Teaching Video NeuroImages: Atypical childhood epilepsy with centrotemporal spikes: Seizures often discussed, rarely seen

A 7-year-old right-handed boy with poorly controlled epilepsy presented to the epilepsy monitoring unit for further clarification of his diagnosis. Seizure onset was at 3 years with focal motor seizures of left face and arm followed by confusion and aphasia. Prominent behavioral and school difficulties were also reported. Valproic acid monotherapy (23 mg/kg/d) was weaned by day 2 and a habitual event captured on day 5 (figure, video 1). Brain MRI and an epilepsy gene panel (including GRIN2A) were nonrevealing. The diagnosis was therefore consistent with atypical childhood epilepsy with centrotemporal spikes. This differs from benign rolandic epilepsy because of earlier seizure onset, increased seizure burden, EEG with background slowing (figure) with stereotyped discharges, seizure semiology, and more prominent comorbidities.1,

A comprehensive wireless neurological and cardiopulmonary monitoring platform for pediatrics.

Neurodevelopment in the first 10 years of life is a critical time window during which milestones that define an individual's functional potential are achieved. Comprehensive multimodal neurodevelopmental monitoring is particularly crucial for socioeconomically disadvantaged, marginalized, historically underserved and underrepresented communities as well as medically underserved areas. Solutions designed for use outside the traditional clinical environment represent an opportunity for addressing such health inequalities. In this work, we present an experimental platform, ANNE EEG, which adds 16-channel cerebral activity monitoring to the existing, USA FDA-cleared ANNE wireless monitoring platform which provides continuous electrocardiography, respiratory rate, pulse oximetry, motion, and temperature measurements. The system features low-cost consumables, real-time control and streaming with widely available mobile devices, and fully wearable operation to allow a child to remain in their naturalistic environment. This multi-center pilot study successfully collected ANNE EEG recordings from 91 neonatal and pediatric patients at academic quaternary pediatric care centers and in LMIC settings. We demonstrate the practicality and feasibility to conduct electroencephalography studies with high levels of accuracy, validated via both quantitative and qualitative metrics, compared against gold standard systems. An overwhelming majority of parents surveyed during studies indicated not only an overall preference for the wireless system, but also that its use would improve their children's physical and emotional health. Our findings demonstrate the potential for the ANNE system to perform multimodal monitoring to screen for a variety of neurologic diseases that have the potential to negatively impact neurodevelopment