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1
Nuttycombe, Rachael Eileen. "Parenting children with epilepsy." Thesis, University of Hull, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440230.
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Thomason, Kate Elizabeth. "Cognitive variiability in children with epilepsy." Thesis, University of Sheffield, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500107.
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Lunn, Judith. "Social understanding in children with epilepsy." Thesis, Lancaster University, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.656313.
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Children with epilepsy are at increased risk of communication and behavioural problems. Previous research has not assessed whether difficulties with social understanding are a contributory factor. This thesis contains three studies that addressed social cognitive reasoning and social attention in a group of children with epilepsy and typically developing children in mainstream education. The studies employed diverse methodologies to explore functioning in a number of cognitive and attention domains known to contribute to social understanding skills. The first study involved 55 children with epilepsy and 69 typically developing children. It employed social cognitive and social perceptual reasoning tasks, standardized assessments of IQ and expressive language and parental report measures of communication and behaviour. The findings suggest that children with epilepsy have difficulty with socio-cognitive reasoning that may be independent of functioning in other non-social domains. The degree of socio-cognitive impairment also predicted increased parental reports of communication and behaviour problems in some children. The second study involved 57 children (34 with epilepsy) and addressed bias in mental states attribution. It provides evidence that atypical mental states attribution is associated with poor executive function and attention in children with epilepsy who have increased reports of behavioural problems. The third study used eye tracking to assess social attention and inhibition to dynamic displays of gaze and emotion. It involved 59 children (25 with epilepsy). The children with epilepsy demonstrated atypical responding to gaze and emotion signals and performance was associated with increased reports of social problems. Overall, the findings suggest that social cognition and social attention are areas of vulnerability in some children with epilepsy.
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Cormack, Karl Frederick Magnus. "Children's cognitive representations of epilepsy." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.396777.
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Beresford, Bryony. "Coping with epilepsy in childhood : an examination into factors mediating adjustment in children with epilepsy." Thesis, University of Exeter, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316379.
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Costolo, Megan. "Evidence-Based Intervention for Families of Children with Epilepsy." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/203001.
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The purpose of this paper is to propose an evidence-based intervention guideline to increase effective coping and positive adaptation in families with a preschool age child who has epilepsy. This population was chosen because there is a lack of research regarding interventions for families of preschool age children with epilepsy. Relevant literature was reviewed to summarize the effects of childhood epilepsy on families, and to assess the effectiveness of interventions to improve coping and adaptation in these families. The main stressors caused by epilepsy are knowledge deficits about epilepsy, knowledge deficits about treatments for epilepsy, increased seizure frequency, and emotional disturbances caused by epilepsy. Prior interventions for families of children with epilepsy included psychoeducational programs, support groups, education programs, family counseling groups, and therapeutic alliance. All interventions in the studies reviewed had positive outcomes for families of children with epilepsy. However, psychoeducational programs tended to address all of the common stressors, whereas other interventions did not. This paper provides an evidence-based intervention guideline for families affected by epilepsy. The significance and limitations of the program are discussed, and recommendations for future research in this area are presented.
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Corrigan, Fiona MacDonald. "Sleep and forgetting in children with genetic generalised epilepsy." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/6695/.
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Objective: Given the well-established association between epilepsy and sleep disturbance and the evidence suggesting the importance of sleep in memory consolidation, there is reason to investigate the relationship between sleep and rate of forgetting in children with epilepsy. This study aimed to investigate the relationship between sleep and forgetting in children with Genetic Generalised Epilepsy (GGE). Methods: Participants were 19 children with GGE (9-15 years old). Actigraphy, sleep diaries and standardised questionnaires were used to measure sleep over a week long period. Rate of forgetting was measured using neuropsychological tests at the beginning and end of the study week. Spearman’s correlation analysis was used to determine if poorer sleep was associated with poorer initial learning and rate of forgetting in verbal memory recall and recognition. Results: No association was found between sleep efficiency or duration and rate of forgetting. Measures of sleep disturbance were mixed, with sleep onset latency found to be associated with rate of forgetting on the Word Lists test. However, increased wake after sleep onset was associated with decreased rate of forgetting. Conclusions: Whilst there was limited evidence of a relationship between some actigraphic sleep parameters and rate of forgetting for verbal information, the results were mixed and likely biased by the small sample size. There is need for further research with a larger sample to establish the nature of the relationship between sleep and rate of forgetting in children with GGE.
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Parker, Alasdair Patrick John. "The investigation and management of children with epileptic encephalopathies." Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391613.
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Kija, Edward Nkingwa. "Bone metabolism abnormalities in children with epilepsy at Red Cross War Memorial Children's Hospital, Cape Town, South Africa." Master's thesis, University of Cape Town, 2017. http://hdl.handle.net/11427/27013.
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Introduction: Epilepsy is the most common neurological condition worldwide. Literature on the antiepileptic medications and biochemical markers of bone metabolism has revealed inconsistent results. Most of these studies were undertaken in Europe and America where the burden and the associated comorbidities are different to the ones in Africa. Methods: A hospital based case control study was undertaken at Red Cross War Memorial Children's Hospital where children were recruited from a dedicated Epilepsy clinic and controls were obtained from a day surgical ward. Blood and urine samples were taken for the assessment of markers of bone metabolism. Results: Seventy-five cases and 75 controls were recruited. The median age for the children with epilepsy was 9 years with a range of 1 to 17 and controls 3 years with a range of 1 to 12. Vitamin D deficiency was present in 11(16.2%) of children with epilepsy compared to 6(8.8%) in the control group. Vitamin D insufficiency was present in 30(44.1%) in children with epilepsy compared to 27(39.7%) in the control group. Children with epilepsy on enzyme inducing AEDs had lower mean Vitamin D levels (24.67±11.4 vs 30.72±7.4, p=0.08), lower mean Vitamin D2 (0.25±0.07 vs 0.4±0.17,p=0.0018),lower mean Vitamin D3 (1.61±1.06 vs 2.58±0.86,p=0.004), lower mean serum phosphate levels (1.39±0.2 vs 1.76±0.7,p=0.000) and a higher mean parathyroid hormone levels (4.47±2.33 vs 2.7±0.97, p=0.03) compared to the control group. Children with Epilepsy on enzyme inhibitors had higher mean Vitamin D2 (0.44±0.37 vs 0.25±0.07,p=0.000004) and mean Vitamin D3 (2.26±0.86 vs 1.61±1.06,p=0.028) compared to children on enzyme inducers. Dietary intake and ancestry did not influence Vitamin D levels between the cases and controls. Conclusion and Recommendations: Vitamin D deficiency is common in children with epilepsy on AEDs. Children on enzyme inducing AEDs should be investigated for vitamin D deficiency and managed accordingly.
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Alkhaldi, Hani M. "Intractable epilepsy in South African children based on criteria defined by the international league against epilepsy (ILAE)." Master's thesis, University of Cape Town, 2011. http://hdl.handle.net/11427/6018.
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Lalkhen, Nuruneesa. "The quality of life of parents of children with epilepsy." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/53152.
