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Abstract
Recent advances in pediatric epileptology are the consequence of the explosive advance
of medical technology in recent years. In this manuscript, some of the major highlights
of these technology driven advances will be presented. Recognition of a typical EEG
spike pattern leads to the identification of benign focal epilepsy of childhood, an
extremely frequent electro-clinical syndrome of excellent prognosis. The development
of CT scan and particularly of high resolution MRI, has led to the easy identification
of a variety of pathologies which were previously recognized only by pathologists.
These include, among others, neuroblast migrational disorders, mesial temporal sclerosis,
forme fruste of tuberous sclerosis, and slow growing small temporal neoplasms. PET
scanning has also shown to be particularly sensitive in the detection of subtle pathological
lesions, which may remain undetected by MRI. This is particularly true in infants
in whom the PET scan may uncover an unsuspected focal lesion in patients with hypsarrhythmia,
indicating that hypsarrhythmia may be a form of a secondary generalized epilepsy.
Advances in surgical techniques have also decreased significantly the risks of callosotomies
and hemispherectomies, techniques that are now widely used to improve seizure control
in patients with catastrophic seizure disorders. A better understanding of neurotransmitters
involved in the generation or inhibition of seizures has led to the development of
a variety of new drugs which promise to improve our ability to control seizures conservatively.
Finally, advances in molecular biology have also had an impact on epileptology, leading
to the discovery of gene abnormalities underlying a number of epileptic syndromes.
Keywords
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Article info
Publication history
Accepted:
June 25,
1993
Received:
June 18,
1993
Footnotes
This paper was presented as an invited lecture at the 35th annual meeting of the Japanese Society of Child Neurology, Kyoto, 17–19 June 1993.
Identification
Copyright
© 1994 Elsevier Science B.V. All rights reserved. Published by Elsevier Inc.