Special Issue "Advances in Pediatric Epilepsy"

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: 1 May 2019

Special Issue Editors

Guest Editor
Dr. Paul R. Carney

Division of Pediatric Neurology, Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, Campus Mail 7025, Chapel Hill, NC 27599 United States
Website | E-Mail
Phone: +1 352 273 9328
Fax: +1 352 392 9802
Interests: children’s health; pediatric sleep medicine; pediatric epilepsy; biomedical engineering
Guest Editor
Dr. Thomas DeMarse

Division of Pediatric Neurology, Department of Neurology, University of North Carolina School of Medicine, 170 Manning Drive, Campus Mail 7025, Chapel Hill, NC 27599 United States
Website | E-Mail
Interests: epilepsy; advanced diagnostic systems; children’s health; brain imaging; genetics; antiepileptic drugs; epilepsy surgery; ketogenic diet; neuromodulation

Special Issue Information

Dear Colleagues,

This Special Issue of Children is devoted to advances in epilepsy diagnosis and treatment. Epilepsy is the second most common neurologic disorder and a source of frequent patient referral. Seizures and medications can cause behavioral, developmental, and intellectual problems in children. In one quarter of all children with epilepsy, seizures remain resistant to treatment with antiepileptic drugs. There is general consensus that despite medication and surgical advances in the treatment of epilepsy, seizures cannot be controlled in many children, and there is an urgent need to understand the underlying mechanisms and pathophysiology, and to leverage this information for prevention and treatment. During the past decade, advances in understanding the risk factors, basic mechanisms, and prognosis of various forms of childhood epilepsy have helped an increasing number of children with epilepsy overcome seizures and associated problems, enabling them to lead full and rewarding lives.

This Special Issue will present a scientific and clinically relevant review of the major advances in pediatric epilepsy, including advances in our understanding of the pathophysiology and underlying mechanisms of childhood epilepsy and major advances in clinical diagnostics and therapeutics. Both reviews and original research will be considered for publication. Examples could include manuscripts that discuss epidemiology, traditional and advanced diagnostic systems, emerging treatments, and inter-relationships between epilepsy and common disease states. This Special Issue will provide a review of the major advances in pediatric epilepsy and provide resources for further education and training programs for medical professionals.

We look forward to receiving your contributions.

Dr. Paul R. Carney
Dr. Thomas DeMarse
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 550 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • childhood epilepsy
  • anticonvulsant drugs
  • epilepsy surgery
  • neurostimulation
  • ketogenic diet
  • behavioral problems
  • autism spectrum disorders
  • brain imaging
  • neurophysiology
  • electroencephalography
  • magnetic electroencephalography.

Published Papers (3 papers)

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Research

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Open AccessArticle Epilepsy in Children with Autistic Spectrum Disorder
Received: 31 December 2018 / Revised: 22 January 2019 / Accepted: 22 January 2019 / Published: 25 January 2019
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Abstract
The comorbidity of autistic spectrum disorder (ASD) and epilepsy has been widely discussed but many questions still remain unanswered. The aim of this study was to establish the occurrence of epilepsy among children with ASD to define the type of epileptic seizures and [...] Read more.
The comorbidity of autistic spectrum disorder (ASD) and epilepsy has been widely discussed but many questions still remain unanswered. The aim of this study was to establish the occurrence of epilepsy among children with ASD to define the type of epileptic seizures and syndromes, the age of onset of epilepsy, EEG abnormalities, the used antiepileptic drugs and the therapeutic responses for seizures and autistic behavior, as well as to find some correlations between epilepsy and gender, etiology and intellectual disability (ID). A retrospective study of medical files of 59 patients (aged 1–18 years) with ASD during a 5-year period was performed. ASD diagnosis was based on the DSM-5 diagnostic criteria. The patients were examined with a detailed medical history, physical and neurological examination, as well as some additional functional, imaging, laboratory and genetic investigations ASD etiology was syndromic in 9, probable syndromic in 9, and idiopathic in 41 children. ID was established in 90% of ASD children, and epilepsy in 44.4%. The onset of epilepsy prevailed before 7 years of age. The most common seizure types were focal with or without secondary generalization (53.4%). Focal epileptiform EEG abnormalities prevailed. Therapeutic response to seizures was good: 58% were seizure-free, while 27% had >50% seizure reduction but no improvement in autistic behavior. There was no correlation between epilepsy and either occurrence or degree of ID. There was a correlation between the frequency of epileptic seizures and the degree of ID. There was no significant difference among epilepsy rates in different etiologic, gender, and ID groups, probably because of the high percentage of ID and because this was a hospital-based study. Our study showed a significant percentage of epilepsy in ASD population and more than 1/4 were of symptomatic etiology. Those could be managed with specific treatments based on the pathophysiology of the gene defect. Full article
(This article belongs to the Special Issue Advances in Pediatric Epilepsy)
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Review