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Thesis (MA)--Stellenbosch University, 2002.ENGLISH ABSTRACT: The focus of the present review is the quality of life (QOL) of parents caring for a child with epilepsy. The review is informed by published books and articles available on the Psychlit and Medline databases. The paper provides an overview of epilepsy and the problems patients, particularly children, are confronted with. The important roles that parents fulfil in their child's life is followed by a discussion of the stress and burden experienced by parents caring for a child with epilepsy. Descriptions and definitions of the construct QOL are followed by reported research findings on the QOL of patients with epilepsy. The importance of the QOL of parents caring for a child with epilepsy is emphasized and this leads to an examination of existing research on the QOL of these parents. Research on the QOL of parents of children with epilepsy is limited despite the important roles parents fulfil in the life of their child with epilepsy and the potentially negative consequences of these additional roles for the child, the parents and the remainder of the family. Identification and an understanding of the dimensions of QOL of parents that are impacted upon by a child's epilepsy may produce improved treatment outcomes and QOL for children diagnosed and living with epilepsy. Recommendations for future research are included in the present review.
AFRIKAANSE OPSOMMING: Die fokus van hierdie oorsig is die lewenskwaliteit van ouers wat 'n epileptiese kind versorg. Die oorsig is gebaseer op gepubliseerde boeke en artikels wat beskikbaar is op Psychlit en Medline databasisse. Die oorsig voorsien 'n omskrywing van epilepsie asook van die probleme wat pasiente, veral kinders, ondervind. Die belangrike rolle wat ouers in hul kinders se lewe speel word bespreek en dit word gevolg deur 'n bespreking van die stres en druk wat ouers wat epileptiese kinders versorg, ondervind. Beskrywings en definisies van die konstruk lewenskwaliteit word aangebied, gevolg deur 'n opgawe van navorsingsbevindinge oor die lewenskwaliteit van epiletiese pasiënte. Die belangrikheid van die lewenskwaliteit van ouers van 'n epileptiese kind word beklemtoon en dit lei tot 'n oorsig van huidige navorsing oor die lewenskwaliteit van hierdie ouers. Ten spyte van die belangrike rolle wat ouers in die lewe van hul epileptiese kind speel en die moontlike negatiewe gevolge van hierdie bykomende rolle vir die kind, die ouers en die ander familielede, is navorsing oor die lewenskwaliteit van ouers met epileptiese kinders beperk. Identifisering van en insig in die faktore wat 'n impak het op die lewenskwaliteit van ouers met 'n epileptiese kind, kan lei tot verbeterde behandelingresultate en hoër lewenskwaliteit vir kinders wat gediagnoseer word en wat met epilepsie saamleef. Aanbevelings vir toekomstige navorsing word ook in hierdie oorsig gemaak.
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Reed, Mary Poyner. "Parental Caregivers' Description of Caring for Children with Intractable Epilepsy." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3153.
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Thesis advisor: Judith VesseyThe objective of this study was to describe the parental perspective of caring for a child with intractable epilepsy. The purpose of this study was twofold: (1) to describe the caregiver transitions from caring for a healthy child to caring for a child with intractable epilepsy, and (2) to study families that provide caregiving, to identify the challenges, and learn how they address the intricacies and nuances of caring for a child with intractable epilepsy. The specific research questions that guide this study were: (1) What do parents of children with epilepsy find helpful or challenging during transitions from caring for a healthy child to a child with intractable epilepsy? (3) What factors enable parents to transition from caring for a healthy child to a child with intractable epilepsy? The research design used qualitative descriptive design and was based on naturalistic inquiry. This methodology was used to describe parental experiences using their own words and not interpret these experiences. Research participants were recruited from a Level 4 National Association of Epilepsy Center at a Children's Hospital in the Northeast. A purposive sample of twelve parental caregivers participated. Themes that emerged from the interviews included (1) Journey to Diagnosis, Connecting the Dots, (2) Drunken Sailor, Medication Management, (3)Negotiating and Advocacy for Education (4) Provider Challenges, Communication and Parenting and (5) It Takes a Village: Sibling, Family Members and Friends. Nurses play a significant role in education, advocating, and guiding families through the initial diagnosis to dealing with activities of daily living and future planning. This research study serves as a foundation for future intervention studies regarding how best to support parents of children with intractable epilepsy
Thesis (PhD) — Boston College, 2013
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Harlan, Drewel Elena. "Peer difficulties in children with epilepsy association with medical, neuropsychological, academic, and behavioral factors /." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/4850.
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Thesis (Ph.D.)--University of Missouri-Columbia, 2007.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on March 19, 2009) Vita. Includes bibliographical references.
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Sillifant, Kate Louise. "Psychiatric morbidity in children with epilepsy : the development and testing of a modified version of the child behavior checklist for use in children with epilepsy." Thesis, University of Leeds, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.415602.
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Clarke, Allison, and n/a. "The impact of epilepsy on the psychosocial functioning of young people." Swinburne University of Technology, 2007. http://adt.lib.swin.edu.au./public/adt-VSWT20080811.093324.
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Both medical and psychological factors have an important impact upon the psychosocial functioning of young people with epilepsy. The key purpose of this thesis was to identify factors that significantly distinguish young people with
epilepsy who function well from those who do not. A total of 114 young people (40 males, 74 females) with active epilepsy and a mean age of 17.92 years (SD = 3.90) participated. They completed either a paper (60.5%) or an Internet based survey
(39.5%) that comprised demographic, medical and psychosocial measures. These included the Family Assessment Device, Adolescent Coping Scale, Orientation of Life Scale, Hospital and Anxiety Scale, Quality of Life in Epilepsy for Adolescents
Scale and Seizure Concerns Scale. Good and poor psychosocial functioning groups were identified via latent class cluster analysis using anxiety, depression, concerns about epilepsy and health-related quality of life scores. To predict membership of the poor psychosocial functioning group, independent variables were entered into a
hierarchical logistical regression. The final model was a good fit with the data (Hosmer-Lemeshow test: χ(8) =5.24, p %gt; .05), explaining 66 per cent of the variance
and correctly predicting 84.1 per cent of the cases. Young people were more likely to
be members of the poor psychosocial functioning group if they had a seizure in the
last month (Wald = 5.63, p %lt; .05), came from families with lower levels of
functioning (Wald = 5.28, p %lt; .05) and made greater use of non-productive coping
strategies such as wishful thinking, withdrawal and worry (Wald = 12.00, p %lt; .01).
The significant contribution of comorbid conditions was reduced when the family
functioning variable was added to the model, suggesting that young people with
multiple chronic illnesses may have lower psychosocial functioning because of
ineffective communication and unsuccessful problem solving within their families.
Similarly, when the non-productive coping strategy variable was added to the model,
the previous significant contribution of sense of coherence was reduced, indicating
that a lower sense of coherence may be a function of the greater use of nonproductive
coping strategies. The findings suggest that in addition to medical
treatment, clinicians can promote better outcomes for young people with epilepsy by
encouraging them to decrease their use of non-productive coping strategies and
increase the levels of communication and problem solving within their families. The
thesis concludes with a review of the methodological limitations of the study and
possible future research directions, including suggestions regarding potential
interventions that may assist the psychosocial functioning of young people with
epilepsy.
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Fong, Chung-yan Gardian. "Electro-clinical study and gene mapping of epilepsies." Hong Kong : University of Hong Kong, 2002. http://sunzi.lib.hku.hk/hkuto/record.jsp?B24463826.
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Papazoglou, Aimilia. "Medical and neuropsychological predictors of adaptive functioning in children with epilepsy." unrestricted, 2009. http://etd.gsu.edu/theses/available/etd-08122009-132658/.
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Thesis (Ph. D.)--Georgia State University, 2009.Title from file title page. Tricia Z. King, committee chair; Robin Morris, Christopher Henrich, Thomas G. Burns, committee members. Description based on contents viewed Sept. 2, 2009. Includes bibliographical references (P. 121-134).
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Praninskienė, Rūta. "Sleep disorders and melatonin secretion-excretion patterns in children with epilepsy." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2013. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2012~D_20130124_081710-20457.
