Electroencephalogram in premature infants: From normal to pathological activity

This study was aimed to assess electrophysiological brain activity in newborns of various gestational ages using electroencephalography (EEG). We summarized the data on the main EEG characteristics of premature infants and their dynamics and described the most common pathological EEG changes that can be identified at this age. We also discussed prognostic value of various neonatal EEG patterns (including their proportion and location), which allow verification of functional brain disorders at early stages. © 2019 ABV-Press Publishing House. All rights reserved.Russian Science Foundation, RSFФинансирование. Работа выполнена при финансовой поддержке гранта №16-18-10371 Российского научного фонда. Исследование прово-дится в рамках программы, поддержанной постановлением №211 Правительства Российской Федерации, соглашение №02.A03.21.0006. Financing. The study was funded by the grant No. 16-18-10 371 from the Russian Science Foundation. The study conducts within a program, supported by the resolution of the Russian Government No. 211, agreement No. 02.A03.21.0006

Mathematical model of diagnostics of perinatal damage of the central nervous system in infants in the neonatal period

Questions of relevance and timeliness of diagnostics of perinatal disturbances of the central nervous system in newborns are considered in the article. Research objective was to determine the reliable recognition of the development of newborn encephalopathy at the age of the first two weeks of life according to neurological examination and neurosonography parameters with Doppler study of cerebral vessels. Features of the neurology status and data of ultrasonic examination of brain with Doppler study of cerebral vessels in 58 newborns with pathology of the nervous system and 23 healthy newborns are investigated. 10 sings of the neurological status and 10 parameters of ultrasonic examination are analyzed. By results of the obtained findings, prognostic rule is developed, governed by application of discriminant analysis of the studied signs, allowing to diagnose encephalopathy in newborn with sensitivity and specificity of 95% in the first week of life. Its application promotes timely identification and the beginning of therapy at infants from risk group of development of severe neurological dysfunction and preventing the growth of disability among infants. © 2017 Team of Authors

Clinical manifestations of the onset and diagnostic problems in children with moyamoya disease

Moyamoya disease in children is a rarely diagnosed entity. Frequent headache is the first symptom of the disease. Headache associated with moya-moya disease (HAMD) is a separated entity reported in the literature. Variants of onset, a spectrum of primary diagnoses and diagnosis verification rate of moyamoya disease in 7 children are presented. A clinical case of moya-moya disease in a 9-year boy, who was primarily diagnosed with migraine with aura, is reported. The results presented by the authors as well as literature data indicate the necessity of using magnetic-resonance angiography in children with headache attacks and focal neurologic symptoms to identify this progressive vascular pathology and timely recommend a surgical treatment. © 2016, Media Sphera. All rights reserved

Predictors of epilepsy in children after ischemic stroke

Objective. To determine clinical/instrumental predictors of symptomatic epilepsy after ischemic stroke in children. Material and methods. One hundred and thirty-six patients, aged 0-15 years, with the diagnosis of ischemic stroke (ICD-10 I63.0-I63.9) were examined. The duration of the study was 18 months - 12 years. Patients were stratified into post-stroke (n=22) and control (n=114) groups, the latter included patients without epilepsy regardless of the presence of convulsive seizures in the acute stage of stroke. Predictors were determined based on EEG and characteristics of convulsive syndrome in the acute stage of stroke. Results and conclusion. The following prognostic criteria were found: generalized type of seizures, focal type of seizures with secondary generalization, epileptiform (peak and/or peak-wave) activity, focal character of epileptiform activity, generalized type of seizures in the combination with slow wave background activity on EEG, generalized type of seizures in the combination with slow wave activity and disorganized activity on EEG. © 2016, Media Sphera. All Rights Reserved

MATHEMATICAL MODEL OF DIAGNOSTICS OF PERINATAL DAMAGE OF THE CENTRAL NERVOUS SYSTEM IN INFANTS IN THE NEONATAL PERIOD

Questions of relevance and timeliness of diagnostics of perinatal disturbances of the central nervous system in newborns are considered in the article. Research objective was to determine the reliable recognition of the development of newborn encephalopathy at the age of the first two weeks of life according to neurological examination and neurosonography parameters with Doppler study of cerebral vessels. Features of the neurology status and data of ultrasonic examination of brain with Doppler study of cerebral vessels in 58 newborns with pathology of the nervous system and 23 healthy newborns are investigated. 10 sings of the neurological status and 10 parameters of ultrasonic examination are analyzed. By results of the obtained findings, prognostic rule is developed, governed by application of discriminant analysis of the studied signs, allowing to diagnose encephalopathy in newborn with sensitivity and specificity of 95% in the first week of life. Its application promotes timely identification and the beginning of therapy at infants from risk group of development of severe neurological dysfunction and preventing the growth of disability among infants

THE IMPACT OF H YPOTHALAMIC-PITUITARY-ADRENAL SYSTEM HORMONES ON EPILEPTOGENESIS

Some issues concerning the impact of hypothalamic-pituitary-adrenal system (HPAS) hormones on epileptogenesis are discussed in the article. It was found, that they have a direct and indirect impact. Direct effect implies the reduction of excitation level in the brain cells by affecting membrane channels and receptors involved in the regulation of certain neurotransmitters synthesis. Indirect effect is realized through positive influence on the brain neurons maturation process, leveling the stimulation of excitation processes mediated by biologically active substances, ions and other agents. Adrenocorticotropic hormone and glucocorticosteroids are the main hormones used in antiepileptic therapy. They have an impact both on epileptogenesis itself, and on induction/inhibition of their own effects in accordance with a feedback mechanism of hormones secretion. The mechanism of antiepileptic action of HPAS hormones allows considering them as true antiepileptic drugs for treatment of drug-resistant and special forms of epilepsy

The specific features and pattern of febrile infection-related epilepsy syndrome (FIRES) in children

The paper considers the etiology, pathogenesis, clinical presentations, diagnosis and treatment in children with febrile infection-related epilepsy syndrome (FIRES) and the aspects of identifying this disease as an individual nosological entity. It details a study of the possible etiological factors of FIRES, such as metabolic, genetic, and immunological disorders, aseptic inflammatory processes, as well as a search for a certain infectious agent by inoculations of different biological environments of the body and by polymerase chain reaction; the diagnostic characteristics of FIRES at the present stage, including the use of electroencephalography, positron emission tomography, and magnetic resonance imaging; different approaches to drug therapy for FIRES at the onset stages of its clinical manifestations, protracted status epilepticus, and drugresistant epilepsy. The issues of the predictable outcome of this disease, including survival and the probability of further development of epilepsy and maintenance of cognitive functions, are also viewed. Diagnostic criteria for the syndrome, such as age at its onset 3 to 15 years in previously healthy children; acute onset as fever to develop high-frequency focal seizures several days later; the absence of the identified disease pathogen detected by the examinations of cerebrospinal fluid, serum, and other environments of the body; the development of drug-resistant epilepsy and severe permanent cognitive and motor deficits after the completion of an acute period in most cases are presented. The paper is clinically exemplified by the authors’ observation of an 11-year-old boy who meets the above criteria for the syndrome, but has a relatively favorable course, without developing severe drug-resistant epilepsy