Continuous spike-waves and dementia in childhood with occipital paroxysms.

Guided by a holistic approach, the combined effects of direct and diffuse radiation on the atmospheric boundary layer dynamics over vegetated land are investigated on a daily scale. Three numerical experiments are designed that are aimed at disentangling the role of diffuse and direct radiation below shallow cumulus at the surface and on boundary layer dynamics. A large-eddy simulation (LES) model coupled to a land surface model is used, including a mechanistically immediate response of plants to radiation, temperature, and water vapor deficit changes. The partitioning in direct and diffuse radiation created by clouds and farther inside the canopy is explicitly accounted for. LES results are conditionally averaged as a function of the cloud optical depth. The findings show larger photosynthesis under thin clouds than under clear sky, due to an increase in diffuse radiation and a slight decrease in direct radiation. The reduced canopy resistance is the main driver for the enhanced carbon uptake by vegetation, while the carbon gradient and aerodynamic effects at the surface are secondary. Because of the coupling of CO2 and water vapor exchange through plant stomata, evapotranspiration is also enhanced under thin clouds, albeit to a lesser extent. This effect of diffuse radiation increases the water use efficiency and evaporative fraction under clouds. The dynamic perturbations of the surface fluxes by clouds do not affect general boundary layer or cloud characteristics because of the limited time and space where these perturbations occur. It is concluded that an accurate radiation partitioning calculation is necessary to obtain reliable estimations on local surface processes

Language breakdown and recovery in a child with an acquired epileptic aphasia.

A longitudinal linguistic analysis of a 6-year-old boy (GA) with an acquired epileptic aphasia (‘‘Landau–Kleffner Syndrome''; LKS) was conducted to determine in what ways language breakdown and recovery occur. Language comprehension and production at the syllabic, phonemic, lexical, and morphosyntactic levels were assessed shortly before, during the acute phase of the illness, and at recovery, which was very rapid. Results show that in the acute phase, GA presented not only an auditory agnosia for speech and nonspeech sounds but also provided strong evidence that in production, prosody and speech processing were impaired

Neuropsychological problems after paediatric stroke: two year follow-up of Swiss children

AIM: The aim of this study was to obtain information about neurological and cognitive outcome for a population-based group of children after paediatric ischaemic stroke. METHODS: Data from the Swiss neuropaediatric stroke registry (SNPSR), from 1.1.2000 to 1.7.2002, including children (AIS 1) and neonates (AIS 2). At 18-24 months after a stroke, a follow-up examination was performed including a history, neurological and neuropsychological assessment. RESULTS: 33/48 children (22 AIS 1, 11 AIS 2) participated in the study. Neurological outcome was good in 16/33. After childhood stroke mean IQ levels were normal (94), but 6 children had IQ < 85 (50-82) and neuropsychological problems were present in 75%. Performance IQ (93) was reduced compared to verbal IQ (101, p = 0.121) due to problems in the domain of processing speed (89.5); auditory short-term memory was especially affected. Effects on school career were common. Outcome was worse in children after right-sided infarction. Children suffering from stroke in mid-childhood had the best prognosis. There was no clear relationship between outcome and localisation of the lesion. After neonatal stroke 7/11 children showed normal development and epilepsy indicated a worse prognosis in the remaining 4. CONCLUSION: After paediatric stroke neuropsychological problems are present in about 75% of children. Younger age at stroke as well as an emergence of epilepsy were predictors for worse prognosis

The first three years of the Swiss Neuropaediatric Stroke Registry (SNPSR): a population-based study of incidence, symptoms and risk factors

We report the results of three years of the population-based, prospective Swiss NeuroPaediatric Stroke Registry (SNPSR) of children (up to 16 years) with childhood arterial ischaemic stroke (AIS1), neonatal stroke (AIS2), or symptomatic sinus venous thrombosis (SVT). Data on risk factors (RF), presentation, diagnostic work-up, localisation, and short-term neurological outcome were collected. 80 children (54 males) have been included, 40 AIS1, 23 AIS2, and 17 SVT. The data presented will be concentrated on AIS. The presentation for AIS1 was hemiparesis in 77% and cerebellar symptoms and seizures in 20%, respectively. AIS2 presented in 83% with seizures and in 38% with abnormality of muscle tone. Two or more RF were detected in 54%, one RF in 35%. The most prominent RF for AIS1 were infections (40%), followed by cardiopathies and coagulopathies (25% each). AIS2 were frequently related to birth problems. Neurological outcomes in AIS1 and AIS2 were moderate/severe in 45 % and 32 %, respectively. The outcome correlated significantly with the size of infarction (p = 0.013) and age at stroke (p = 0.027). The overall mortality was 6%. Paediatric stroke is a multiple risk problem, which leads to important long-term sequelae