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Sleep disorders in children provide a frequent cause for parents to seek medical care. If a child has several kinds of sleep disorders and (or) has another illness, their diagnosis and treatment typically become more complicated. Sleep disorders are a frequent comorbidity to epilepsy. In the clinical practice, synthetic melatonin is prescribed for treatment of sleep disorders in children with epilepsy. Clinical trials suggest that melatonin may shorten the duration to sleep onset and balance the sleep structure, leading to decrease in the number of epileptic attacks. However, the melatonin system in these trials has not been explored, and changes of the melatonin system in children with epilepsy are not yet understood.
The main objectives of the present study were: i) to determine the most frequent kinds of sleep disorders in children with epilepsy; ii) to characterize the melatonin (MLT) system in children with epilepsy in detail: to describe full diurnal profile, to search correlation with anthropometric data, seizure characteristics (time, type of seizures, antiepileptic medications), as well as the other physiological circadian rhythms (body temperature, pulse, blood pressure).
The study results have shown that sleep disorders were more frequent in the group of children with epilepsy (Sleep disorders scale for children (SDSC) (Bruni O et al, 1996)).The most frequent were: the disorders of excessive somnolence (DOES) and sleep - wake transition disorders (SWTD)... [to full text]Vaikų miego sutrikimai – dažna problema, dėl kurios tėvai kreipiasi į gydytoją. Jei vaikui būdingi keli miego sutrikimai ir (ar) jis serga kita liga, tai diagnozuoti ir gydyti miego sutrikimus yra sudėtinga. Miego sutrikimams ir epilepsijai būdingas komorbidiškumas. Literatūros duomenimis, vaikams, sergantiems epilepsija, empiriškai skiriama sintetinių melatonino preparatų. Įrodyta, kad jie sutrumpina užmigimo laiką, reguliuoja miego struktūrą, todėl retėja epilepsijos priepuoliai. Tačiau epilepsija sergančių vaikų melatonino sistema dar nebuvo tiriama. Darbo tikslas – išsiaiškinti epilepsija sergančių vaikų dažniausius miego sutrikimus ir kankorėžinės liaukos hormono melatonino, jo metabolito 6-sulfatoksimelatonino (aMT6s) paros cirkadinio profilio ypatumus bei ryšį su epilepsijos formomis, priepuoliais, priepuolių laiku, vartojamais vaistais nuo epilepsijos (VNE) bei kitų fiziologinių rodiklių cirkadiniu ritmu (kūno temperatūros, širdies susitraukimų dažnio, arterinio kraujo spaudimo). Rezultatai parodė, kad epilepsija sergančių vaikų miego sutrikimų skalės (VMSS) rodikliai buvo aukštesni visuose miego sutrikimų pogrupiuose. Dažnesni buvo padidėjusio mieguistumo bei miego ir budrumo ritmo sutrikimai. Kontrolinėje ir sergančių epilepsija vaikų grupėse melatonino apykaita, išreikšta ekskrecijos metabolito aMT6s kiekis kūno svorio vienetui, turėjo neigiamą ryšį su amžiumi ir lytinės brandos stadija. Vaikų, sergančių epilepsija, cirkadinis melatonino sekrecijos ir ekskrecijos... [toliau žr. visą tekstą]
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Wood, Stephen James. "Memory dysfunction and focal pathology in children with temporal lobe epilepsy." Thesis, University College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.300670.
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Chan, Samantha Yuen-Sum. "The contribution of sleep to cognitive function in children with epilepsy." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/10024776/.
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Cognitive impairment is the major co-morbidity in childhood epilepsy, and in many cases will have a larger long-term impact than the seizures themselves. However, the mechanisms contributing to this are poorly understood, precluding targetted intervention. Sleep is crucial for intelllectual functioning. Yet sleep in children with epilepsy, and its impact on intellectual function has scarcely been studied. This thesis aims to examine the structure and regulation of sleep in children with epilepsy, and to provide direct evidence of the impact of sleep on cognitive function by correlating neurophysiological characteristics with performance on sleep dependent neuropsychological tasks administered over the same interval as the sleep recorded. To examine sleep architecture in children with epilepsy, I developed a modified system for visual sleep scoring, taking into account nocturnal seizures and interictal activity. This was validated in a pilot sample, then applied to the scoring of 52 recordings from children with epilepsy. Based on established memory consolidation tasks and open-source psycholinguistic data, I developed and piloted a memory consolidation task battery suitable for testing school-aged English-speaking children, comprising parallel versions of a visuospatial and a verbal task. With these tools, I performed a prospective, within-subject comparison of memory retention across similar length intervals with or without sleep, in order to determine the contribution of sleep to memory consolidation. I compared results from patient (n=22) and healthy control (n=21) samples, finding – contrary to expectations – that sleep benefits memory consolidation in children with epilepsy to the same degree as controls. However, the benefit of sleep showed an inverse relationship to the nocturnal interictal discharge load. I also employed quantitative EEG analysis of slow wave activity to examine sleep homeostasis in patients with epilepsy, studying a retrospective sample (n=16) who had undergone partial sleep deprivation. Sleep homeostasis was fundamentally intact in these patients, who had similar clinical characteristics to the prospective sample. Findings from this thesis provide the first direct evidence that sleep benefits intellectual functioning in children with epilepsy, particularly where its structure and regulation is intact. Sleep-related memory consolidation may represent a compensatory mechanism, perhaps accounting for the relative cognitive preservation in this cohort of children with epilepsy with a structural aetiology, despite the early onset of seizures.
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Hunter, Matthew. "NEUROPROFILES : NEUROdevelopment in PReschool children Of FIfe and Lothian Epilepsy Study." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/28870.
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Neurobehavioural problems (i.e. cognitive impairment/behaviour problems) are common in childhood epilepsy. There are very limited data in children with early-onset epilepsy (CWEOE; onset ≤4 years). This study: (1) estimated the incidence of early-onset epilepsy, (2) described the spectrum and prevalence of neurobehavioural problems in CWEOE, and their risk factors, and (3) explored eye-gaze behaviour as a marker of neurobehavioural problems. This two year, prospective, population-based, case-controlled study identified newly diagnosed CWEOE in South East Scotland using active multi-source capture-recapture surveillance. CWEOE and controls completed detailed age-appropriate neuropsychological assessment - including Bayley III/WPPSI III, NEPSY II and social-emotional behaviour questionnaires. Children completed five eye-tracking tasks which assessed memory, attention, and social cognition. 59 CWEOE were identified (36M:23F); ascertainment-adjusted incidence 62/100,000 ≤4yrs/yr (95%CI 40-88). Asian and White-European children were at increased risk of epilepsy. 46 CWEOE (95%CI 62-84, 27M:19F) and 37 sex-age matched controls (18M:19F) underwent neuropsychological assessment. CWEOE had poorer general cognitive ability (p < .001, η²=.24), and increased parent reports of abnormal behaviour – significantly so in adaptive behaviour, ASD behaviours, hyperactivity/inattention, and atypical social behaviour. Overall 63% of CWEOE met criteria for neurobehavioural problems across multiple domains, vs 27% of controls (p < .001). Risk factors varied by domain. Prematurity and symptomatic/cryptogenic aetiology were common risk factors but other seizure-related variables were not. CWEOE with social problems exhibited abnormal eye-gaze behaviour toward social stimuli. Subtle atypicalities in sustained attention were noted in CWEOE, and an unexpected absence of antisaccade production was seen in all children. This is the first population-based study to describe the neurobehavioural profile, and explore eye-gaze behaviour, in CWEOE. Neurobehavioural problems are present, detectable, and highly prevalent in CWEOE, with implications for medical, psychosocial and educational resource provision, and provides an argument for early intervention. Eye-tracking may be a viable marker of neurobehavioural problems, and this study provides impetus for future eye-tracking investigations in CWEOE. Lastly, certain ethnic groups may be at increased risk of early-onset epilepsy in Scotland, providing opportunity for targeted intervention.
