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Donald W Shields - One of the best experts on this subject based on the ideXlab platform.

  • psychopathology and pediatric Complex Partial Seizures Seizure related cognitive and linguistic variables
    Epilepsia, 2004
    Co-Authors: Rochelle Caplan, Prabha Siddarth, Suresh Gurbani, Raman Sankar, Donald W Shields
    Abstract:

    Summary: Purpose: This study examined the role of cognition, language, Seizure-related, and demographic variables in the psychopathology of children with Complex Partial Seizure disorder (CPS) of average intelligence. Methods: One-hundred one CPS and 102 normal children, aged 5.1 to 16.9 years, had a structured psychiatric interview and cognitive and language testing. Parents provided demographic, perinatal, and Seizure-related information, as well as behavioral information through the Child Behavior Checklist (CBCL) and a structured psychiatric interview about the child. Results: Significantly more CPS patients had psychopathology, cognitive deficits, and linguistic deficits than did those in the normal group. Among the patients, Verbal IQ predicted the presence of a psychiatric diagnosis, as well as CBCL scores in the borderline/clinical range. Seizure, linguistic, and demographic variables were unrelated to psychopathology. The cognitive and linguistic deficits of the CPS group, however, were predicted by Seizure factors (e.g., prolonged Seizures/febrile convulsions; Seizure frequency/number of antiepileptic drugs) and demographic factors (e.g., minority status). Conclusions: Because subtle verbal cognitive deficits predict behavioral disturbances in pediatric CPSs, the study's findings highlight the importance of assessing behavior, cognition, and language in these children. They also underscore the negative impact of prolonged Seizures, febrile convulsions, Seizure frequency, and antiepileptic drug polytherapy on cognition and language in pediatric CPSs.

  • blink rate in pediatric Complex Partial Seizure disorder
    Journal of Child Psychology and Psychiatry, 1998
    Co-Authors: Rochelle Caplan, Donald Guthrie, Scott Komo, Donald W Shields
    Abstract:

    This study examined spontaneous blink rate, a putative measure of dopamine function, in 30 children with Complex Partial epilepsy and 61 normal children. The children with epilepsy had significantly lower blink rates than the normal children in a conversation and a verbal recall task, particularly if they had a schizophrenia-like psychosis, EEG evidence for left focal epileptic activity, illogical thinking, discourse deficits, and distractibility. They modulated their blink rates across a listening, a conversation, and a verbal recall task like the normal children. Given previously reported low blink rates in schizophrenic children, these findings suggest that children with Complex Partial epilepsy or schizophrenia might have similar biological features.

Ruggero G Fariello - One of the best experts on this subject based on the ideXlab platform.

  • correlation of abnormalities of interictal n isopropyl p iodoamphetamine single photon emission tomography with focus of Seizure onset in Complex Partial Seizure disorders
    Epilepsia, 1991
    Co-Authors: Marlene E Dietrich, Donna Bergen, Michael C Smith, Ruggero G Fariello
    Abstract:

