PEDIATRIC NEUROLOGY

Corrigendum to Cortical Gyrification Is Associated With the Clinical Phenotype in Tuberous Sclerosis Complex [Pediatric Neurology, Volume 161, December 2024, Pages 170-175]
Trevisan N, Brunello F, Sambataro F, Biscalchin G, Nosadini M, Sartori S, Luisi C, Pelizza MF, Manara R and Toldo I
Neurocognitive Evaluation of Patients With DiGeorge Syndrome
Karali Z, Karali Y, Cekic S, Altinok B, Bodur M, Bostanci M and Kilic SS
DiGeorge syndrome (DGS), the most common microdeletion syndrome, affects multiple organs, including the heart, the nervous system, and the immune system. In this study, we aimed to evaluate the clinical, laboratory, brain magnetic resonance imaging (MRI), and neurocognitive findings of our patients with DGS.
New-Onset Refractory Status Epilepticus With Diffuse Cerebral Restricted Diffusion in Young Children: A Novel Clinical-Radiologic Presentation
Reecher HM, Mehta NP, Patel ND, Sawdy RA and Farias-Moeller R
New-onset refractory status epilepticus (NORSE) is a clinical presentation characterized by explosive-onset refractory status epilepticus (RSE) without evident etiology or active epilepsy, often leading to devastating epilepsy. There is heterogeneity in neuroradiographic findings for NORSE. We encountered a series of young patients with NORSE who had diffuse cerebral restriction in diffusion (DCRD) with similar radiographic appearances as acute encephalopathy with biphasic seizures and late restricted diffusion/acute leukoencephalopathy with restricted diffusion (AESD/ALERD). We explore clinical similarities and proposed pathophysiologic overlaps to highlight a novel clinical-radiologic presentation.
Pediatric Suprasellar Tumors: Unveiling the Mysteries of Craniopharyngioma and Germ Cell Tumors-Insights From Diagnosis to Advanced Therapeutics
Shatara M and Abdelbaki MS
Pediatric suprasellar tumors represent a unique and intricate challenge in the landscape of pediatric neuro-oncology.
Diagnostic and Therapeutic Insights Into Pediatric Neurosarcoidosis: Observations From French Pediatric Rheumatology Centers
Tohme R, Tanase A, Dumaine C, Dusser P, Adle-Biassette H, Despert V, Faye A, Mannes I, Melki I, Kone-Paut I, Meinzer U and
The diagnosis and management of neurosarcoidosis (NS) in pediatric patients remain challenging, with limited case documentation to guide clinicians. Most existing reports focus on initial presentations. This study aimed to outline the clinical features, management, and medium-term outcomes of pediatric NS METHODS: In this retrospective, multicentric, observational study, we collected data from pediatric patients followed in French pediatric rheumatology centers with a diagnosis of NS between January 2001 and June 2023.
Use of Stiripentol in Dravet Syndrome: A Guide for Clinicians
Wheless J and Weatherspoon S
Dravet syndrome is a developmental and epileptic encephalopathy characterized by frequent, prolonged convulsive seizures and status epilepticus. Symptoms usually appear in the first year of life, and in addition to ongoing severe and intractable epilepsy, children with Dravet syndrome experience neurodevelopmental, behavioral, and motor impairments, along with high rates of mortality, especially in the first 12 years of life. Prompt diagnosis and initiation of treatment with broad-spectrum antiseizure medications are recommended to reduce seizure frequency and status epilepticus, and to potentially minimize the comorbidities associated with the epileptic encephalopathy. Stiripentol is an antiseizure medication approved for adjunctive use in Dravet syndrome in patients aged as young as six months. Data from randomized clinical trials and real-world studies demonstrate that stiripentol added to first-line therapy with clobazam and/or valproate is associated with high rates of seizure control, including freedom from status epilepticus, for extended periods of time including into adulthood. Stiripentol has multiple mechanisms of action and also inhibits several metabolic drug-metabolizing enzymes that can enhance the efficacy of coadministered antiseizure medications. Stiripentol is well tolerated, and treatment-emergent adverse events can often be managed by dose adjustments of comedications. This review updates the use of stiripentol in the modern era.
