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Nobusuke Kimura Yukitoshi Takahashi Hideo Shigematsu Katsumi Imai Hiroko Ikeda Hideyuki Ootani Rumiko Takayama Yukiko Mogami Noriko Kimura Koichi Baba Kazumi Matsuda Takayasu Tottori Naotaka Usui Satohiko Kondou Yushi Inoue 《Brain & development》2019,41(1):77-84
Objective
The purpose of this study was to identify the risk factors of cognitive impairment in pediatric epilepsy patients with focal cortical dysplasia (FCD).Methods
77 patients with histopathologically confirmed FCD were studied. The statistical relationship between cognition levels and clinical factors at presurgical evaluation was analyzed. Cognitive function was evaluated by development quotient or intelligence quotient (DQ-IQ).Results
Ages at seizure onset were younger than 15?years (mean?±?SD; 5.0?±?4.2?years). Mean disease duration was 14.5?±?8.5?years. Mean age at pre-surgical DQ-IQ evaluation was 34.8?±?10.7?years. Mean DQ-IQ was 60.5?±?20.5, and 41 of 77 (53.2%) patients had mental retardation (DQ-IQ?<?70). Younger seizure onset and seizure clustering were significantly associated with lower DQ-IQ (p?<?0.001). A multiple regression study identified higher seizure frequency pattern, a history of epileptic spasm and status epilepticus as aggravating factors of DQ-IQ decline (R2?=?0.63, p?<?0.001). On the other hand, the risk was decreased in patients with habitual focal aware seizure and transient seizure-free periods up to 6?months in the course of epilepsy. FCD location (FCD site, extent of radiological lesion and laterality) and histopathology of FCD did not affect DQ-IQ.Conclusions
Our study suggests that seizure characteristics including higher seizure frequency pattern, a history of epileptic spasm, status epilepticus, seizure clustering and early onset of seizure are risk factors of cognitive impairment in FCD patients. 相似文献4.
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Shigeru Ono Kosaku Maeda Katsuhisa Baba Yoshiko Usui Yuki Tsuji Insu Kawahara Atsuhisa Fukuta Sachi Sekine 《Pediatric surgery international》2014,30(9):957-960
Neonates with congenital tracheal stenosis (CTS) sometimes develop respiratory distress and may be difficult to intubate. We used balloon tracheoplasty with a rigid bronchoscope for emergency airway management in neonates with symptomatic CTS. Herein, we describe the balloon tracheoplasty procedure and the early outcomes following its use as the initial treatment of neonatal symptomatic CTS. We performed a retrospective analysis of five neonates with CTS who were initially treated with balloon tracheoplasty at our institution from January 2010 to December 2013. Five patients with a mean birthweight of 2,117 g were treated during the study period. Of these, four developed respiratory distress after birth, and all patients had difficult intubations. In all five patients, definitive diagnosis of CTS was made by rigid bronchoscopy and 3-dimensional reconstruction scan. A total of nine balloon dilatations were performed in five patients. Following balloon tracheoplasty, two patients were extubated, one was extubated after resection and end-to-end anastomosis following initial balloon dilatation, and one remained hospitalized with tracheostomy for tracheomalacia. The remaining patient died from tracheal bleeding associated with congenital heart disease. Although our sample size was small, balloon tracheoplasty is a potentially effective initial treatment for selected cases with neonatal symptomatic CTS. 相似文献