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Rushe, Helen. "Living with a sibling with refractory epilepsy children's experience of having a sibling with epilepsy." Thesis, University of Essex, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.549276.
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Yung, Wing-yan Ada, and 楊穎欣. "Clinical outcome and prognosis of childhood epilepsy (1996-2006)." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45153322.
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Korman, Brandon M. "Memory Performance in Children with Temporal Lobe Epilepsy: Neocortical vs. Dual Pathologies." Diss., NSUWorks, 2016. https://nsuworks.nova.edu/cps_stuetd/107.
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This study investigated memory in children with temporal lobe epilepsy and the ability to discern hippocampal dysfunction with conventional memory tests that are typically used to detect more global memory impairment. All data was obtained retrospectively from the epilepsy surgery program at a local children’s hospital. The research population consisted of 54 children with intractable epilepsy of temporal onset, balanced across pathology types (with and without hippocampal disease) and other demographics. Each was given a clinical battery prior to surgical intervention, which included the WRAML/WRAML2 Verbal Learning subtest from which the dependent variables for this study were extracted. The research hypothesis had predicted that memory retention between verbal learning and recall would be worse for participants with pathology that included hippocampal sclerosis than for those with non-hippocampal temporal lobe pathology. A two-way mixed-design ANOVA was used to test the hypothesis, which allowed incorporation of variables of interest related to memory factors, pathology type, and hemispheric laterality, as well as their various interactions. There was a significant main effect for change in the number of words retained from the final learning trial to the delayed recall. Although the interaction between memory retention and pathology type was not statistically significant, the average of the memory scores as it related to pathology by side did show significance. Thus, results did not support the hypothetical relationship between retention and hippocampal function. However, additional exploratory analyses revealed that the final learning trial by itself was associated with hippocampal pathology, which applied only to those participants with left-hemisphere lesions. Logistic regression with the final learning trial correctly classified 74 percent of participants into the appropriate pathology category, with 81 percent sensitivity to hippocampal dysfunction. Mean participant memory scores were nearly one standard deviation below the normative mean for both delayed recall and total learning scaled scores, regardless of pathology type or lesion hemisphericity. Thus, while the conventionally used indices of the WRAML Verbal Learning test are useful for determining overall memory status, they are not specific to pathological substrate. The within-subject main effect showed an expected loss of information across the time of the delay, but overall the recall score showed no association with hippocampal functioning. This study revealed the possibility of measuring hippocampal function at statistically significant group levels using learning scores from a widely used measure of verbal memory, even in participants with intact contralateral mesial temporal structures. It also indicated that hippocampal structures do not play a role during recall measures given after a standard time delay. Data further demonstrated a role of the hippocampus for encoding and transferring information beyond short term/working memory into long term. During the learning process, the hippocampus appears to work in concert with short-term memory systems, but does not take over the encoding process until enough repetitions have occurred to saturate the working memory buffer. This research represents a small, yet important step forward in our understanding of the hippocampus, with potentially important implications for the future study of memory constructs and mensuration.
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Dahllöf, Göran. "Phenytoin-induced gingival overgrowth in epileptic children a clinical, histological and biochemical study /." Stockholm : [Karolinska Institutet], 1986. http://catalog.hathitrust.org/api/volumes/oclc/13674550.html.
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Duffy, Lisa. "Testing the Efficacy of the Creating Opportunities for Parent Empowerment (COPE) Intervention During Hospital to Home Transition: Empowering Parents of Children with Epilepsy and Other Neurological Conditions." Thesis, Boston College, 2013. http://hdl.handle.net/2345/3030.
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Thesis advisor: Judith A. VesseyBackground: Parents of children with epilepsy and other neurological conditions live with a feeling of constant uncertainty. The uncertainty associated with caring for a child with epilepsy and other neurological conditions produces stress, which leads to decreased parental belief in caregiving skills, anxiety, and depression, ultimately altering parental functioning resulting in an increase in child behavioral problems. The stress associated with caring for a child with epilepsy and other neurological conditions is unlike caring for children with other chronic conditions. Epilepsy and other neurological conditions are unpredictable and there are often no warning signs prior to an acute event. This unpredictability accompanied with stigma results in social isolation and impacts family functioning. In addition, children with epilepsy have a higher rate of psychological co-morbidities and behavior problems when compared to children with other chronic conditions. This produces an additional burden on the parents and family. Study Design: This randomized controlled trial tested the efficacy of the COPE intervention for parents of children with epilepsy and other neurological conditions. This intervention was administered at three intervals: 1) during hospital admission in writing and by audiotape, MP3 download, or Podcast; 2) three days following hospital discharge by telephone; and 3) four to six weeks after hospital discharge in writing and by audiotape, MP3 download, or Podcast. Results: Forty-six parents of children admitted to the inpatient neuroscience unit at Boston Children's Hospital participated in the study. Several study limitations resulted in an inadequate sample size to obtain the power necessary to reach statistically significant results for a majority of the research questions. A one-between, one-within multivariate analysis of variance (MANOVA) revealed that the main effect of time was significant for differences in state anxiety for both the Usual Care Group and the Intervention Group, F, (1, 20) = 9.86, p = .005, indicating that state anxiety for both groups combined was more pronounced during the hospitalization. A one-between, one-within MANOVA demonstrated that the effect of the interaction between time and group was significant for internalized behavior assessment system score only (p=.037) as the Usual Care Group reported a significant decrease in internalizing behavior scores in their children over time. Conclusions: Findings from this study have significant implications for clinical practice and future research. Parents of children with neurological conditions often struggle to manage a constant feeling of uncertainty in their daily lives. Nurses possess the knowledge and expertise necessary to identify the psychosocial needs of these parents and provide education and support as needed. Future research should focus on designing interventions to meet the needs of these families and develop strategies to help improve the quality of life for both the parent and child living with a neurological condition
Thesis (PhD) — Boston College, 2013
Submitted to: Boston College. Connell School of Nursing
Discipline: Nursing
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Bencivenga, Roberto. "A statistical analysis of electroencephalographic spikes in benign Rolandic epilepsy of childhood." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26165.
Full textAbstract:
The occurrence of spikes during an electroencephalogram is a basic feature of Benign Epilepsy of Childhood (BREC). In this thesis we analyze several problems related to the structure of such spikes.
The currently used mathematical model describing the spike assumes that all the inter-spike variations are due to background activity. We show that non-negligible additional variability is present during the spike and propose a slightly richer model which takes such variability into account. In particular we conclude that background noise may not be used to assess the precision of the estimates of the signal.
The technique of spike averaging is presently used to obtain more precise estimates of the signal. By comparing averaging with trimmed mean, median and the "lowess" smoother, we find no discrepancies indicating the presence of skewness or long tails in the underlying distribution of the data and conclude that spike averaging is an adequate method for estimating the deterministic part of the spike.
Next, three automated procedures for the detection of the peak of the spike are compared to the existing method, which is based on a visual analysis of the EEG tracing. None of the alternative methods is found to be superior, but the methodology developed for this problem is rather general and could be applied to other similar comparisons.