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Open AccessReview Morphological and Advanced Imaging of Epilepsy: Beyond the Basics
Received: 31 December 2018 / Revised: 27 February 2019 / Accepted: 5 March 2019 / Published: 11 March 2019
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Abstract
The etiology of epilepsy is variable and sometimes multifactorial. Clinical course and response to treatment largely depend on the precise etiology of the seizures. Along with the electroencephalogram (EEG), neuroimaging techniques, in particular, magnetic resonance imaging (MRI), are the most important tools for [...] Read more.
The etiology of epilepsy is variable and sometimes multifactorial. Clinical course and response to treatment largely depend on the precise etiology of the seizures. Along with the electroencephalogram (EEG), neuroimaging techniques, in particular, magnetic resonance imaging (MRI), are the most important tools for determining the possible etiology of epilepsy. Over the last few years, there have been many developments in data acquisition and analysis for both morphological and functional neuroimaging of people suffering from this condition. These innovations have increased the detection of underlying structural pathologies, which have till recently been classified as “cryptogenic” epilepsy. Cryptogenic epilepsy is often refractory to anti-epileptic drug treatment. In drug-resistant patients with structural or consistent functional lesions related to the epilepsy syndrome, surgery is the only treatment that can offer a seizure-free outcome. The pre-operative detection of the underlying structural condition increases the odds of successful surgical treatment of pharmacoresistant epilepsy. This article provides a comprehensive overview of neuroimaging techniques in epilepsy, highlighting recent advances and innovations and summarizes frequent etiologies of epilepsy in order to improve the diagnosis and management of patients suffering from seizures, especially young patients and children. Full article
(This article belongs to the Special Issue Advances in Pediatric Epilepsy)
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Open AccessReview Pediatric Epilepsy Mechanisms: Expanding the Paradigm of Excitation/Inhibition Imbalance
Received: 10 January 2019 / Revised: 31 January 2019 / Accepted: 31 January 2019 / Published: 5 February 2019
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Abstract
Mechanisms underlying seizures and epilepsy have traditionally been considered to involve abnormalities of ion channels or synaptic function. Those considerations gave rise to the excitation/inhibition (E/I) imbalance theory, whereby increased excitation, decreased inhibition, or both favor a hyperexcitable state and an increased propensity [...] Read more.
Mechanisms underlying seizures and epilepsy have traditionally been considered to involve abnormalities of ion channels or synaptic function. Those considerations gave rise to the excitation/inhibition (E/I) imbalance theory, whereby increased excitation, decreased inhibition, or both favor a hyperexcitable state and an increased propensity for seizure generation and epileptogenesis. Several recent findings warrant reconsideration and expansion of the E/I hypothesis: novel genetic mutations have been identified that do not overtly affect E/I balance; neurotransmitters may exert paradoxical effects, especially during development; anti-seizure medications do not necessarily work by decreasing excitation or increasing inhibition; and metabolic factors participate in the regulation of neuronal and network excitability. These novel conceptual and experimental advances mandate expansion of the E/I paradigm, with the expectation that new and exciting therapies will emerge from this broadened understanding of how seizures and epilepsy arise and progress. Full article
(This article belongs to the Special Issue Advances in Pediatric Epilepsy)
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