Shlomo Shinnar

..This review summarizes recent data on the epidemiology and prognosis of pediatric epilepsy...

..The remaining five subjects all had multiple seizures and were on medications. Treatment following the first seizure would not have altered mortality in any of the nine cases...

..Zonisamide is licensed in the EU and USA for the adjunctive treatment of partial-onset seizures in adults but there are few data about its use in children...

..Febrile status epilepticus (FSE) has been associated with hippocampal injury and subsequent mesial temporal sclerosis and temporal lobe epilepsy. However, little is known about the semiology of FSE...

..This has led to a changing view of how we approach the treatment of these common and largely benign seizures. This chapter will review the current understanding of the prognosis and management of febrile seizures...

..On a risk-benefit basis, the available epidemiologic data do not justify starting treatment after the first seizure to attempt to influence long-term prognosis...

..To determine the long-term cognitive and educational outcomes in children prospectively identified at the time of a first unprovoked seizure...

..Its use reduces morbidity and costs associated with hospital visits and provides parents a treatment option for home management of prolonged or repetitive seizures...

..Providing appropriate education and counseling to patients and families may be the most important aspect of treatment of a first unprovoked seizure...

..Differences of opinion among ISWG members occurred in areas where data were lacking; however, this article represents a consensus of the U.S. approach to the diagnostic evaluation and treatment of IS...

..The ongoing diary study will refine the definition of seizure clustering and further evaluate specific predictors of poor and favorable outcomes of clustering...

..An association was observed between children with language regression, a family history of autoimmune disease, and gastrointestinal symptoms. Additional studies are needed to examine a possible shared autoimmune process...

..Whereas the morbidity and mortality in patients with prolonged ASE or CPSE is low, the mortality associated with SSE can exceed 30% if the seizure duration is greater than 60 minutes...

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..The deaths occurred in the context of a prolonged seizure and respiratory depression was not the main symptom. When used as recommended, diazepam rectal gel has a low rate of serious morbidity or mortality...

..An understanding of the available data on clinical characteristics, EEG findings, pathology, prognosis, and treatment of these syndromes is essential for further progress in this area...

..This article also addresses criteria used to justify treatment of a seizure once it has continued longer than 5 minutes and the rationale for such treatment...

..04). Newer antiepileptic drugs, especially those without significant drug-drug interactions, may be a more appropriate first choice in children with brain tumors and seizures...

..We believe that these findings indicate a need for a prospective study to evaluate the role of stress and stress reduction as an additional potential therapeutic modality for epilepsy...

..At this time there are no other clear candidates for imaging-related biomarkers of epileptogenesis in human studies...

..Children with ASD have a higher rate of GI symptoms than children with either typical development or other DDs. In this study, there was no association between a family history of autoimmune disease and GI symptoms in children with ASD...

..Improvement was more likely in the 49% who were entirely developmentally normal before the regression. We conclude that language regression in childhood is a serious disorder with significant long-term morbidity...

..We believe that this study demonstrates the feasibility of implementing multicenter protocols for neurologic management, especially those involving localization, as well as protocols combining study results with clinical decision making...

..There are few studies on long-term mortality in prospectively followed, well-characterized cohorts of children with epilepsy. We report on long-term mortality in a Finnish cohort of subjects with a diagnosis of epilepsy in childhood...

..It is important to have a plan for management of prolonged and repetitive seizures. Long-term therapy should be managed in a manner that will eliminate the need for rescue therapies and visits to the emergency department...

..Such information is necessary for providing the epidemiologic and clinical context in which epilepsy surgery is currently performed in the United States and in other developed countries...

..Childhood-onset epilepsy is a common disorder. The long-term impact of having childhood epilepsy on quality of life (QOL) as an adult, whether or not seizures are in remission, has not been systematically studied...

..Its advantage is that it allows one to track the individuals' outcome over time even as the condition fluctuates. The technique would also be applicable in virtually any remitting-relapsing disorder...

..Little evidence guides practice regarding the reduction of antiepileptic drugs (AEDs) in individuals who achieve significant periods of remission after resective surgery...

..To examine factors influencing obtaining a driver's license and subsequent prognosis among people with epilepsy vs control subjects...

..To evaluate the outcome of children with cryptogenic infantile spasms treated with high-dose synthetic adrenocorticotropic hormone (ACTH) and the relation between early treatment, within 1 month of onset, and outcome...

..Although there have been many exciting advances in the last few decades-both molecular and epidemiologic-what we have learned has not appreciably changed what we tell families, and what we tell them can remain reassuring...

..We investigated evidence for maternal inheritance, female excess and patterns of familial seizure risk in a well-characterized sample of JME families...

..We conclude that in children with developmental disabilities the presence of macrocephaly even when not associated with hydrocephalus is associated with an increased risk of seizures...

..When it does occur, it occurs early in the course of the disorder. The occurrence of status epilepticus does not appear to have significant adverse impact on long-term prognosis of childhood-onset epilepsy...

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..To determine prospectively when in the course of epilepsy intractability becomes apparent...

..The Pediatric Epilepsy Surgery Sub-commission of the International League Against Epilepsy conducted a survey to determine the frequency of epilepsy procedures and etiologies...

..We examined the independent effects of syndrome type, seizure control, and etiology over time on adaptive behavior as measured by the Vineland Scales of Adaptive Behavior...

..This suggests an independent effect associated with the epilepsy itself...

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..This review of clinical data and discussion of the current understanding of the risk:benefit of felbamate therapy supports its use as an important therapeutic option for some patients with refractory epilepsy...

..To examine possible changes over time in the incidence of epilepsy in different age groups...

..To evaluate mortality in children with newly diagnosed epilepsy, to determine the risk of death, and to identify predictors of death from the point of diagnosis...

..This suggests that behavioral and cognitive abnormalities may predate the onset of epilepsy and are not necessarily the direct consequences of epilepsy...

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..4) Subjects with MTS will have impaired memory, whether or not they have epilepsy. ..

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..The results will provide critical information about the long- term outcomes of childhood seizures in a cohort prospectively followed since the time of their first seizure...

..Less than 10% of children with a first seizure are treated with long term medications at our institution. Therefore these results will reflect the true course of the disorder...

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