Responsive Neurostimulation in Pediatric and Young Adult Patients With Drug-Resistant Focal, Multifocal, and Generalized Epilepsy: A Single-Center Experience
Swartwood SM, Bollo RJ, Sweney MT, Wilson CA, Sandoval Karamian AG, Kaur H, Orton K, Baker M and Espinoza AC
Responsive neurostimulation (RNS) is used off-label in pediatric patients with drug-resistant epilepsy (DRE). Our study aims to assess the safety and efficacy of RNS in pediatric and young adult patients with focal, multifocal, and generalized DRE.
Pediatric Central Nervous System Embryonal Tumors: Presentation, Diagnosis, Therapeutic Strategies, and Survivorship-A Review
Ronsley R, Cole B, Ketterl T, Wright J, Ermoian R, Hoffman LM, Margol AS and Leary SES
Central nervous system (CNS) embryonal tumors represent a diverse group of neoplasms and have a peak incidence in early childhood. These tumors can be located anywhere within the CNS, and presenting symptoms typically represent tumor location. These tumors display distinctive findings on neuroimaging and are staged using magnetic resonance imaging of the brain and spine as well as evaluation of cerebrospinal fluid. Diagnosis is made based on an integrated analysis of histologic and molecular features via tissue sampling. Risk stratification is based on integration of clinical staging and extent of resection with histologic and molecular risk factors. The therapeutic approach for these tumors is multimodal and includes surgery, chemotherapy, and radiation, tailored to the individual patient factors (including age) and specific tumor type. Comprehensive supportive care including management of nausea, nutrition support, pain, fertility preservation, and mitigation of therapy-related morbidity (including hearing protection) is imperative through treatment of CNS embryonal tumors. Despite advances in therapy and supportive care, the long-term consequences of current treatment strategies are substantial. Integration of less toxic, molecularly targeted therapies and a comprehensive, multidisciplinary approach to survivorship care are essential to improving survival and the overall quality of life for survivors.
Effect of Piracetam and Iron Supplementation on Heart Rate Variability in Children With Breath-Holding Spells: Effective Treatment or Placebo?
Panda PK and Sharawat IK
Association Between Television Viewing and Sensory Reactivity in Childhood: The Cross-Sectional InProS Study
Fernández-Pires P, Valera-Gran D, Hurtado-Pomares M, Espinosa-Sempere C, Sánchez-Pérez A, Juárez-Leal I, Muñoz-Sánchez R, León-García AS, Peral-Gómez P and Navarrete-Muñoz EM
Current evidence suggests a potential detrimental effect of increased television viewing on children's health, including sensory processing issues. Therefore, this study examined the association between television viewing time and atypical sensory reactivity (SR) in children aged from three to seven years.
Adjuvant High-Dose Erythropoietin With Delayed Therapeutic Hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy
Jongruk P, Soontaravarapas N, Angkurawaranon S, Kosarat S, Khuwuthyakorn V, Tantiprabha W, Manopunya S, Boonchooduang N, Louthrenoo O, Likhitweerawong N, Katanyuwong K, Sanguansermsri C and Wiwattanadittakul N
To evaluate the benefits of high-dose erythropoietin (EPO) combined with therapeutic hypothermia (TH) on brain magnetic resonance imaging (MRI) scores and neurodevelopmental outcomes in neonates with moderate to severe hypoxic-ischemic-ecephalopathy (HIE), especially in neonates who received TH between six to 12 hours of birth.
Predictors of Surgical Failure in Pediatric Lesional Temporal Lobe Epilepsy Surgery
Tomschik M, Moser K, Diehm R, Herta J, Wais J, Kasprian G, Czech T, Roessler K, Feucht M and Dorfer C
Epilepsy surgery can potentially cure pharmacoresistant temporal lobe epilepsy (TLE) in children. However, surgical failures, where patients continue to experience seizures, still exist. We evaluated outcomes in pediatric patients after resective temporal lobe surgery to identify risk factors for failure.