Finally we address the question of whether "atypical" BREC patients, who are characterized by having other neurological abnormalities besides seizures, have a spike structure different from that of the "typical" patients. The non parametric method of "classification trees" is discussed and then applied to find whether certain features of the spike can discriminate between typical and atypical patients. The location and amplitude of the spike are found to provide a satisfactory classification rule, suggesting that the two groups may be affected by different types of epilepsy.
We have used, throughout the thesis, simple methods which do not require strong assumptions. In particular we have tried to avoid assumptions of normality and linearity and to rely mostly on non parametric methods.Science, Faculty of
Statistics, Department of
Graduate
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Graveline, Chantal. "Reorganization of sensorimotor functions pre and post hemispherectomy in children with refractory epilepsy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0005/NQ41166.pdf.
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Riney, Catherine Josephine. "Improving the detection of focal brain abnormality in children with intractable focal epilepsy." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/17230/.
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Children with intractable focal epilepsy pose a difficult management problem. For those who have a visible structural brain lesion on magnetic resonance imaging (MRI), epilepsy surgery may be a possible treatment option. Hippocampal sclerosis, one of the commonest structural pathologies that can underlie intractable temporal lobe epilepsy, is one such structural lesion that is usually clearly defined on MRI and outcome following surgical resection is good. However, in those with no visible MRI abnormality, the option of surgery becomes much more difficult to consider. Subtle areas of developmental pathology such as focal cortical dysplasia (FCD) or areas of gliosis can exist in these patients that are difficult to detect with current high resolution MRI. In the first part of this thesis, the results of a study of voxel based morphometric (VBM) analysis of structural imaging (in particular fluid-attenuated inversion-recovery (FLAIR) imaging) of children with intractable focal epilepsy are presented. VBM of FLAIR imaging allowed detection of known visible FCD and in addition detected abnormality in a proportion of children with intractable focal seizures who had normal MRI. In the second part of this thesis, the role of both visual and VBM assessment of diffusion tensor imaging is explored. Diffusion tensor imaging is not demonstrated to have a useful role in presurgical evaluation of children with intractable focal epilepsy. In the final part of this thesis, the development of hippocampal sclerosis as a dual pathology in the context of extrahippocampal lesional epilepsy is explored. In this patient group, it is most likely that hippocampal sclerosis is acquired as a result of extra-hippocampal seizures and that children who are young at the time of their first seizure have a lower chance of acquiring hippocampal sclerosis.
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Sarri, Margarita. "Factors predictive of emotional and behavioural difficulties in children with refractory focal epilepsy." Thesis, Royal Holloway, University of London, 2014. http://digirep.rhul.ac.uk/items/e1e081c7-3d68-8a76-2a43-b294e1dd7dad/1/.
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Focal epilepsy in childhood is associated with increased risk for developing behavioral, emotional, cognitive and social–adaptive impairments. The present thesis focused on mental health difficulties in paediatric refractory focal epilepsy. It undertook a detailed evaluation of the predictive power of several demographic (gender, age at assessment), clinical (age at onset and duration of epilepsy, seizure frequency), localization (lobe and lateralization of pathology) and cognitive variables (performance in intellectual, memory and academic attainment measures) for mood, conduct, inattention/hyperactivity and peer relationship difficulties, as assessed by parental report. Data from a population of 282 children and adolescents, previously collected for clinical purposes, were examined, using a series of univariate and multivariate analyses. Mental health difficulties were found to be highly prevalent, with peer relationships the most frequently reported area of difficulty, followed by inattention/hyperactivity and emotional difficulties. Different patterns of associations between the variables examined here and individual emotional/behavioural difficulties were revealed, partially confirming and extending previous findings in the literature. Longer duration of epilepsy was found to increase the risk for developing emotional difficulties; male gender and earlier age at onset the risk for conduct difficulties; male gender, earlier age at onset, longer duration and frontal lobe localization the risk for attention/hyperactivity difficulties; and finally longer duration, higher seizure frequency and right hemisphere lateralization the risk for peer difficulties. Lower cognitive functioning was found associated with overall increased mental health difficulties and a lower VIQ was predictive of all types of difficulties. Developing a firm understanding of the risk factors that contribute to mental health comorbidities in focal paediatric epilepsy can help identify and provide assessment and intervention to children who are at higher risk earlier, thus significantly improving quality of life.
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方頌恩 and Chung-yan Gardian Fong. "Electro-clinical study and gene mapping of epilepsies." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2002. http://hub.hku.hk/bib/B31981781.
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Pressler, Ronit. "Effects of interictal discharges on cognition and behaviour in children with well-controlled epilepsy." Thesis, King's College London (University of London), 2006. https://kclpure.kcl.ac.uk/portal/en/theses/effects-of-interictal-discharges-on-cognition-and-behaviour-in-children-with-wellcontrolled-epilepsy(f7e23f78-3a00-49eb-a594-959f0bcfe4e0).html.
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Objective: There is evidence that in patients with epilepsy interictal discharges can be accompanied by transitory cognitive impairment (TCI). However, it is not kno\vn whether interictal discharges and TCI impair day to day psychosocial functioning, and if so whether drug treatment to suppress discharges is effective in the absence of clinical seizures. Aims of study: (1) Effect of lamotrigine on interictal discharges, behaviour and cognition in children with epilepsy. (2) Effect of interictal discharges on behaviour and cognition in children with epilepsy. (3) Effect of suppression of discharges behaviour in children with epilepsy. Method: In a randomised, double-blind, placebo-controlled, cross-over study with lamotrigine ambulatory EEG, cognitive test battery and behavioural scores were measured in 61 patients at baseline, placebo and lamotrigine phase. Results: Interictal discharges are common in children with epilepsy even if seizures are well controlled. Lamotrigine reduced the duration of discharges per hour, but not the total number per hour in this group of patients. Lamotrigine had no significant negative or positive effect on cognitive performance in children with epilepsy. Tel was found in over 500/0 of patients with sufficient discharges for analysis. There was a significant correlation of side of discharges to the type of test (spatial or verbal), when correcting for dominant hemisphere. Interictal discharges were associated with impaired cognitive performance (working memory). During treatment with lamotrigine global rating of behaviour significantly improved in patients with a reduction in discharges rate, but not in patients with without a change in discharge rate. This was independent of randomization or presence of seizures. Conclusion: lnterictal discharges are common even in children with well-controlled epilepsy and associated with cognitive impairment particularly affecting \\orking memory. Our data suggest that suppressing interictal discharges can improve behaviour in children with behavioural problems and epilepsy.
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Strekas, Amy Marie. "Listener quality judgments of narratives produced by children with and without localization-related epilepsy." College Park, Md.: University of Maryland, 2008. http://hdl.handle.net/1903/8610.
Full textAbstract:
Thesis (M.S.) -- University of Maryland, College Park, 2008.Thesis research directed by: Dept. of Hearing and Speech Sciences. Title from t.p. of PDF. Includes bibliographical references. Published by UMI Dissertation Services, Ann Arbor, Mich. Also available in paper.
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Glidden, Gina. "Intensity of participation among children with epilepsy: an exploratory factor analysis of child components." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119358.
