Learning disorders (LDs) are diagnosed in children whose academic skills of reading, writing or mathematics are impaired and lagging according to their age, schooling and intelligence. Children with LDs experience substantial working memory (WM) deficits, even more pronounced if more than one of the academic skills is affected. We compared the task-related electroencephalogram (EEG) power spectral density of children with LDs (n = 23) with a control group of children with good academic achievement (n = 22), during the performance of a WM task. sLoreta was used to estimate the current distribution at the sources, and 18 brain regions of interest (ROIs) were chosen with an extended version of the eigenvector centrality mapping technique. In this way, we lessened some drawbacks of the traditional EEG at the sensor space by an analysis at the brain-sources level over data-driven selected ROIs. Results: The LD group showed fewer correct responses in the WM task, an overall slower EEG with more delta and theta activity, and less high-frequency gamma activity in posterior areas. We explain these EEG patterns in LD children as indices of an inefficient neural resource management related with a delay in neural maturation.
Pre-surgical motor function continues to play a role in the pre-surgical evaluation process in order to provide a baseline for outcome. Hemispheric surgery, once regarded as a radical intervention and last treatment resource, may become routinely indicated for refractory hemispheric epilepsy in children and adolescents, with oftentime favourable motor outcomes.
Highlights
A multipronged teleneurology based approach for management of infantile spasms is needed for developing countries.
Key principles: Fundamentals of management of IS, decentralization of patient care to local health providers, and early initiation of first-line therapeutic options.
Efforts should be made for improving sensitivity and specificity of diagnosis.
Constant motivation of parents and local health providers for monitoring therapeutic response, adverse effects of therapy, and infections.
Startle epilepsy is a syndrome of reflex epilepsy in which the seizures are precipitated by a sudden and surprising, usually auditory, stimulus. We describe herein a girl who had been suffering with startle‐induced seizures since 2 years of age. She had focal, tonic and tonic‐clonic seizures, refractory to antiepileptic treatment. Daily tonic seizures led to very frequent falls and morbidity. Neurologically, she had no deficit. Interictal EEG showed slow waves and epileptiform discharges in central and fronto‐central regions. Video‐polygraphic recordings of seizures, triggered by stimuli, showed generalised symmetric tonic posturing with ictal EEG, characterised by an abrupt and diffuse electrodecremental pattern of fast activity, followed by alpha‐theta rhythm superimposed by epileptic discharges predominantly over the vertex and anterior regions. Magnetic resonance imaging showed no abnormalities. Corpus callosotomy was performed when the patient was 17. Since surgery, the patient (one year follow‐up) has remained seizure‐free. Corpus callosotomy may be considered in patients with startle epilepsy and tonic seizures, in the absence of focal lesions amenable to surgery. [Published with video sequences]
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