victoria 3168, Australia
| | - Katherine B Howell
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
| | - Dinah Reddihough
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
| | - Susan Reid
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
| | - A Simon Harvey
- The Royal Children's Hospital, Melbourne, Victoria 3052, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria 3052, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria 3052, Australia
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Characteristics and Challenges of Epilepsy in Children with Cerebral Palsy-A Population-Based Study. J Clin Med 2023; 12:jcm12010346. [PMID: 36615146 PMCID: PMC9821172 DOI: 10.3390/jcm12010346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
The aim of this population-based study was to describe the prevalence and characteristics of epilepsy in children with cerebral palsy (CP), focusing on antiseizure medication (ASM) and seizure outcome. Findings were related to CP type, gross motor function and associated impairments. Data on all 140 children with CP born in 2003-2006 were taken from the CP register of Western Sweden. Medical records were reviewed at ages 9-12 and 13-16 years. In total 43% had a diagnosis of epilepsy. Epilepsy was more common in children with dyskinetic CP, who more often had a history of infantile spasms, continuous spike-and-wave during sleep and status epilepticus. Neonatal seizures, severe intellectual disability, severe motor disability and autism were associated with a higher risk of epilepsy. Many children were on polytherapy, and valproate was frequently used, even in girls. At age 13-16 years, 45% of the children with epilepsy were seizure free for at least one year. Onset after 2 years of age, female sex and white matter injury were associated with good seizure outcome. Despite the risk of relapse, reduction or discontinuation of ASM could be an option in selected cases. It is important to optimize ASM and to consider the possibility of epilepsy surgery.
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Li Z, Cao W, Sun H, Wang X, Li S, Ran X, Zhang H. Potential clinical and biochemical markers for the prediction of drug-resistant epilepsy: A literature review. Neurobiol Dis 2022; 174:105872. [PMID: 36152944 DOI: 10.1016/j.nbd.2022.105872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 12/01/2022] Open
Abstract
Drug resistance is a major challenge in the treatment of epilepsy. Drug-resistant epilepsy (DRE) accounts for 30% of all cases of epilepsy and is a matter of great concern because of its uncontrollability and the high burden, mortality rate, and degree of damage. At present, considerable research has focused on the development of predictors to aid in the early identification of DRE in an effort to promote prompt initiation of individualized treatment. While multiple predictors and risk factors have been identified, there are currently no standard predictors that can be used to guide the clinical management of DRE. In this review, we discuss several potential predictors of DRE and related factors that may become predictors in the future and perform evidence rating analysis to identify reliable potential predictors.
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Affiliation(s)
- ZhiQiang Li
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Wei Cao
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - HuiLiang Sun
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - ShanMin Li
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - XiangTian Ran
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Hong Zhang
- Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, China.
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8
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Wang J, Xiao L, Wang J, Ding Z, Ni J, Long X. Mosaic ring chromosome 18 in a Chinese child with epilepsy: a case report and review of the literature. Neurol Sci 2021; 42:5231-5239. [PMID: 33829328 DOI: 10.1007/s10072-021-05143-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/22/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Ring chromosome 18 (r[18]) is a rare syndrome in which one or both ends of chromosome 18 are lost and the remaining chromosome rejoins to form ring-shaped figures. It is characterized by developmental delay/cognitive disability, facial dysmorphisms, and immunological problems. The phenotype associated with epilepsy is rare and has not yet been reported in China. METHODS We report herein the case of a 12-year-old Chinese girl who presented with typical facial dysmorphisms, developmental delay, cognitive disability, hyperactivity, and epilepsy and discuss the clinical features of r(18) syndromes through comparison with previously described cases worldwide. RESULTS We describe the characteristics of all seizures that have been reported in these cases and propose that the appearance of epilepsy in r(18) patients may be associated with the abnormality of chromosome karyotypes. Further studies are warranted to confirm this.
