Search

We studied the clinical, EEG and MRI findings in 19 patients with epilepsy secondary to congenital destructive hemispheric insults. Patients were divided in two groups: 10 with cystic lesions (group 1), and 9 with atrophic lesions (group 2). Seizure and EEG features, as well as developmental sequelae were similar between the two groups, except for the finding that patients of group 2 more commonly presented seizures with more than one semiological type. MRI showed hyperintense T2 signal extending beyond the lesion in almost all patients of both groups, and it was more diffuse in group 2. Associated hippocampal atrophy (HA) was observed in 70% of group 1 patients and 77.7% of group 2, and it was not correlated with duration of epilepsy or seizure frequency. There was a good concordance between HA and electroclinical localization. The high prevalence of associated HA in both groups suggests a common pathogenesis with the more obvious lesion. Our findings indicate that in some of these patients with extensive destructive lesions, there may be a more circumscribed epileptogenic area, particularly in those with cystic lesions and HA, leading to a potential rationale for effective surgical treatment.

Background The association of chromosomal imbalances and neurologic abnormalities is well known. Objective To describe a family with 2 brothers presenting with 15q trisomy due to a maternal equilibrated translocation involving chromosomes 12 and 15. Design, Setting, and Patients Among patients with epilepsy followed up in our hospital, we identified 2 brothers with epilepsy and mental retardation who presented dysmorphic features. Detailed clinical, electroencephalographic, and magnetic resonance imaging investigation was performed. In addition, we collected blood samples for karyotyping. Results Clinical findings included minor dysmorphic features, mental retardation, abnormal behavior, and secondary generalized epilepsy. Electroencephalography showed left temporal slow waves in the older brother and background abnormality associated with generalized and multifocal epileptiform discharges in the other. Their magnetic resonance images showed mesial temporal lobe malformation, including the hippocampus and parahippocampal and fusiform gyri, with abnormal shape and axis. Conclusions To our knowledge, this is the first report of mesial temporal lobe malformation associated with chromosomal abnormalities. Our finding may contribute to the understanding of the genetic mechanisms involved in central nervous system malformations, especially in the mesial temporal lobe structures.

The occurrence of de novo psychogenic seizures after epilepsy surgery is rare, and is estimated in 1.8% to 3.6%. Seizures after epilepsy surgery should be carefully evaluated, and de novo psychogenic seizures should be considered especially when there is a change in the ictal semiology. We report a patient with de novo psychogenic seizures after anterior temporal lobe removal for refractory temporal lobe epilepsy. Once psychogenic seizures were diagnosed and psychiatric treatment was started, seizures stopped.

The impact of nutrition on HIV-infected children has been evaluated in multiple studies. Our review of the current trends of nutrition-related studies revealed that the focus has moved from simply the disease consequences of HIV to ensuring that antiretroviral therapy-treated children are well nourished to ensure growth and development. This update aims to present the state of the art regarding nutrition of HIV-infected children and the real potential for nutrition to serve as a dynamic therapy in this group. Recent World Health Organization reports indicate that the HIV/AIDS disease is curbing in incidence worldwide despite the high 1.8 million children, less than 15 years, reported in 2017. In addition, the literature supports the complexity and bidirectional relation between nutrition and HIV. HIV infection has a substantial effect on the nutritional status, in particular, the gastrointestinal side effects, which, in turn, have a profound impact on HIV infection. Advances in the field have transformed the course of the disease into a chronic illness, where more attention was given to lifestyle and quality of life including nutrition. However, achievement of food security, nutrition accessibility, and appropriate handling of nutrition-related complications of HIV infection are remarkable challenges, particularly, in resource poor environments, where most HIV infections exist.