The impact of a newly established specialized pediatric epilepsy center in Tanzania: An observational study

Purpose: This study evaluated the impact of a newly established clinic for the diagnosis of pediatric epilepsy in a resource-limited center (Ifakara, Tanzania). Methods: Patients aged 0-18 years referred to the Pediatric Epilepsy Unit of Saint Francis Referral Hospital were recruited. Demographic and clinical data were collected through Kobo Toolbox and analyzed through a descriptive analysis.. Results: 143 patients were evaluated, and for 48 of them an EEG was recorded (abnormalities were detected in 80.85% of the cases). The diagnosis of epilepsy was confirmed in 87 patients. Focal epilepsy was diagnosed in 57 patients, generalized epilepsy in 24 patients, and forms of unknown onset in 6 patients. Epilepsy was excluded for 9 children. Etiologies included hypoxic-ischemic encephalopathy (39%), central nervous system infections (3.4%), and genetic diseases (3.4%). A specific epilepsy syndrome was diagnosed in 16 patients. 74 patients were under treatment; the most used antiseizure medication (ASM) was phenobarbital (43.36%), followed by carbamazepine (16.08%), sodium valproate (11.19%), phenytoin (2.8%), and lamotrigine (0.7%). Therapeutic changes were proposed to 95 patients, more frequently consisting of withdrawing phenobarbital (39.16%), switching to sodium valproate (27.97%), switching to or adjusting carbamazepine dosage (27.27%), and starting prednisone (2.8%). 76% of the patients with confirmed epilepsy achieved complete seizure freedom at the fourth follow-up consultation. Conclusions: Our data depicted the epilepsy spectrum and highlighted the prognostic implications of improving the availability of ASMs such as sodium valproate and second- and third-generation ones in resource-limited countries

K-SADS-PL DSM-5

La K-SADS-PL è un'intervista diagnostica per la valutazione dei disturbi psicopatologici (passati e attuali) in bambini e adolescenti secondo i criteri del DSM-5. Viene somministrata da psicologi o neuropsichiatri infantili sia ai ragazzi che ai loro genitori, e consente di ottenere un punteggio complessivo che tiene conto di tutti i dati raccolti dalle varie fonti disponibili (famigliari, bambini, insegnanti, pediatri, ecc.). Essa è composta da: un'intervista introduttiva non strutturata, un'intervista diagnostica di screening, una checklist per la somministrazione dei supplementi diagnostici, cinque supplementi diagnostici (disturbi dell'umore, disturbi psicotici, disturbi d'ansia, disturbi da deficit di attenzione e da comportamento dirompente, abuso di sostanze) per ciascuno dei quali sono forniti i criteri richiesti dal DSM, una checklist complessiva della storia clinica del paziente e una scala per la valutazione globale del funzionamento attuale del bambino (VGF).In particolare se utilizzata all'interno di una valutazione psichiatrica e psicodiagnostica completa e articolata, la K-SADS-PL si dimostra uno strumento fondamentale poiché permette di effettuare un corretto bilancio prognostico, indispensabile per programmare un adeguato intervento terapeutico

Turn taking and children with autism spectrum disorder (asd): could an imitation-based training promote it?

P02.92 TURN TAKING AND CHILDREN WITH AUTISM SPECTRUM DISORDER (ASD): COULD AN IMITATION-BASED TRAINING PROMOTE IT? Di Noia S.P.*[1], Di Maggio C.[1], Giovannone F.[1], Pelosi S.[1], Nadel J.[2], Sogos C.[1] [1]Child and Adolescent Neurology and Psychiatry Unit -“Sapienza” University of Rome – Department of Neurosciences and Mental Health- ~ Rome ~ Italy, [2]Pierre and Marie Curie University ~ Paris ~ France Imitation has two faces. Imitate and being imitated. Imitation skills are significantly impaired in children with ASD whereas their response to “being-imitated” seems relatively preserved. Some evidences suggest that ASD patients, like typically developing children, strongly recognize and respond positively when adult partners imitate their own actions. Therefore, behavioral interventions involving imitation of the child’s actions have been demonstrated to be effective in improving social attention and responsiveness, imitation and playing skills, as well as promoting social engagement. Early interventions might result not only in an increase of social abilities, but also in a reorganization of neural circuits altered in ASD. The aim of our study was to evaluate turn taking as a non-verbal communication skill before and after a specific imitation-based training, assuming that the alternation of imitation and being-imitated phases could encourage communication reciprocity. In our non-randomized controlled trial we submitted to two groups of 20 preschool children a game with a clear turn taking structure during an intensive group therapy Denver-oriented. Each group was composed of four ASD patients and six children with language disorders but without interaction impairment. Using a five-level-item Likert scale we measured the children propensity to be engaged in a turn taking game and their ability to respect their turn. Moreover two examiners blindly filled-out a CGI-scale for each child. After the turn taking activity only one of the two groups received a specific training imitation and being imitated-based, as suggested by Nadel et al. in addition to the Denver-oriented intervention they were attending. Our results suggest the efficacy of the imitation-based training. Moreover, our trail provides positive evidence on intensive rehabilitative therapy groups too, showing, also for the patients who did not receive the specific training, improvements, even if smaller, of the turn taking skill regardless of their diagnosis