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Children
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Diagnosis and Treatment in Childhood Epilepsy
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Diagnosis and Treatment in Childhood Epilepsy

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Child Neurology".

Deadline for manuscript submissions: 15 January 2025 | Viewed by 4283

Special Issue Editor

Dr. Debopam Samanta

E-Mail Website
Guest Editor
Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, AR, USA
Interests: epilepsy; child neurology; clinical neurophysiology; EEG analysis; tuberous sclerosis; neurometabolism; neurogenetics

Special Issue Information

Dear Colleagues,

Epilepsy is the most common serious chronic neurological condition in children. Although there are some parallels, the diagnosis and treatment of childhood epilepsy might differ significantly from adult-onset epilepsy. Some epileptic disorders, such as infantile spasms, Dravet syndrome, and Lennox–Gastaut syndrome appear uniquely depending on age. Furthermore, the objective in treating these children is to enhance cognition, learning,  school performance, and seizure freedom with minimal adverse effects.

Although seizures and epilepsy have been diagnosed and treated since ancient times, there is cutting-edge research in many aspects of childhood epilepsy that we wish to highlight in this Special Issue.

The International League Against Epilepsy recently published a new epilepsy classification scheme that would aid the prompt diagnosis and appropriate treatment of epilepsy. Furthermore, the global epilepsy community will have a common language to effectively communicate about the numerous dimensions of epilepsy, including a better appreciation of different comorbid conditions. Various facets of epilepsy, including epileptogenesis and underlying pathophysiology, are now being elucidated due to advances in genetics, neuroimaging, and neuroimmunology. In addition, advances in genetics paved the way for precision therapeutics.

Many new antiseizure medicines with novel mechanisms of action have been approved for childhood-onset rare epilepsy syndromes. Despite the advent of new and effective pharmacologic therapies, about 20–30% of children have drug-resistant epilepsy (DRE). Various efforts (dietary therapies, neurostimulation, new epilepsy surgical approaches) are underway to expand nonpharmaceutical options to decrease seizure frequency and improve the quality of life of these children living with DRE. Vagus nerve stimulator therapy has long been available for children with DRE, but responsive neurostimulation therapy and deep-brain stimulation therapy are now on the horizon, both of which are approved for adults with refractory epilepsy. Less-invasive surgical techniques are also explored in children with epilepsy, including laser interstitial thermal ablation. These recent advancements underscore one of the most exciting periods in childhood epilepsy. We feel the extensive discussion of cutting-edge research will strongly influence the practice in clinicians managing childhood epilepsy.

On behalf of the Editorial Office, we invite you to contribute your research papers and review articles for peer review and possible publication.

Dr. Debopam Samanta
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • epilepsy
  • seizure
  • antiepileptic drugs
  • antiseizure medicine
  • epilepsy surgery
  • neuromodulation

Published Papers (3 papers)

