BACKGROUND Various studies suggest that the insular cortex may play an underappreciated role in pediatric frontotemporal/parietal epilepsy. Here, we report on the postsurgical outcomes in 26 pediatric patients with confirmed insular involvement by depth electrode monitoring. OBJECTIVE To describe one of the largest series of pediatric patients with medically refractory epilepsy undergoing laser interstitial thermal therapy (LITT) or surgical resection of at least some portion of the insular cortex. METHODS Pediatric patients in whom invasive insular sampling confirmed insular involvement and who subsequently underwent a second stage surgery (LITT or open resection) were included. Complications and Engel Class outcomes at least 1 yr postsurgery were compiled as well as pathology results in the open surgical cases. RESULTS The average age in our cohort was 10.3 yr, 58% were male, and the average length of follow-up was 2.43 ± 0.20 (SEM) yr. A total of 14 patients underwent LITT, whereas 12 patients underwent open resection. Complications in patients undergoing either LITT or open resection were mostly minimal and generally transient. Forty-three percent of patients who underwent LITT were Engel Class I, compared to 50% of patients who underwent open insular resection. CONCLUSION Both surgical resection and LITT are valid management options in the treatment of medically refractory insular/opercular epilepsy in children. Although LITT may be a less invasive alternative to craniotomy, further studies are needed to determine its noninferiority in terms of complication rates and seizure freedom, especially in cases of cortical dysplasia that may involve extensive regions of the brain.
Automation is a trending topic in the 21st century making it play an important role in our daily lives. The main attraction of any automated system is reducing human labour, effort, time and errors due to human negligence. With the development of modern technology, smart phones have become a necessity for every person on this planet. Applications are being developed on Android systems that are useful to us in various ways. Another upcoming technology is natural language processing which enables us to command and control things with our voice. Combining all of these, our paper presents a micro controller based voice controlled home automation system using smartphones. Such a system will enable users to have control over every appliance in his/her home with their voice. All that the user needs is an Android smartphone, which is present in almost everybody's hand nowadays, and a control circuit. The control circuit consists of an Arduino Uno microcontroller, which processes the user commands and controls the switching of devices. The connection between the microcontroller and the smartphone is established via Bluetooth, a widespread wireless technology used for sharing data. General TermsVoice recognition
Intractable epilepsy is a common diagnosis among child neurology practitioners with medical management remaining unsatisfactory in many cases. GLUT1 deficiency syndrome (GLUT1-DS) is a disorder that should be considered in such situations. Evaluation by comparing serum to CSF glucose levels is a fast and relatively easy test, with hypoglycorrhachia being highly suggestive of GLUT1-DS. Furthermore, treatment with the ketogenic diet is well-established and can result in significant improvement in quality of life for these patients. The following case report outlines the presentation of one such patient and highlights common features that can be seen with GLUT1-DS. Of interest, she was found to have a spontaneous, novel mutation that has not been reported previously. Her case allows us to expand on the present literature and demonstrate the improvements that can be seen in a child with appropriate treatment. Neurology ® 2015;84:e111-e114 SECTION 1An 18-month-old girl with intermittent paroxysmal events was brought to our clinic for workup. Medical history revealed recurrent 1-to 2-minute episodes of unresponsiveness, head rolling, and disconjugate gaze beginning around 3 months of age. Distinct from these events, she also had occasional dystonic posturing of her left arm. Prior MRI and 2 4-hour video EEGs were normal; medication had not been started due to the uncertain etiology of her episodes.Brief unresponsive episodes were present in the setting of mild developmental delay; she sat at 7 months, walked at 16 months, and had 1 word and followed 2-step commands at 18 months. She had low muscle tone and poor coordination but her motor examination was symmetric.Questions for consideration:
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