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Radhika Dhamija Brian D. Moseley Gregory D. Cascino Elaine C. Wirrell 《Epilepsia》2011,52(8):1522-1526
Purpose: To evaluate long‐term seizure outcome in children with epilepsy and a focal or hemispheric neuroimaging abnormality. Methods: All children (<18 years and residing in Olmsted County, Minnesota) with new‐onset epilepsy diagnosed between 1980 and 2004 and a single focal lesion on neuroimaging were identified by review of the Rochester Epidemiologic Project database. Outcomes were divided into three categories: (1) seizure freedom for 1 or more years at last follow‐up, (2) ongoing seizures but not medically intractable epilepsy, and (3) medically intractable epilepsy or undergoing epilepsy surgery. We also evaluated the proportion who achieved seizure control without surgical intervention and whether lesion type predicted intractability. Key Findings: Of the 359 children with newly diagnosed epilepsy, 37 (10%) had a focal or hemispheric lesion on neuroimaging. Median age of diagnosis was 89 months (25th percentile 26 months, 75th percentile 142 months) and at follow‐up was 137 months (25th percentile 95 months, 75th percentile 211 months). Eighty‐three percent of children with malformations of cortical development, 67% with mesial temporal sclerosis, 33% with encephalomalacia, and 50% with vascular malformations had intractable epilepsy at follow‐up or underwent resective surgery for medically intractable epilepsy. Among the different etiologies, presence of encephalomalacia predicted the lowest likelihood of medical intractability or undergoing surgery (p < 0.01). At final follow‐up, 24 (65%) of our entire cohort was seizure free. Following surgery, seizure freedom was achieved in 80% with mesial temporal sclerosis, 67% with encephalomalacia, 67% with vascular malformation, and 50% with malformations of cortical development. There was no statistically significant difference between the different etiologies on neuroimaging and seizure freedom after surgery. Twelve children (32%) achieved seizure freedom with medical management alone. Significance: Focal lesions on neuroimaging confer a high risk of medical intractability among children with new‐onset epilepsy. However, 32% of this cohort achieved seizure remission with medical management alone, including 58% with encephalomalacia and 33% with mesial temporal sclerosis. 相似文献
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Making science relevant to students' lives, future careers, or societies by introducing controversial socio-scientific issues in classrooms motivates students to take more active roles in learning science. This study explored the influence of integrating two sustainability-oriented socio-scientific issues (SOS2Is) - alternative energies and nanotechnology-into the General Chemistry curriculum on 743 students' career aspirations and perceptions of science relevancy. For the presentation of topics, two learning environments on Prezi were prepared. The participants were guided to explore these learning environments that focused on pros and cons of each topic, including environmental and health hazards of technological developments. In addition, students were encouraged to link these discussions to sustainability issues in the context of the UN SDGs. The analysis of Changes in Attitude Towards the Relevancy of Science and Career Aspirations surveys indicated that the interventions improved students' perception of science relevancy and altered their career aspirations in many areas, regardless of their socioeconomic status and ethnic background. This study provides empirical evidence for the effectiveness of discussions around socio-scientific issues in changing students’ perceptions of science and career aspirations and recommends practical methods to encourage students to become global and scientifically literate citizens. 相似文献
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