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12 pages, 1254 KiB  
Article
Enhancing Executive Functions in Pediatric Epilepsy: Feasibility and Efficacy of a Computerized Cognitive Training Program
by José Luis Tapia, Luis Miguel Aras and Jon Andoni Duñabeitia
Children 2024, 11(4), 484; https://doi.org/10.3390/children11040484 - 18 Apr 2024
Viewed by 503
Abstract
Epilepsy, a prevalent neurological disorder characterized by recurrent seizures, significantly impacts individuals’ neurobiological, cognitive, and social lives. This report presents a feasibility study investigating the effects of a computerized cognitive training program on enhancing executive functions, particularly inhibitory control, in children and adolescents [...] Read more.
Epilepsy, a prevalent neurological disorder characterized by recurrent seizures, significantly impacts individuals’ neurobiological, cognitive, and social lives. This report presents a feasibility study investigating the effects of a computerized cognitive training program on enhancing executive functions, particularly inhibitory control, in children and adolescents with epilepsy. Employing a pre-test–intervention–post-test design, the study involved 26 participants with diverse epileptic syndromes, focusing on those without severe intellectual disabilities. The intervention, based on the CogniFit Inc. platform, consisted of personalized tasks aiming to improve participants’ inhibitory skills over 16 weeks, with an average of 40 sessions completed per participant. Results indicated significant improvements in reaction times and error rates in an anti-saccade task, demonstrating enhanced inhibitory control and general performance post-intervention. These findings suggest that targeted cognitive training is a feasible approach to bolster executive functions in young individuals with epilepsy, potentially improving their academic performance, employability, and social interactions. The study underscores the importance of early cognitive interventions in epilepsy management, highlighting the potential for computerized programs to aid in mitigating cognitive deficits associated with the condition. Full article
(This article belongs to the Special Issue Diagnosis and Treatment in Childhood Epilepsy)
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13 pages, 3322 KiB  
Article
Genotype–Phenotype Analysis of Children with Epilepsy Referred for Whole-Exome Sequencing at a Tertiary Care University Hospital
by Fahad A. Bashiri, Rawan AlSheikh, Muddathir H. Hamad, Hamad Alsheikh, Rana Abdullah Alsheikh, Amal Kentab, Najd AlTheeb and Malak Alghamdi
Children 2023, 10(8), 1334; https://doi.org/10.3390/children10081334 - 1 Aug 2023
Viewed by 1350
Abstract
Background: Despite the high consanguinity rates, data on genetic epilepsy in Saudi Arabia is limited. The objective of the current study was to characterize genetic mutations associated with epilepsy in pediatric patients and describe their phenotypic presentations. Methods: A retrospective chart review was [...] Read more.
Background: Despite the high consanguinity rates, data on genetic epilepsy in Saudi Arabia is limited. The objective of the current study was to characterize genetic mutations associated with epilepsy in pediatric patients and describe their phenotypic presentations. Methods: A retrospective chart review was conducted among children presented with epilepsy in one center in Saudi Arabia between 2015 and 2018. Only those who had undergone genetic testing were included. Results: A total of 45 patients had positive whole-exome sequencing (WES) genetic testing with 37 mutations. Six mutations (SCN1A, DENND5A, KCNQ2, ACY1, SCN2A, and PCDH19) were repeated in 15 patients, with largely heterogeneous phenotypic presentations in patients with the same mutation. Several mutations are reported for the first time in Saudi Arabia. The median age at epilepsy onset was four months. Consanguineous parents and family history of epilepsy were frequent (31.8% and 33.3%, respectively). Developmental delay (44.4%), cognitive delay (42.2%), language delay (40.0%), behavioral features (28.9%), and microcephaly (20.0%) were frequent presentations. At initial diagnosis, 68.9% of EEG and 48.9% of brain MRI were abnormal. The most currently used antiseizure medications (ASMs) were levetiracetam (48.9%), topiramate (28.9%), and valproic acid (20.0%). Approximately 60% of the patients were controlled with (47.6%) or without (11.9%) ASMs, and three (7.1%) patients died. Conclusions: Multiple mutations among children with epilepsy are reported in one hospital in Saudi Arabia, with the majority reported for the first time. The current findings highlight the importance of doing genetic testing for the evaluation of childhood epilepsy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment in Childhood Epilepsy)
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8 pages, 257 KiB  
Brief Report
Effect of Vagus Nerve Stimulation on Blood Inflammatory Markers in Children with Drug-Resistant Epilepsy: A Pilot Study
by Valentina Baro, Maria Vittoria Bonavina, Francesco Saettini, Giovanna D’Amico, Andrea Trezza, Luca Denaro, Daniele Grioni and Andrea Landi
Children 2022, 9(8), 1133; https://doi.org/10.3390/children9081133 - 29 Jul 2022
Cited by 2 | Viewed by 1546
Abstract
Background: Since one of the suggested mechanisms of action of VNS on epilepsy is the reduction of central inflammation, we carried out a comprehensive analysis of blood inflammatory markers in children considered for VNS surgery. Materials and methods: Five pediatric patients were studied. [...] Read more.
Background: Since one of the suggested mechanisms of action of VNS on epilepsy is the reduction of central inflammation, we carried out a comprehensive analysis of blood inflammatory markers in children considered for VNS surgery. Materials and methods: Five pediatric patients were studied. An extensive analysis of blood inflammatory markers was performed before surgery (T0) and six weeks after VNS implantation (T1). An epileptological outcome was obtained according to the McHugh score. Results: The variations of IgA, IgE, IgG, CD19, and PTX3 displayed a tendency toward a positive statistical correlation between T0 and T1. According to McHugh score, the patients were divided into Group 1 (i.e., Class I) and Group 2 (i.e., Classes II and III). IL-1β and PTX-3 tended to decrease more in Group 1, while TNF-α decreased in Group 2 (−56.65%) and slightly increased (+3.61%) in Group 1 at T1 without statistical correlation. Conclusions: The variation of IL-1β and PTX-3 seem to be related to a better outcome; thus, they do not reach statistical significance. A larger series of patients is needed to determine whether biochemical changes could relay with the clinical improvement of epilepsy. Full article
(This article belongs to the Special Issue Diagnosis and Treatment in Childhood Epilepsy)
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