Seizure disorders are relatively common in childhood, and the International League Against Epilepsy (ILAE) provides a hierarchical classification system to define seizure types. At the final level of classification, specific epilepsy syndromes are defined that represent a complex of signs and symptoms unique to an epilepsy condition. The present review discusses the issues related to several of these epilepsy syndromes in childhood, including those classified as generalized idiopathic epilepsies (e.g., childhood absence epilepsy, juvenile absence epilepsy, juvenile myoclonic epilepsy), focal epilepsies (benign rolandic epilepsy, occipital epilepsy, temporal lobe epilepsy, frontal lobe epilepsy) and the "epileptic encephalopathies," including Dravet's Syndrome, West Syndrome, Lennox-Gastaut Syndrome, Myoclonic Astatic Epilepsy, and Landau-Kleffner Syndrome. For each syndrome, the epidemiology, clinical manifestations, treatments, and neuropsychological findings are discussed.
Deficits in the ability to recognize emotions in others have been noted in a wide variety of disorders, ranging from the psychiatric to the neurologic. Emotions are vital to social interactions, yet there are currently few standardized neuropsychological measures in common use to assess emotion perception abilities. This study examined the effects of age on performance of the Comprehensive Affect Testing System, a new assessment battery designed to measure perception of emotion via facial affect, prosody, and semantic content. Age was not associated with a significant decline in performance on facial tasks, although there was a significant age effect when discrete emotions were examined. Age was strongly associated with a decline in performance on prosody and cross-modal tasks, and this decline was independent of the decline in fluid ability that also accompanies the aging process. The results underscore the need for standardized instruments to assess emotion recognition abilities.
Background: Surgery on patients with lesions in the dominant hemisphere for language is best done with awake language mapping. Intraoperative MRI (iMRI) has also been proposed as an ideal method for tumor resection control in patients with primary brain tumors. Objectives: This study examines the feasibility of low-field iMRI during awake craniotomy and tumor resection. Methods: 36 patients underwent awake resection with a compact iMRI for guidance. Outcomes were grouped using an A–D classification. Outcome A was defined as gross total resection (GTR) without iMRI, B as GTR achieved secondary to iMRI findings, C as resection stopped due to mapping but prior to iMRI, and, finally, D as resection stopped after iMRI had showed residual tumor but subsequent mapping limited further resection. Results: Diagnoses included primary brain tumors in all but 2 patients: 1 had mesial temporal sclerosis and 1 cysticercosis. Overall, outcomes A and D were the most common with 12 patients each, outcome C was the least common occurring in only 3 patients, and outcome B occurred in 9 patients. Hence, in 12 patients, iMRI led to increased tumor resection while in another 12 brain mapping limited the extent of resection. Conclusions: Combined awake language and motor mapping and iMRI guidance is feasible for resection of brain lesions. A compact iMRI has unique advantages for this approach.
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