5 research outputs found
Social Cognition in Neurodevelopmental Disorders and Epilepsy
Introduction: The purpose of our study was to perform a comparative analysis of social cognition in children and adolescents with epilepsy, autism spectrum disorder (ASD), specific learning disorder (SLD) and in typical development (TD) controls. The secondary aim was to relate social cognition to some clinical and demographic characteristics. Methods: Our work is a transversal observational study. The recruits were 179 children and adolescents aged between 6 and 18 years diagnosed with epilepsy, ASD, or SLD and 32 subjects with TD. All the participants underwent neuropsychological assessment of Emotion Recognition (ER) and Theory of Mind (ToM) skills. Results: All three clinical groups performed significantly worse than controls in ER and ToM. The ASD group achieved significantly lower performance than the other groups; however, the scores of SLD and epilepsy groups were comparable. The ER performances are related to non-verbal intelligence only in the group with epilepsy. Conclusion: Children and adolescents with focal epilepsy, SLD, or ASD may present a deficit of varying extent in emotion recognition and ToM, compared with TD peers. These difficulties are more pronounced in individuals with ASD, but impairment worthy of clinical attention also emerges in individuals with SLD and epilepsy
Ketogenic diet and epilepsy: an up-date review.
Journal of Pediatric Science
Topiramate in children and adolescents with epilepsy and mental retardation: a prospective study on behavior and cognitive effects
The aim of the present study was to assess the behavioral and cognitive effects following treatment with topiramate in children and
adolescents with epilepsy with mild to profound mental retardation. The study group comprised 29 children, 16 males and 13 females,
aged 3 to 19 years, affected by partial (4) and generalized (25) crypto/symptomatic epilepsy and mental retardation (7 mild, 5 moderate,
15 severe, 2 profound), who were administered topiramate (TPM) as add-on therapy to their baseline antiepileptic treatment. At baseline,
3 months, 6 months, and 12 months, parents or caregivers of each patient were administered a questionnaire based on the Holmfrid
Quality of Life Inventory. After a 3-month follow-up, the add-on topiramate caused overall mild to moderate cognitive/behavioral worsening
in about 70% of children and adolescents with mental retardation and epilepsy. After 6 and 12 months of follow-up, global worsening
persisted in 31 and 20.1% of cases, respectively. In conclusion, this trial confirms that TPM can have significant adverse cognitive
and behavioral side effects, even in mentally disabled children and adolescents
Bone mineral density in children, adolescents and young adults with epilepsy.
Purpose: The aim of this study was to assess bone
mineral density (BMD) in a large population of
children, adolescents, and young adults with epilepsy
alone or in association with cerebral palsy
and/or mental retardation.
Methods: Ninety-six patients were enrolled in the
study. The group comprised 50 males and 46
females, aged between 3 and 25 years (mean age
11 years). The control group consisted of 63
healthy children and adolescents (23 males, 40
females), aged between 3 and 25 years (mean age
12.1 years). Patients underwent a dual-energy
x-ray absorptiometry (DEXA) scan of the lumbar
spine (L1–L4) and the z scores were calculated for
each patient; the t score was considered for
patients 18 years of age or older.
Results: Abnormal BMD was found in 56 patients
(58.3%), with values documenting osteopenia in 42
(75%) and osteoporosis in 14 (25%). A significant
difference emerged between epileptic patients
and the control group in BMD, z score, and body
mass index (BMI) (p = <0.001). Lack of autonomous
gait, severe mental retardation, long duration
of antiepileptic treatment, topiramate
adjunctive therapy, and less physical activity significantly
correlated with abnormal BMD.
Discussion: This study detected abnormal BMD in
more than half of a large pediatric population with
epilepsy with or without cerebral palsy and/or
mental retardation. The clinical significance of
these findings has yet to be clarified
Polysomnographic findings in fragile x syndrome children with EEG abnormalities
Fragile X syndrome (FXS) is a genetic syndrome with intellectual disability due to the loss of expression of the FMR1 gene located on chromosome X (Xq27.3). This mutation can suppress the fragile X mental retardation protein (FMRP) with an impact on synaptic functioning and neuronal plasticity. Among associated sign and symptoms of this genetic condition, sleep disturbances have been already described, but few polysomnographic reports in pediatric age have been reported. This multicenter case-control study is aimed at assessing the sleep macrostructure and at analyzing the presence of EEG abnormalities in a cohort of FXS children. We enrolled children with FXS and, as controls, children with typical development. All subjects underwent at least 1 overnight polysomnographic recording (PSG). All recorded data obtained from patients and controls were compared. In children with FXS, all PSG-recorded parameters resulted pathological values compared to those obtained from controls, and in FXS children only, we recorded interictal epileptiform discharges (IEDs), as diffuse or focal spikes and sharp waves, usually singles or in brief runs with intermittent or occasional incidence. A possible link between IEDs and alterations in the circadian sleep-wake cycle may suggest a common dysregulation of the balance between inhibitory and excitatory pathways in these patients. The alteration in sleep pattern in children with FXS may negatively impact the neuropsychological and behavioral functioning, adding increasing burn of the disease on the overall management of these patients. In this regard, treating physicians have to early detect sleep disturbances in their patients for tailored management, in order to prevent adjunctive comorbidities