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Affiliation(s)
- Jing Wang
- Department of Neurology, Dingxi Second People's Hospital, Dingxi, Gansu, People's Republic of China
| | - Ling Xiao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Junling Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Laboratory of Medical Genetics, Central South University, Changsha, Hunan, People's Republic of China.,Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, Hunan, People's Republic of China.,National Clinical Research Centre for Geriatric Diseases, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Zijin Ding
- Department of Anesthesiology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Jie Ni
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Laboratory of Medical Genetics, Central South University, Changsha, Hunan, People's Republic of China
| | - Xiaoyan Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
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9
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Pavone P, Gulizia C, Le Pira A, Greco F, Parisi P, Di Cara G, Falsaperla R, Lubrano R, Minardi C, Spalice A, Ruggieri M. Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity. CHILDREN-BASEL 2020; 8:children8010016. [PMID: 33396243 PMCID: PMC7823826 DOI: 10.3390/children8010016] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/26/2020] [Accepted: 12/28/2020] [Indexed: 12/13/2022]
Abstract
Cerebral palsy (CP) is a frequent cause of childhood disability often associated with a complex group of disorders, including epilepsy, which is reported to impact approximately 40% of affected individuals. This retrospective study involved a group of children affected by CP, some of whom also had comorbid epilepsy. The aim of this study was to report our experience of analyzing, in particular, (a) some of the clinical aspects of the different type of CP, and (b) the relationship between the clinical data of children affected by CP plus epilepsy and each type of CP. Methods: This retrospective single-center study was performed with 93 children admitted to the Pediatric Department of the University of Catania, Italy, affected by CP and distinguished according to the type of motor clinical presentation, with 46 showing epileptic seizures, compared to a control group of 136 children affected by epilepsy without other neurologic disorders. Results: Among the 93 CP children, 25 (27%) had spastic quadriplegia (plus one patient with dystonic quadriplegia), 39 (42%) had spastic hemiplegia, 11 (12%) had spastic diplegia (plus two with ataxia and one with dyskinetic CP), and 14 (15%) did not have a well-defined type of CP. The frequency of epilepsy was higher in affected CP children who showed major motor dysfunction (GMFCS IV–V types). As regards the 46 children with CP plus epilepsy, compared to the group of the control, the age of epilepsy onset was found to be statistically significant: 21 ± 35.1 months vs. 67 ± 39.7. Conclusions: Epilepsy represents one of the most frequent comorbidities of cerebral palsy. In children with CP, particular attention should be paid to the early identification and treatment of comorbid epilepsy.
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Affiliation(s)
- Piero Pavone
- Unit of Clinical Pediatrics, Department of Clinical and Experimental Medicine, AOU "Policlinico", PO "G. Rodolico", University of Catania, 95123 Catania, Italy; (P.P.); (A.L.P.); (F.G.)
| | - Carmela Gulizia
- Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy;
| | - Alice Le Pira
- Unit of Clinical Pediatrics, Department of Clinical and Experimental Medicine, AOU "Policlinico", PO "G. Rodolico", University of Catania, 95123 Catania, Italy; (P.P.); (A.L.P.); (F.G.)
| | - Filippo Greco
- Unit of Clinical Pediatrics, Department of Clinical and Experimental Medicine, AOU "Policlinico", PO "G. Rodolico", University of Catania, 95123 Catania, Italy; (P.P.); (A.L.P.); (F.G.)
| | - Pasquale Parisi
- NESMOS Department of Pediatrics, Sapienza University of Rome, Sant’Andrea University Hospital, 00161 Rome, Italy;
| | - Giuseppe Di Cara
- Department of Pediatrics, University of Perugia, 06132 Perugia, Italy;
| | - Raffaele Falsaperla
- Neonatal Intensive Care Unit (NICU), Neonatal COVID-19 Center, AOU “Policlinico”, PO San Marco, University of Catania, 95123 Catania, Italy;
| | - Riccardo Lubrano
- Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria, Neonatologia, Ospedale Santa Maria Goretti, Polo di Latina, 04010 Latina, Italy;
| | - Carmelo Minardi
- Department of Anaesthesia and Intensive Care, University Hospital “G. Rodolico” of Catania, 95123 Catania, Italy;
| | - Alberto Spalice
- Child Neurology Division, Department of Pediatrics, Sapienza University of Rome, 00161 Rome, Italy;
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and experimental Medicine, Section of Pediatrics and Child Neuropsychiatry, University of Catania, 95123 Catania, Italy
- Correspondence:
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