    Summary: Single-photon emission tomography (SPECT) scanning with n-isopropyl-p-iodoamphetamine (IMP) was performed on 23 patients with Complex Partial Seizures undergoing long-term video/electroencephalographic (EEG) Seizure monitoring. Twenty-one of the 23 patients had abnormalities on SPECT scanning consisting of areas of decreased activity reflecting diminished cerebral blood flow. In 15 of these 21 patients, there was good correlation between the site of the abnormality on SPECT scan and the site of origin of Seizures monitored by EEG. Of the six remaining patients, four had multifocal SPECT abnormalities, with one of the abnormal areas corresponding with an ictal site. The two remaining patients had SPECT abnormalities and major ictal EEG foci in entirely different areas. In contrast to the high proportion of abnormal SPECT scans, only 10 of 23 focal abnormalities were discovered on magnetic resonance imaging (MRI) scans. Three patients who had Seizures within 2 h of an initial scan were rescanned 4–5 h after injection. Focal areas of increased blood flow were noted on all three scans, although not always at the ictal site. The SPECT scan appears to be useful in interictal localization of Seizure foci. Postictal scans may also be useful, although our numbers are too small to draw conclusions. RESUME La tomographie par emission monophotonique (SPECT) utilisant la n-isopropyl-p-iodoenphetamine (IMP) a ete pratiquee chez 23 patients presentant des crises partielles Complexes, beneficiant d'un monitorage prolonge EEG et video. 21 sur 23 patients ont presente des anomalies au SPECT, sous la forme de zones de moindre activite, refletant une diminution du debit sanguin cerebral. Chez 15 de ces 21 cas, il y avait une bonne cor-relation entre le site de l'anomalie au SPECT et le site d'origine des crises selon le monitorage EEG. Parmi les 6 patients restants, 4 presentaient des anomalies multifocales au SPECT, l'une des zones anormales correspondant a la region d'origine des crises. Les deux autres avaient des anomalies au SPECT et des foyers critiques au niveau de regions entierement differentes. Contrairement a la forte proportion de SPECT anormaux, l'IRM n'a permis de mettre en evidence ces anomalies focales que chez 10 patients sur 23. Trois patients qui ont presente des crises en moins de deux heures apres un SPECT initial ont ete reexamines 4 a 5 heures apres l'injection. Des zones focales d'augmentations du debit sanguin cerebral ont ete constatees chez ces 3 patients, mais pas toujours au niveau du foyer critique. Le SPECT semble utile dans la localisation intercritique des foyers epileptiques. Des examens realises en post-critique peuvent egalement etre utiles, bien que les auteurs ne disposent que d'un nombre trap reduit d'observations. RESUMEN Se ha realizado una tomografia con emision de foton unico (SPECT) practicada con n-isopropyl-p-iodoanfetamina (IMP) en 23 enfermos con ataques parciales complejos sometidos a una monitorizacion a largo plazo de los ataques mediante EEG y video. Veintiuno de los 23 enfermos tenian anormalidades en el SPECT que consistian en areas de actividad deprimida que re-flejaban un flujo cerebral reducido. En 15 de estos 21 casos se obtuvo una buena correlateon entre el lugar de la anormalidad en el SPECT y el lugar de origen de los ataques monitarizados con EEG. De los 6 restantes enfermos, 4 tenian anormalidades multifocales en el SPECT y una de las areas anormales correspondia al lugar de los ataques. Los 2 pacientes restantes tenian anormlaidades en el SPECT y focos ictales en el EEG en lugares totalmente diferentes. En contraste con la elevada proporcion de SPECT anormales solamente 10/23 anormalidades focales fueron detectadas en estudios con Resonancia Magnetica. Tres enfermos que tenian ataques dentro de las dos horas de un SPECT inicial fueron estudiados nuevamente 4–5 despues de la inyec-cion. Se observaron areas de incremento de flujo cerebral en los tres estudios pero no siempre en el lugar del foco electrico. El SPECT parece ser util en la localizacion interictal de los focos. El scaner post-ictal puede ser util, aunque el numero de nuestros estudios es damasiado bajo para sacar conclusiones. ZUSAMMENFASSUNG Eine Single photon emission tomographie (SPECT) mit n-isopropyl-p-Iodoamphetamin (IMP) wurde bei 23 Patienten mit komplexen Partialanfallen (KPA) durchgefuhrt zusammen mit Langzeit-EEG und Video-Anfallsaufnahman. 21 der 23 Patienten boten pathologische Befunde im SPECT mit minderdurchbluteten Arealen. Bei 15 der 21 Patienten ergab sich eine enge Korrelation zwischen abnormer Region im SPECT und Lage des im EEG aufgezeichneten Anfallbeginns. Von 6 weiteren Patienten boten 4 multifokale SPECT-Storungen mit jeweils einer, den iktalen Veranderungen entsprechenden Region. Die beiden verbleibenden Patienten zeigten SPECT-Befunde und iktale Haupt-EEG-Foci in vollig unterschiedlcihen Arealen. Im Gegensatz zur hohen Anzahl pathologischer SPECTs, fanden sich nur bei 10/23 Patienten fokale Storungen im MRI. 3 Patienten mit Anfallen wahrend der initialen SPECT-Untersuchung wurden 4–5 Stunden nach der Injektion nochmals untersucht. In alien 3 Scans zeigte sich fokale Hyperperfusion, jedoch nicht immer auf der iktalen Seite. Das SPECT scheint nutzlich zu sein, um in-teriktale Anfallsfoci zu lokalisieren. Auch postiktale Befunde konnen sinnvoll sein, obwohl unsere Zahlen zu klein sind, um daraus Schlusse zu Ziehen.

Hans J Biersack - One of the best experts on this subject based on the ideXlab platform.

  • brain single photon emission tomography using technetium 99m bicisate ecd in a case of Complex Partial Seizure
    European Journal of Nuclear Medicine and Molecular Imaging, 1994
    Co-Authors: Christian Menzel, Christian E Elger, F Grunwald, L Pavics, A Hufnagel, Brigitte Stawovy, K Reichmann, Hans J Biersack
    Abstract:

    The clinical application of technetium-99m bicisate (ethyl cysteinate dimer, ECD) for ictal and interictal studies of regional cerebral blood flow (rCBF) in a patient suffering from medically intractable simple and Complex Partial Seizures is reported. The interictal study was performed 60 min p.i. and the ictal studies were performed at 60 min p.i. using an annular crystal single-photon emission tomography (SPET) system dedicated for high-resolution brain SPET imaging. Visual evaluation of the studies was carried out, as well as semiquantitative measurement of regional tracer uptake. Magnetic resonance imaging (MRI) scans revealed atrophy of almost the complete left frontal lobe and the ventral parts of the left temporal lobe, including in part the temporomesial structures. The left parietal and occipital structures and the right hemisphere were normal. The interictal study showed a large perfusion defect involving the whole left frontal lobe as well as the left temporal lobe with remaining small areas of normal cortical tracer uptake. The ictal studies detected circumscribed hyperperfusion within the left mesial temporal lobe (ventral part of the hippocampus). Additionally an increase in perfusion could be seen within the entire remaining left temporal lobe. Semiquantitative evaluation of tracer uptake comparing both studies detected markedly increased uptake within the focus compared to the remaining left temporal lobe. On this basis the newly available tracer for studies of rCBF, 99mTc-bicisate, seems to be of value for the detection of epileptogenic foci. Additionally, the value of ictal rCBF studies in the presurgical evaluation of those patients presenting severe morphological alterations on MRI is clearly underlined by this case.

