Attention deficit hyperactivity disorder (ADHD) is one of the most common developmental disorders in school-aged children. Symptoms consistent with ADHD have been observed in 8-77 % of children with epilepsy. Researchers have been motivated to search for alternative forms of treatment because 30 % of patients with ADHD cannot be treated by psychostimulants. Several studies support the use of a multimodal treatment approach that includes neurofeedback (NF) for the long-term management of ADHD. These studies have shown that NF provides a sustained effect, even without concurrent treatment with stimulants. We aimed to assess cognitive flexibility in ADHD children with and without temporal lobe epilepsy (TLE), and to evaluate the effects of NF on cognitive flexibility in these groups of children. We prospectively evaluated 69 patients with ADHD aged 9-12 years. The control group was 26 ADHD children without TLE who received no treatment. The first experimental group comprised 18 children with ADHD. The second experimental group comprised 25 age-matched ADHD children with TLE. This group was further divided in two subgroups. One subgroup comprised those with mesial temporal lobe epilepsy (16 patients, 9 with hippocampal sclerosis and 7 with hippocampal atrophy), and the other with lateral temporal lobe epilepsy (9 patients, 5 with temporal lobe dysplasia, 3 with temporal lobe cysts, and 1 with a temporal lobe cavernoma). We treated their ADHD by conducting 30 sessions of EEG NF. Reaction time and error rates on the Trail Making Test Part B were compared before and after treatment, and significant differences were found for all groups of patients except those who had mesial temporal lobe epilepsy with hippocampal atrophy. Our results demonstrate that in most cases, NF can be considered an alternative treatment option for ADHD children even if they have TLE. Additional studies are needed to confirm our results.

Paediatric epilepsy is a multifaceted neurological disorder with various aetiologies. Up to 30% of patients are considered drug-resistant. The background impact of interfering inflammatory and neuronal pathways has been closely linked to paediatric epilepsy. The characteristics of the inflamed state have been described not only in epilepsies, which are considered prototypes of an inflammatory pathophysiology, but also in patients with drug-resistant epilepsy, especially in epileptic encephalopathies. The imbalance of different cytokine levels was confirmed in several epileptic models. Chemokines are new targets for exploring neuroimmune communication in epileptogenesis, which control leukocyte migration and have a possible role in neuromodulation. Additionally, prostaglandin E2 (PGE2) is an important effector molecule for central neural inflammatory responses and may influence drug responsiveness. We measured the serum interictal quantitative levels of chemokines (CCL2, CCL4, CCL11) and PGE2 in correlation with the seizure frequency and severity in controlled and intractable childhood epilepsies. Our refractory seizure group demonstrated significantly increased concentrations of eotaxin (CCL11) compared to the controlled epilepsy group. The higher level of CCL11 was correlated with an increased seizure frequency, while the PGE2 levels were associated with the severity of seizure and epilepsy, supporting the findings that proinflammatory cytokines may contribute to epileptogenesis and possibly have a role in developing seizure resistance.

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Background: Epilepsy is the most frequent chronic neurologic disorder of childhood, with a reported higher incidence in underdeveloped countries. The pathogenesis of epilepsy involves complex mechanisms that are still not fully understood. In recent years, researchers have shown increasing interest in understanding the role of inflammation in epilepsy. One such component of the neuroinflammatory cascade is Interferon-Gamma (IFN-γ), a pro-inflammatory cytokine known for its role in immune responses. However, recent studies have revealed that IFN-γ possesses multifaceted properties, including potential neuroprotective and anticonvulsant effects. Multiple studies have reported elevated levels of IFN-γ in the serum, cerebrospinal fluid, and brain tissue of patients with epilepsy. The precise mechanisms through which IFNγ contributes to epilepsy remain incompletely understood. Objectives: The present study aimed to compare IFN-γ levels in drug-resistant epilepsy patients with those with well-controlled epilepsy and healthy controls. Methods: This prospective cross-sectional study enrolled 56 children: 20 with drug-resistant epilepsy, 20 with well-controlled epilepsy, and 16 healthy controls matched in demographic characteristics. Venous blood samples were collected from all participants for cytokine (chemokines, PGE2, and interferon-gamma (IFN-γ) analysis. Results: IFN-γ levels were not elevated in the study groups. The results indicate a considerable heterogeneity in IFN-γ levels among different types of epilepsy. The interquartile range (IQR) of targeted IFN-γ was lower in the drug-resistant epilepsy patients compared to well-controlled epilepsy and healthy control groups. Conclusions: The role of IFN-γ in epilepsies is complex and context-dependent. The precise role of IFN-γ in epilepsy warrants exploration; further research is needed to explore the current understanding of the relationship between IFN-γ and childhood epilepsy. The findings from this study may contribute to a better understanding of the role of cytokines in the pathogenesis of epilepsy and could potentially support the development of novel therapeutic approaches targeting cytokine dysregulation in epilepsy.

Panayiotopoulos syndrome is "a benign age related focal seizure disorder occurring in early and mid-childhood. It is characterized by seizures, often prolonged, with predominantly autonomic symptoms, and by an EEG that shows shifting and/or multiple foci, often with occipital predominance" (definition of International League Against Epilepsy).In literature the clinical features of PS was frequently mistaken as non-epileptic conditions such as acute encephalitis, syncope, migraine, cyclic vomiting syndrome, motion sickness, sleep disorder, or gastroenteritis.In our experience during the last 2 years we have observed 4 children misdiagnosed by clinical history for GERD. Until now PS is underestimated with the consequences of high morbidity and costly mismanagement.These 4 children were referred to general pediatrician at the age of 2-3 years because they started suffering from gastrointestinal emetic symptoms: nausea, retching, and vomiting. The attacks occurred mainly during sleep without sensory-motor clinical signs of seizure. One child also had monthly episodes of severe headache with clinical characteristics of migraine without aura.After a treatment with proton pump inhibitors (PPI) and antiacid without benefits, according to the literature, they were sent to neurologist for suspection of PS which was confirmed by EEGs occipital features.Because of the importance of the symptomatology, the children have been treated with Lamotrigine with benefit. Conclusions When a child presents symptoms suggestive of GERD but non responding to specific GERD therapy, there is indication to effect an EEG to investigate a PS. Background and Aim To investigate the effect of surgery time on prognosis of newborns with meningomyelocele. Methods The records of neonates with meningomyelocele were retrospectively analyzed. Demographic and clinical characteristics as well as information, timing of surgery, and durations of hospital stay and antibiotic therapy were recorded. Results The records of 30 babies were included in the final analysis. Overall, the mean gestational age was 37.7±2.7 weeks, with a mean birth weight of 2967±755 g and head circumference of 35.8±3.8 cm. In terms of localization, 46.6% of the meningomyeloceles were lumbosacral, 40% were lumbar, 10% were thoracolumbar and 3.3% were thoracal. The mean size of the meningomyelocele sacs was 4.33±1.2 cm. Newborns underwent surgery on average of 8.2±5.9 days after birth, with an overall mean duration of hospital stay of 30±25.1 days. Patients were divided into two groups based on timing of surgery (group 1, ≤5 days; group 2, >5 days), and comparisons between groups revealed that earlier surgery was associated with significantly shorter durations of hospital stay (p<0.001) and antibiotic therapy (p<0.05). THE EFFECT OF SURGERY TIME ON PROGNOSIS IN NEWBORNS WITH MENINGOMYELOCELE