Full textAbstract:
Although participation has been the focus of numerous studies of children and youth with Cerebral Palsy and few other chronic health conditions, very little is known about the participation of children and youth with epilepsy. The goal of this thesis is to derive primary components from a set of theoretically-derived variables thought to be related to the intensity of participation of children and youth with epilepsy. Sixteen variables were originally identified. This study uses a database of n=506 children with epilepsy to perform an exploratory factor analysis of relevant child variables from the Qualité study, a longitudinal pan-Canadian study on outcome trajectories of children with epilepsy. Results located four principal components that together, accounted for 63.41% of the total variance: Behaviors that Facilitate Interactions with Others is made up of four child social skills variables and accounts for 32.042% of variance; Behaviors that Challenge Interactions with Others, is made up of 3 variables on child externalizing behaviours and accounts for 12.058% of variance; Anticipatory Reaction to Distressing Stimuli, is made up of variables related to submissiveness, victimisation and anxiety and accounts for 9.414% of variance and Child's Social Self, comprises variables related to social support and self perception and accounts for 8.408% of variance. Further study is required to examine the relationship and impact these components have to the participation of children and youth with epilepsy.Bien que la participation ait été étudiée comme objectif de résultat chez des enfants atteints de paralysie cérébrale ainsi que d'autres conditions chroniques de la santé, très peu est connu au sujet de l'expérience de participation des enfants atteints d'épilepsie. L'objectif de ce mémoire est de déterminer les composantes principales de variables issues de théories liées à l'intensité de la participation des enfants et des adolescents atteints d'épilepsie afin de susciter une discussion qui approfondira notre compréhension de la participation de ce groupe. Seize variables ont été identifiées. Cette étude utilise une base de données comprenant n=506 enfants atteint d'épilepsie afin d'effectuer une analyse exploratoire de facteurs des variables pertinentes liées à l'enfant issues de l'étude QUALITÉ, une étude longitudinale à travers le Canada sur les objectifs de résultat d'enfants atteints d'épilepsie. Quatre composantes principales ont été extraites des résultats, totalisant 63.41% de la variance. La composante Comportements qui facilitent les interactions avec autrui est constituée de quatre variables d'habiletés sociales chez l'enfant et représente 32,04% de la variance. La composante Comportements qui restreignent les interactions avec les autres est constituée de trois variables sur les comportements extériorisés et représente 12.05% de la variance. La composante Cycle de réaction anticipée de l'enfant à des stimuli bouleversants est constituée de variables liées à la soumission, à la victimisation et à l'anxiété et représente 9.41% de la variance. La composante L'être social de l'enfant comprend trois variables liées au soutien social et à la perception de soi et représente 8.40% de la variance. Une étude plus approfondie est nécessaire afin d'examiner la relation et l'impact de ces composantes sur la participation des enfants et des adolescents atteints d'épilepsie.
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Mankinen, K. (Katariina). "Neuropsychological performance and functional MRI findings in children with non-lesional temporal lobe epilepsy." Doctoral thesis, Oulun yliopisto, 2014. http://urn.fi/urn:isbn:9789526203546.
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Abstract The purpose of the present work was to investigate whether children with non-lesional temporal lobe epilepsy (TLE) have deficits in neuropsychological performance and whether the possible deficits can be investigated using functional magnetic resonance imaging (fMRI). In this population-based study, 21 children aged 8-15 with non-lesional TLE and a normal intelligence quotient were evaluated and compared with 21 healthy, age- and gender-matched controls. Neuropsychological assessments, clinical examinations, electroencephalography (EEG) and structural and functional MRI were performed on all the subjects. Three fMRI methods were used: resting-state regional homogeneity, resting-state functional connectivity and task-induced blood oxygenation level-dependent activation. The patients with non-lesional TLE showed good neuropsychological performance on average, although the girls were found to have significant problems in several neuropsychological tests. The deficits were not restricted to elements of performance involving the classical temporal lobe memory system but were also found in tests requiring frontal and parietal lobe functioning. Early onset of epilepsy and duration of epilepsy had significant negative effects on neuropsychological performance. All the fMRI methods detected significant functional differences between the TLE patients and the healthy controls, not only in the temporal lobes but also in broad networks extending to the frontal, parietal and thalamic areas. These differences seemed to differ markedly in location between the TLE patients depending on the interictal EEG findings. Neuropsychological performance results were supported by the fMRI findings, implying that TLE should be regarded as a widespread disruption of the brain networks and not just malfunction of a single region in the brain within these networks. This needs to be taken into consideration when evaluating learning abilities among TLE patients even at an early stage in epilepsyTiivistelmä Tutkimuksen tarkoituksena oli selvittää onko lapsilla, jotka sairastavat tuntemattomasta syystä aiheutuvaa ohimolohkoepilepsiaa, neuropsykologisia ongelmia ja aiheuttavatko mahdolliset ongelmat aivojen toiminnallisessa magneettikuvauksessa nähtäviä muutoksia. Tähän väestöpohjaiseen tutkimukseen otettiin 21 tuntemattomasta syystä ohimolohkoepilepsiaa sairastavaa normaaliälyistä 8-15-vuotiaista lasta ja verrattiin heitä 21 terveeseen, ikä- ja sukupuolivakioituun kontrollihenkilöön. Kaikille tutkimukseen osallistuneille tehtiin neuropsykologinen tutkimus, kliininen tutkimus, aivosähkökäyrä sekä rakenteellinen ja toiminnallinen aivojen magneettikuvaus. Toiminnallisessa magneettikuvauksessa käytettiin veren happipitoisuudesta riippuvaista (engl. blood oxygenation level-dependent) kontrastia kuvantamaan levossa aivojen paikallista homogeniteettia (engl. regional homogeneity) ja toiminnallista kytkennällisyyttä (engl. functional connectivity) sekä kognitiivisten tehtävien herättämiä aktivaatio-vasteita. Tuntemattomasta syystä ohimolohkoepilepsiaa sairastavien lasten neuropsykologinen suoriutuminen oli keskimäärin hyvää, vaikkakin tytöillä oli nähtävillä tilastollisesti merkitseviä ongelmia useissa eri testeissä. Ongelmat eivät rajoittuneet pelkästään klassisiin ohimolohkoalueen muistitoimintoihin, vaan niitä havaittiin myös otsa- ja päälakilohkojen toimintoja edellyttävissä testeissä. Varhainen sairastumisikä ja epilepsian kesto heikensivät suoriutumista tilastollisesti merkitsevästi osatesteissä, joissa tarvittiin näönvaraisen hahmottamisen taitoja, psykomotorista nopeutta ja työmuistia. Ohimolohkoepilepsiaa sairastavien ja terveiden kontrollien aivoissa löydettiin toiminnallisia eroja kaikilla toiminnallisen magneettikuvauksen menetelmillä. Eroja ei todettu ainoastaan ohimolohkoissa, vaan niitä löytyi myös otsa- ja päälakilohkoon sekä tyvitumakealueelle ylettyvissä laaja-alaisissa hermoverkostoissa. Epilepsiapotilailla erojen paikantuminen riippui kohtaustenvälisestä aivosähkökäyrälöydöksestä. Neuropsykologisen suoriutumisen tulokset tukevat toiminnallisen magneettikuvauksen löydöksiä kuvastaen temporaaliepilepsian olevan laaja-alainen hermoverkostojen häiriö eikä pelkästään tietyn aivoalueen toiminnan häiriö. Tämä tulee huomioida arvioitaessa ohimolohkoepilepsiaa sairastavien lasten oppimiskykyä jo epilepsian alkuvaiheessa
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Raffaele, Martin. "An exploration of the psychosocial effects that school-age children with Child Absence Epilepsy (CAE) experience when their condition is misdiagnosed as Attention-Deficity/Hyperactivity Disorder (ADHD)." Connect to full text, 2009. http://hdl.handle.net/2123/5390.