Rochelle Caplan - One of the best experts on this subject based on the ideXlab platform.

  • psychopathology and pediatric Complex Partial Seizures Seizure related cognitive and linguistic variables
    Epilepsia, 2004
    Co-Authors: Rochelle Caplan, Prabha Siddarth, Suresh Gurbani, Raman Sankar, Donald W Shields
    Abstract:

    Summary: Purpose: This study examined the role of cognition, language, Seizure-related, and demographic variables in the psychopathology of children with Complex Partial Seizure disorder (CPS) of average intelligence. Methods: One-hundred one CPS and 102 normal children, aged 5.1 to 16.9 years, had a structured psychiatric interview and cognitive and language testing. Parents provided demographic, perinatal, and Seizure-related information, as well as behavioral information through the Child Behavior Checklist (CBCL) and a structured psychiatric interview about the child. Results: Significantly more CPS patients had psychopathology, cognitive deficits, and linguistic deficits than did those in the normal group. Among the patients, Verbal IQ predicted the presence of a psychiatric diagnosis, as well as CBCL scores in the borderline/clinical range. Seizure, linguistic, and demographic variables were unrelated to psychopathology. The cognitive and linguistic deficits of the CPS group, however, were predicted by Seizure factors (e.g., prolonged Seizures/febrile convulsions; Seizure frequency/number of antiepileptic drugs) and demographic factors (e.g., minority status). Conclusions: Because subtle verbal cognitive deficits predict behavioral disturbances in pediatric CPSs, the study's findings highlight the importance of assessing behavior, cognition, and language in these children. They also underscore the negative impact of prolonged Seizures, febrile convulsions, Seizure frequency, and antiepileptic drug polytherapy on cognition and language in pediatric CPSs.

  • blink rate in pediatric Complex Partial Seizure disorder
    Journal of Child Psychology and Psychiatry, 1998
    Co-Authors: Rochelle Caplan, Donald Guthrie, Scott Komo, Donald W Shields
    Abstract:

    This study examined spontaneous blink rate, a putative measure of dopamine function, in 30 children with Complex Partial epilepsy and 61 normal children. The children with epilepsy had significantly lower blink rates than the normal children in a conversation and a verbal recall task, particularly if they had a schizophrenia-like psychosis, EEG evidence for left focal epileptic activity, illogical thinking, discourse deficits, and distractibility. They modulated their blink rates across a listening, a conversation, and a verbal recall task like the normal children. Given previously reported low blink rates in schizophrenic children, these findings suggest that children with Complex Partial epilepsy or schizophrenia might have similar biological features.

  • Communication deficits in pediatric Complex Partial Seizure disorder and schizophrenia
    Development and Psychopathology, 1994
    Co-Authors: Rochelle Caplan, Donald Guthrie, W. Donald Shields, Sue Yudovin
    Abstract:

    AbstractBased on findings that, like schizophrenic children, children with Complex Partial Seizure disorder have illogical thinking, this study examined whether or not these same epileptic subjects had other thought processing impairments found in schizophrenic children. Compared to normal children (N = 38), both the epileptic (N = 27) and schizophrenic children (N = 31) underutilized discourse (cohesive) devices that make speech coherent. The severity of the discourse deficits and formal thought disorder of the schizophrenic children was associated with age, but not with IQ scores. Age, IQ, and Seizure-related, not behavioral variables, were associated, however, with the severity of the discourse deficits of the epileptic subjects. The study' findings suggest that measures of impaired thought processing and communication in schizophrenic children could be a model to study the developmental impact of Complex Partial Seizure disorder in middle childhood. The clinical implications of the study's findings are discussed.

  • Formal thought disorder in pediatric Complex Partial Seizure disorder.
    Journal of Child Psychology and Psychiatry, 1992
    Co-Authors: Rochelle Caplan, Donald Guthrie, W. Donald Shields, Lisa Mori
    Abstract:

    : We compared the formal thought disorder ratings of 27 children with Complex Partial Seizure disorder, 31 schizophrenic children and 58 normal children. The epileptic children with fullscale IQ scores below 100 had significantly more formal thought disorder than normal children with a similar IQ. The severity of their formal thought disorder was related to the age of Seizure onset, Seizure control and a diagnosis of schizophrenia spectrum disorder. The schizophrenic children had thought disorder irrespective of IQ scores. The cognitive correlates of their formal thought disorder scores differed from those of the epileptic children. Possible anatomical substrates of thought disorder in childhood Complex Partial Seizure disorder and schizophrenia are discussed.

Sanjeev V Kothare - One of the best experts on this subject based on the ideXlab platform.