The purpose of this study was to investigate the sensitivity and specificity of a standardized placebo protocol using a moist swab pad application in children and adolescents with psychogenic seizures vs epileptic seizures. Methods: We retrospectively reviewed clinical data and video-EEG monitoring records with the standardized placebo protocol of 408 patients. Video -EEG diagnosis with PNES-consistent semiology was made in the context of clinical data by a two-certified epileptologist. Results of induction of psychogenic seizure by moist swab pad application were analyzed in 158 patients with PNES. A control group was composed of 74 patients with epilepsy in which induction was performed. Results: Sensitivity of placebo test for the diagnosis of PNES was 81.1%, specificity 79.8%, positive predictive value 89.6% and negative predictive value 66.3%.
Conclusion:The placebo technique with a moist swab can be regarded as helpful in triggering a psychogenic episode in children and adolescents.
SUMMARYThe problems of children and adolescents with epilepsy pose an important challenge for educational systems around the world. Epilepsy is the most common chronic neurological disease, which occurs in up to 1% of children and adolescents. The largest incidence of onset is from early childhood to adolescence, therefore, mostly the emotional, cognitive and social problems experienced by patients coincide with the school period. It is commonly believed, as indicated by research, that some of the children and adolescents with epilepsy experience learning difficulties and school problems. This article presents the educational problems of a group of patients in Poland with epilepsy and the co-occurring specific difficulties in the acquisition of scholastic skills like dyslexia, spelling disorder or dyscalculia. The work is a review with an analysis of a case study.
Recently, extensive studies investigating executive functions in children with specific language impairment (SLI) have been performed. In the present study, we compared the level of executive functions (i.e., inhibitory control and cognitive flexibility) and literacy skills between 53 healthy children and 53 children with SLIs between the ages of 3 and 11 years. The groups were matched by age, gender and parental education level. Executive functions were assessed using the Children Card Sort, and the Literacy Assessment Battery was applied to measure literacy skills. The patients with SLI displayed a significantly lower level of cognitive flexibility than that of the healthy children. No significant differences were observed between the groups in inhibitory control and the majority of literacy skills. The results confirm the hypothesis that patients with SLI experience difficulties in cognitive flexibility.
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