Full textAbstract:
Thesis (M. Phil.)--University of Sydney, 2009.Title from title screen (viewed 21st September, 2009) Submitted in fulfilment of the requirements for the degree of Master of Philosophy to the Faculty of Education and Social Work, University of Sydney. Includes bibliographical references. Also available in print form.
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Greechan, Martha. "Illness meaning and perceived support of parents of children with severe myoclonic epilepsy of infancy." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0002/MQ36451.pdf.
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Dahlin, Maria. "Pharmacodynamics of low-dose clonazepam in children with epilepsy or spasticity : neurophysiological and clinical studies /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4862-3/.
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Burton, Kathryn Joanna. "Prevalence, risk factors, co-morbidity and perception of epilepsy in children from Hai District, Tanzania." Thesis, University of Cambridge, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.610294.
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Vollmer, B. "The neural basis of epilepsy and cognitive impairment in children born preterm : a neuroimaging study." Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1446148/.
Full textAbstract:
The work described in this thesis aimed to investigate the characteristics and neural correlates of epilepsy and cognitive impairment in preterm children. From a large cohort of preterm children (born at gestational age < 33 weeks), those who had developed epilepsy by age eight years were included in the study. Since the main hypothesis was that in those children with epilepsy and/or cognitive impairment additional undetected grey matter abnormalities are present, preterm control children without epilepsy from the same cohort were selected such that balance was achieved with respect to white matter abnormalities identified on neonatal cranial ultrasound. Conventional structural magnetic resonance (MR) imaging data were analysed qualitatively (visual inspection) for white and grey matter abnormalities. In addition, a quantitative MR imaging analysis method, voxel-based morphometry (VBM), was used for detection of more subtle grey matter abnormalities that may not be detected by purely visual analysis of MR images. Perinatal and neonatal data, data from neurological and psychometric assessments, from the medical history and data obtained from electroencephalography (EEG) were analysed and related to neuroimaging findings. Visual analysis of MR images identified brain abnormalities that had gone undetected on neonatal ultrasound. VBM analysis identified subtle grey matter abnormalities that had not been detected on visual analysis of MR images. VBM-detected grey matter abnormalities were associated with periventricular white matter reduction identified on visual inspection of MR images. The analyses provide evidence for epilepsy and/or cognitive impairment to be related to both reduction of periventricular white matter and subtle VBM-detected grey matter abnormalities. The data suggest that using combined information from visual inspection of MR images and VBM analysis of grey matter improves significantly the prediction of epilepsy and cognitive outcome compared to using findings from clinical variables alone. The data also indicate that in this study group, the extent of brain injury had a stronger effect on cognitive outcome than the presence of epilepsy.
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Elliott, Jesse. "Medical Cannabis for the Treatment of Drug-Resistant Epilepsy in Children: A Health Technology Assessment." Thesis, Université d'Ottawa / University of Ottawa, 2020. http://hdl.handle.net/10393/40474.
Full textAbstract:
Interest in the use of medical cannabis for the treatment of drug-resistant epilepsy in children has grown over the last decade; however, little is known about its potential benefits and harms, cost-effectiveness, or the perspectives of key stakeholders. In this thesis, a health technology assessment approach was adopted to assess the intended and unintended consequences of medical cannabis use in the treatment of pediatric drug-resistant epilepsy. This thesis comprises three main sections: (1) a living systematic review of the benefits and harms of medical cannabis for the treatment of pediatric epilepsy, including drug-resistant forms; (2) an economic evaluation of the cost-effectiveness of medical cannabis for the treatment of pediatric drug-resistant epilepsy, and (3) qualitative exploration of the perspectives of neurologists and parents of children with drug-resistant epilepsy about the use of medical cannabis in this population. While neurologists generally perceived medical cannabis as a viable treatment option for drug-resistant epilepsy in children, particularly after other treatments have failed, they identified several gaps in the evidence base, including a lack of long-term studies and a lack of evidence related to cannabinoids other than cannabidiol. This is in keeping with the findings of the living systematic review, which support a beneficial role for medical cannabis in reducing seizures associated with drug-resistant epilepsy, although the certainty of the evidence was moderate at best. Parents described experiencing many barriers to accessing medical cannabis for their children, primarily related to finding a health care provider to authorize its use, the high cost of cannabis-based treatments, and a lack of reimbursement through public or private insurance programs. However, cannabinoid oil may be a more cost-effective treatment for some types of pediatric drug-resistant epilepsy compared with antiepileptic drugs currently reimbursed by some provincial insurance programs. These findings suggest that medical cannabis is a potentially effective and cost-effective treatment for drug-resistant epilepsy that may addresses an unmet need. However, additional studies are needed to address uncertainty related to the long-term benefits and harms of cannabis-based products, particularly with respect to products available in Canada.
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Joshi, S. M., K. Gali, L. Radecki, P. R. Sachdeva, T. Calabrese, A. Shah, S. Huenke, L. Brown, E. Kimball, and David Wood. "Integrating Quality Improvement into the ECHO Model to Improve Care for Children and Youth with Epilepsy." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7671.
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Objective: Telementoring programs like Project ECHO® (Extension for Community Healthcare Outcomes) employ didactics, case-based learning and an “all teach-all learn”approach to increase PCP knowledge/confidence in managing chronic health conditions. The AAP Epilepsy and Comorbidities ECHO aimed to incorporate Quality Improvement (QI) methodology to create sustainable practice change, while increasing PCP knowledge/confidence/self-efficacy in epilepsy management using the ECHO model.
Methods: ECHO sessions occurred monthly (5/2018-12/2018). Sessions included lectures, case presentations/discussion and QI review. Practices, recruited through the AAP, implementedmonthly PDSA cycles using team huddles, chart reviews, QI coaching calls and discussion. Measures for improvement were selected from the American Academy of Neurology Epilepsy Measures set. The AAP Quality Improvement Data Aggregator was used for data entry, run chart development, tracking outcomes. Participants completed pre and post-surveys and received Maintenance of Certification Part 4 credits.
Results: Average session attendance was 14 (13-17), across 7 practices in 5 states. QI coaching facilitated practice change and development of resource toolkits with documentation templates, safety handouts, medication side effects sheets. Individual and aggregate run charts with data analysis augmented workflow changes. 479 chart reviews demonstrated improvement in 6/7 measures (Table1): documenting seizure frequency (7.1% increase), anti-seizure therapy side effects (23%), safety education(41.6%, p=0.036); Mental/behavioral health screening(32.2% p=0.027); Tertiary Center referral(26.7%); Health Care transition(45.3%, p=0.005). Counseling for women of childbearing age decreased by 7.8%. Participants reported gains in knowledge/confidence/self-efficacy regarding epilepsy management (p< 0.02).
Conclusions: This project demonstrated that integrating QI into an ECHO model results in sustainable practice change and increases PCP knowledge/confidence/self-efficacy in managing epilepsy.
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Neri, Marina Liberalesso 1980. "Avaliação neuropsicológica de crianças com epilepsia rolândica = funções executivas." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309169.