Pilot Study: Behavioral and Medical Clinical Partnership for Optimization of Positive Airway Pressure Therapy in Pediatric Patients
Singer EV, Martins H, Boursoulian L, Hicklin A, Loring W, Malow BA, Poirier N, Smith D and Shelton A
To assess the effectiveness of a structured algorithm for pediatric positive airway pressure (PAP) initiation for the treatment of obstructive sleep apnea (OSA).
Patient-Reported Outcomes in Childhood Moyamoya Arteriopa1thy
Ahmad SA, Gatti JR, Peterson RK, Burton N, Malone LA and Sun LR
Little is known about quality of life, sleep, and mental health in children with moyamoya arteriopathy (MMA). A better understanding of patient-reported outcomes may lead to improved treatment.
Horner Syndrome Secondary to Rapid Enlargement of a Mediastinal Lymphatic Malformation
Pickup E, Spagnolo K and Kornbluh AB
Horner syndrome is a clinical triad of ptosis, miosis, and anhidrosis, which commonly prompts urgent neuroimaging. The differential diagnosis of new-onset Horner syndrome in children includes neurological emergencies. We report here a case of a 13-month-old male infant with acute-onset Horner syndrome, subsequently found to have a large mediastinal lymphatic malformation compressing the trachea and neck vasculature.
Functional Syncope in Children and Adolescents: A Retrospective Cohort Study
Jarjour IT, Jarjour LK, Tran K and Czyzewski D
Functional syncope, or psychogenic pseudosyncope, is often under-recognized. We aimed to show that functional syncope may be diagnosed in most pediatric patients by the initial neurological consultation.
Alice in Wonderland Syndrome in Children With Severe Acute Respiratory Syndrome SARS-CoV-2 Infection: A Case Series of Two Patients in an Italian Hospital
Staccioli S, Mariani R, Bompard S, Olivini N, Fanfoni C, Mirra G, Bisozzi E, Campana A and Lettori D
Alice in Wonderland syndrome (AIWS) is a disorienting neurological condition that affects human perception to the senses of vision, hearing, touch, and sensation and the phenomenon of time. Herein we report two pediatric cases of AIWS temporally related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Response to Hamid et al., "Equitable Access of Delandistrogene Moxeparvovec for Patients With Duchenne Muscular Dystrophy"
Urion DK, Cabello JF and Salinas R
Do Vaccines Cause Postural Orthostatic Tachycardia Syndrome? Review of Cases in the National Vaccine Injury Compensation Program
Waheed W and Holmes GL
The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP), a no-fault alternative to the traditional tort system. Since 1988, the total compensation paid exceeds $6 billion. Although postural orthostatic tachycardia syndrome (POTS) is a frequent reason for filing a claim, there has been no review of the process and validity of the legal outcomes given current medical information. The purpose of this study was to review vaccine-related POTS and assess the rationale behind decisions made by the court.
MECP2 Variants in Males: More Common than Previously Appreciated
Ananth A, Fu C, Neul JL, Benke T, Marsh E, Suter B, Ferdinandsen K, Skinner SA, Annese F and Percy AK
To assess the age and MECP2 variants of recently identified males and set the stage for further study of clinical features in males.
Biallelic Variants in LIPT2 as a Cause of Infantile-Onset Dystonia: Expanding the Clinical and Molecular Spectrum
Sen K, Vera AZ, Puronurmi A, Gropman A, Wongkittichote P, Ganetzky R, Autio K and Kastaniotis A
Lipoyl transferase 2 is involved in the biosynthesis of lipoate. Lipoate is the cofactor for the glycine cleavage system and four dehydrogenase enzymes. Biallelic variants in LIPT2 causing severe neonatal encephalopathy was first described in 2017.