关键词： EEG   epilepsy   genetics   investigation   metabolic disorder   neuro-imaging  

摘要： The epilepsies of childhood are a markedly heterogeneous group of diseases with different presentations, outcomes and aetiologies. There is no single, gold-standard investigation that will unequivocally diagnose an epilepsy. The range of aetiologies includes genetic, structural brain malformations and metabolic;in many, there may be a combination of causes. Despite major advances in neuro-imaging and genetics, a cause will not be identified in approximately 40% of all children with epilepsies. This article outlines the available investigations and provides a practical and structured approach on their most effective use in the childhood epilepsies. © 2018

关键词： Pericyte   Capillary   Blood-brain barrier   Ischaemia   Alzheimer's   Spinal cord injury   Diabetes  

摘要： Manycentral nervous system diseases currently lack effective treatment and are often associated with defects in microvascular function, including a failure to match the energy supplied by the blood to the energy used on neuronal computation, or a breakdown of the blood-brain barrier. Pericytes, an under-studied cell type located on capillaries, are of crucial importance in regulating diverse microvascular functions, such as angiogenesis, the blood-brain barrier, capillary blood flow and the movement of immune cells into the brain. They also form part of the glial scar isolating damaged parts of the CNS, and may have stem cell-like properties. Recent studies have suggested that pericytes play a crucial role in neurological diseases, and are thus a therapeutic target in disorders as diverse as stroke, traumatic brain injury, migraine, epilepsy, spinal cord injury, diabetes, Huntington's disease, Alzheimer's disease, diabetes, multiple sclerosis, glioma, radiation necrosis and amyotrophic lateral sclerosis. Here we report recent advances in our understanding of pericyte biology and discuss how pericytes could be targeted to develop novel therapeutic approaches to neurological disorders, by increasing blood flow, preserving blood-brain barrier function, regulating immune cell entry to the CNS, and modulating formation of blood vessels in, and the glial scar around, damaged regions.

关键词： Neurological examination   Asymmetry   Cerebral palsy   Herniplegia  

摘要： BACKGROUND: The Hammersmith Infant Neurological Examination is one of several useful tools for early identification of cerebral palsy;however, cut-off scores for cerebral palsy do not consistently distinguish infants with hemiplegia from those typically developing. We hypothesized that use of an asymmetry score, in addition to the assessment's standard total cutoff score, could remedy this problem in a clinical setting. METHODS: This retrospective study of a neonatal intensive care follow-up program with consistent clinical use of the Hammersmith Infant Neurological Examination matched infants with a diagnosis of cerebral palsy to infants without motor delays or evidence of neurodevelopmental impairments. Groups had same corrected and gestational ages at Hammersmith Infant Neurological Examination assessment. Asymmetry presence was recorded. RESULTS: Of 74 infants with cerebral palsy, 28 had quadriplegia, 11 had diplegia, and 35 had hemiplegia. Median total Hammersmith Infant Neurological Examination and asymmetry scores for hemiplegia were 57.5 and 10 versus 76 and 0 for those without cerebral palsy. Sensitivity and specificity to distinguish hemiplegia from typical development by combining a total Hammersmith Infant Neurological Examination score less than 63 and an asymmetry score greater than 5 were 91.8% and 100%, respectively. CONCLUSIONS: In a clinical setting, combining total Hammersmith Infant Neurological Examination and asymmetry scores can help providers differentiate infants with hemiplegia from those typically developing. (C) 2018 Elsevier Inc. All rights reserved.

摘要： The article presents case study of a 80-year-old man who was diagnosed with traumatic mid-thoracic spondyloptosis. It mentions that secondary assessment and computed tomography (CT) scanning in the emergency department of a Level 1 trauma hospital revealed complete traumatic spondyloptosis. It presents information on initial laminectomy and decompression of the spinal cord was performed as there was a risk of injuring the cord peri-reduction manoeuvre.

关键词： Spinal instability neoplastic score   Spinal neoplasms   Palliative surgery   Spinal fusion   Prognosis  

摘要： Study Design: Retrospective study. Purpose: To evaluate the efficacy of the Spinal Instability Neoplastic Score (SINS) in predicting surgical outcomes and survival. Patients were categorized into two groups according to the SINS, and their surgical outcomes and survival following decompression and stabilization were assessed. Overview of Literature: Palliative surgery in patients with a life expectancy >= 3 months may effectively improve their overall condition in the long term. Currently, the effectiveness of the SINS for predicting surgical results and survival remains controversial. Methods: This study included 44 patients who underwent decompression and stabilization for spinal metastases at Yokosuka Kyosai Hospital between 2008 and 2017. The patients were divided into two groups: stable (SINS <= 12) and unstable (SINS >= 13). Changes in the Frankel score and Eastern Cooperative Oncology Group Performance Status (ECOG-PS) were compared between the two groups, and patient survival was evaluated according to the SINS, Tokuhashi score, and Katagiri score. Results: The stable group (SINS range, 7-12) included 24 patients while the unstable group (SINS range, 13-16) included 20 patients. The Frankel score significantly improved from 2.8 to 3.6 in the stable group (p<0.001) and from 2.7 to 3.9 in the unstable group (p<0.001). The ECOG-PS significantly improved from 3.2 to 2.1 in the stable group (p<0.001) and from 3.0 to 1.8 in the unstable group (p<0.001). There was a statistically significant difference in median survival between the two groups. Conclusions: All patients treated with palliative surgery showed favorable outcomes, as indicated by improved the Frankel score and ECOG-PS following surgery. However, median survival was significantly better in the stable group. The results of this study indicate that the SINS is appropriate for surgical decision making and may be used to predict survival.

关键词： Lats1   neurological deficit   neuronal apoptosis   traumatic brain injury   YAP1  

摘要： AimsTo investigate the roles of Lats1/p-YAP1 pathway in TBI-induced neuronal apoptosis and neurological deficits in rats. ResultsWe found that Lats1 and YAP1 were expressed in cerebral cortex neurons of Sprague-Dawley rats, and the phosphorylation levels of Lats1 and YAP1 in injured regions were significantly increased after TBI. Furthermore, inhibition of Lats1 not only decreased the level of p-YAP1, but also attenuated neuronal apoptosis and neurological impairment. ConclusionsOur work demonstrates that inhibition of Lats1/p-YAP1 pathway mitigates neuronal apoptosis and neurological deficits in a rat model of TBI.

关键词： Central Nervous System   Neonatal encephalopathy   Premature Mortality   Global Burden of Disease   Southern Asia   Africa south of the Sahara   High angle of attack   Premature Obstetric Labor  

摘要： Neurological conditions in children represent a significant proportion of the global burden of disease, since they contribute to premature mortality and years lived with disability. The burden of neurological conditions, as measured by the total disability adjusted live years has decreased significantly over the last 25 years (1990-2015), mainly due to the reduction in the mortality, as the years lived with disability has increased slightly. However, in some regions of the world, notably South Asia and sub-Saharan Africa, the burden remains high, driven by the high incidence of prematurity, neonatal encephalopathy and infections of the central nervous system. (C) 2018 Elsevier Inc. All rights reserved.