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Orientadores: Marilisa Mantovani Guerreiro, Catarina Abrão GuimarãesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A epilepsia benigna da infância com pontas centrotemporais (EBIPCT) ou rolândica (ER) é a forma mais freqüente de epilepsia na infância e é classificada como sendo focal, genética e de evolução benigna. Apesar de não haver déficit intelectual, essas crianças podem apresentar alterações cognitivas específicas. O presente estudo teve como objetivos: identificar e descrever alterações de funções executivas em crianças com ER e verificar a influência de variáveis clínicas da epilepsia nas funções executivas. Os participantes foram submetidos à aplicação de testes de funções executivas. Foram incluídas crianças com diagnóstico clínico e eletroencefalográfico de ER. A maioria dos pacientes estava controlada e muitos deles encontravam-se sem medicação. Os resultados obtidos foram comparados com os de um grupo de crianças de um grupo-controle (GC) constituído de indivíduos normais, com idade e nível sócio-educacional semelhantes ao das crianças com epilepsia. Os dados coletados nos dois grupos foram analisados e comparados através dos testes estatísticos: Mann-Whitney, teste Qui-quadrado e teste Exato de Fisher. Os resultados mostraram que quanto aos dados numéricos crianças com ER obtiveram pior desempenho em cinco das seis categorias consideradas do Wisconsin Card Sorting Test (WCST): nº de erros, nº de erros perseverativos, nº de respostas perseverativas, nº de categorias completadas e nº de fracassos em manter o set. Considerando-se resultados categóricos crianças com ER obtiveram pior desempenho no Trail Making Test (TMT) parte B, no Teste de fluência verbal FAS e em três categorias do WCST: nº de erros, nº de erros perseverativos e nº de respostas perseverativas. Em relação à variável idade de início da epilepsia, crianças com início mais precoce apresentaram pior desempenho em um dos instrumentos utilizados quando comparadas com crianças com início mais tardio da epilepsia; em relação às demais variáveis da epilepsia, não foi possível qualquer tipo de análise; quanto às variáveis das crises, não houve diferença nos resultados obtidos pelos pacientes divididos em grupos. Diante desses resultados concluímos que: as crianças com ER apresentaram déficit em funções executivas quando comparadas com o grupo-controle; a bateria utilizada mostrou-se adequada para detecção das disfunções apresentadas pelas crianças com ER; em relação à variável da epilepsia idade de início, crianças com início mais precoce apresentaram pior desempenho do que crianças com início mais tardio da epilepsia; em relação às demais variáveis da epilepsia e às variáveis das crises, não houve diferença entre os dois grupos. Assim, nosso estudo segue a linha de raciocínio de que o termo benigno deve ser usado com cautela uma vez que nossos pacientes apresentaram déficits neuropsicológicos em funções executivas, independentemente da fase ativa da epilepsia e do uso de medicações
Abstract: The benign childhood epilepsy with centrotemporal spikes (EBIPCT) or rolandic epilepsy (RE) is the most common type of childhood epilepsy and is considered to be a focal, genetic and benign epilepsy. Although there is no intellectual deficit, these children may have specific cognitive impairments. This study aimed: to identify and describe changes in executive functions in children with RE and to verify the influence of clinical variables of epilepsy in executive functions. Participants were evaluated with tests to assess executive functions. We included children with clinical and EEG features of RE. Most patients were controlled and several were without medication. The results were compared with those of a control group (CG) comprised of normal subjects with age and socioeconomic level similar to that of the RE group. The data collected from both groups were analyzed and compared using statistical tests: Mann-Whitney, Chi-square and Fisher exact tests. The results showed that concerning the numerical data, children with RE had the worst performance in five of the six categories of the WCST: number of errors, number of perseverative errors, number of perseverative answers, number of completed categories and number of failures to maintain the set. Considering categorical results, children with RE had worse performance in Trail Making Test part B, Verbal fluency test FAS and three categories of the WCST: number of errors, number of perseverative errors and number of perseverative answers. Concerning the variable age of onset of epilepsy, children with earlier onset of epilepsy had a worse performance in one of the tools when compared with children with later onset of epilepsy; the other variables of epilepsy did not allow any analysis; considering seizure variables, there was no difference between the two groups. We conclude that: children with RE showed deficits in executive functions when compared with the control group; the set of tests was adequate to detect the dysfunctions presented by children with RE; in relation to the variable age of onset of epilepsy, children with earlier onset had a worse performance than children with later onset of epilepsy; concerning other epilepsy and seizure variables, there was no difference between the two groups. Thus, our study is in keeping with the idea that the term benign should be cautiously used since our patients had neuropsychological deficits in executive functions regardless of the active phase of epilepsy and the use of medications
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
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Harrison, Jordan. "Longitudinal Health-Related Quality of Life in Children with Newly-Diagnosed Epilepsy: Identifying Predictors and Assessing Meaningful Change over Time." Xavier University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=xavier1510307341014498.
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Brown, Karen. "Relationships between knowledge, clinical decision-making, and psychosocial adjustment in children with epilepsy and their parents." Thesis, Bangor University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.298013.
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Roux, Amy Loomis. "Examining teacher knowledge and attitudes about school issues for children with epilepsy a mixed-method investigation /." [Gainesville, Fla.] : University of Florida, 2009. http://purl.fcla.edu/fcla/etd/UFE0024859.
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Linek, Madison K. "The Relationship Between Serum Carnitine Levels and Ketones in Children with Epilepsy Following a Ketogenic Diet." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1573571647173707.
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Wright, Sukhvir. "Autoimmunity in idiopathic epilepsies and encephalopathies of childhood." Thesis, University of Oxford, 2014. https://ora.ox.ac.uk/objects/uuid:685944ee-8135-47ba-a90a-173fb195e3ec.
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Immune mechanisms are thought to be involved in the pathological disease process in a number of childhood epileptic syndromes and encephalitis. Of particular interest is the occurrence of autoantibodies to essential neuronal proteins, for example the N-methyl-D-aspartate receptor (NMDAR), in the blood and spinal fluid in some of these patients. The aims of this study were: to examine the sera of newly diagnosed paediatric epilepsy patients for specific neuronal autoantibodies, correlate to epilepsy phenotype and disease outcomes; to investigate the pathogenicity and epileptogenicity of central nervous system autoantibodies (CNS) in vivo; and to test new therapies in vitro and in vivo based on the potential pathogenic mechanisms. In 290 paediatric patients with new-onset epilepsy and seizures tested for CNS autoantibodies, 11.4% were positive (33/290 versus 8/112 in controls; p=0.01, Fisher's exact test). Previously unreported contactin-2 antibody positive and contactin-associated-protein 2 (CASPR2) antibody positive epilepsy patients were described. Patients with 'focal epilepsy of unknown cause' were more likely to be antibody positive. To test the pathogenicity and epileptogenicity of these antibodies, a novel in vivo telemetry system was used to continuously record electroencephalogram (EEG) in mice injected into the cerebral lateral ventricle with NMDAR antibody (NMDAR-Ab) positive immunoglobulin (IgG). Although no spontaneous seizures were seen, mice challenged with the pro-convulsant pentylenetetrazole (PTZ) had increased seizure susceptibility, and more epileptiform "spikes" in the EEG after PTZ compared to healthy control (HC) IgG injected mice. Seizure susceptibility strongly correlated with binding intensity of NMDAR-Ab IgG analysed in post-mortem tissue. Given the hypothesis this epileptogenic effect was mediated by NMDAR-Abs internalising cell surface NMDARs, and to try and rescue this deficit, a neurosteroid, pregnenolone sulphate (PregS) known to increase NMDAR cell surface expression, was therapeutically used. This approach worked in vitro, and although in vivo effects were not yet established, treatment with neurosteroids may be beneficial for autoantibody mediated neurological disease.
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Billingsley, Rebecca Lynn. "Implicit and explicit memory in focal epilepsy, dissociations of epileptogenic and excised cortex in children and adults." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ53858.pdf.
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Passweg, Jakob. "Salivary caffeine clearance for measurement of liver function in children with liver disease, cystic fibrosis and epilepsy /." [S.l : s.n.], 1987. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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