W. Donald Shields
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View article: Nonpharmacologic care for patients with <scp>L</scp>ennox‐<scp>G</scp>astaut syndrome: Ketogenic diets and vagus nerve stimulation
Nonpharmacologic care for patients with <span>L</span>ennox‐<span>G</span>astaut syndrome: Ketogenic diets and vagus nerve stimulation Open
Summary Individuals with L ennox‐ G astaut syndrome ( LGS ) often do not respond to or become resistant to pharmacologic treatments. Ketogenic diets ( KDs ) and vagus nerve stimulation ( VNS ) are nonpharmacologic treatment options for the…
View article: Treatment of infantile spasms with very high dose prednisolone before high dose adrenocorticotropic hormone
Treatment of infantile spasms with very high dose prednisolone before high dose adrenocorticotropic hormone Open
Summary Purpose This study investigated the short‐term response to a standardized hormonal therapy protocol for treatment of infantile spasms. Methods Twenty‐seven children with video electroencephalography ( EEG )–confirmed infantile spas…
View article: Vigabatrin 35 years later - from mechanism of action to benefit-risk considerations
Vigabatrin 35 years later - from mechanism of action to benefit-risk considerations Open
Shields WD, Pellock JM. Vigabatrin 35 years later — from mechanism of action to benefit–risk considerations.Acta Neurol Scand: 2011: 124 (Suppl. 192): 1–4.© 2011 John Wiley & Sons A/S.
View article: Infantile spasms: A U.S. consensus report
Infantile spasms: A U.S. consensus report Open
Summary The diagnosis, evaluation, and management of infantile spasms (IS) continue to pose significant challenges to the treating physician. Although an evidence‐based practice guideline with full literature review was published in 2004, …
View article: Improved outcomes in pediatric epilepsy surgery
Improved outcomes in pediatric epilepsy surgery Open
Improved technology and surgical procedures along with changes in clinical practice were likely factors linked with enhanced and sustained seizure-free outcomes in the post-1997 series. These findings support the general concept that clear…
View article: Noninvasive testing, early surgery, and seizure freedom in tuberous sclerosis complex
Noninvasive testing, early surgery, and seizure freedom in tuberous sclerosis complex Open
Magnetic source imaging and (18)fluorodeoxyglucose PET/MRI coregistration noninvasively localized the epileptogenic zones in many children with intractable epilepsy from tuberous sclerosis complex (TSC), with 67% seizure free postoperative…
View article: Language in pediatric epilepsy
Language in pediatric epilepsy Open
Summary Purpose: This study examined the severity and range of linguistic impairments in young, intermediate, and adolescent youth with epilepsy and how these deficits were associated with illness effects, nonverbal intelligence, psychopat…
View article: FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy
FDG-PET/MRI coregistration improves detection of cortical dysplasia in patients with epilepsy Open
Incorporating fluorodeoxyglucose-PET/MRI coregistration into the multimodality presurgical evaluation enhanced the noninvasive identification and successful surgical treatment of patients with cortical dysplasia (CD), especially for the 33…
View article: Childhood absence epilepsy: Behavioral, cognitive, and linguistic comorbidities
Childhood absence epilepsy: Behavioral, cognitive, and linguistic comorbidities Open
Summary Purpose: Evidence for a poor psychiatric, social, and vocational adult outcome in childhood absence epilepsy (CAE) suggests long‐term unmet mental health, social, and vocational needs. This cross‐sectional study examined behavioral…
View article: Infantile Spasms: Little Seizures, BIG Consequences
Infantile Spasms: Little Seizures, BIG Consequences Open
Infantile spasms is one of the “catastrophic childhood epilepsies” because of the difficulty in controlling seizures and the association with mental retardation. However, early recognition, a careful diagnostic evaluation, and proper treat…
View article: Status Epilepticus and Frequent Seizures: Incidence and Clinical Characteristics in Pediatric Epilepsy Surgery Patients
Status Epilepticus and Frequent Seizures: Incidence and Clinical Characteristics in Pediatric Epilepsy Surgery Patients Open
Summary: Purpose: The literature suggests that pediatric epilepsy surgery cases that present in status epilepticus (SE) are an unusual occurrence. However, this concept is based on case reports, and the incidence and clinical characteristi…
View article: Depression and Anxiety Disorders in Pediatric Epilepsy
Depression and Anxiety Disorders in Pediatric Epilepsy Open
Summary: Purpose: This study examined affective disorders, anxiety disorders, and suicidality in children with epilepsy and their association with seizure‐related, cognitive, linguistic, family history, social competence, and demographic v…
View article: Psychopathology and Pediatric Complex Partial Seizures: Seizure‐related, Cognitive, and Linguistic Variables
Psychopathology and Pediatric Complex Partial Seizures: Seizure‐related, Cognitive, and Linguistic Variables Open
Summary: Purpose: This study examined the role of cognition, language, seizure‐related, and demographic variables in the psychopathology of children with complex partial seizure disorder (CPS) of average intelligence. Methods: One‐hundred …
View article: Diagnosis of Infantile Spasms, Lennox‐Gastaut Syndrome, and Progressive Myoclonic Epilepsy
Diagnosis of Infantile Spasms, Lennox‐Gastaut Syndrome, and Progressive Myoclonic Epilepsy Open
Summary: The epilepsies of childhood are distinguished by an interesting dichotomy between the benign and catastrophic disorders. Approximately 50% of children outgrow childhood epilepsy as they mature; although the disorder is disruptive …
View article: Practice Parameter: Medical Treatment of Infantile Spasms
Practice Parameter: Medical Treatment of Infantile Spasms Open
ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective.
View article: Behavioral Disorders in Pediatric Epilepsy: Unmet Psychiatric Need
Behavioral Disorders in Pediatric Epilepsy: Unmet Psychiatric Need Open
Summary: Purpose: This study examined the relation between psychiatric diagnosis and mental health services in children with epilepsy and the associated demographic, cognitive, linguistic, behavioral, and seizure‐related variables. Methods…
View article: Pharmacokinetic Study of Levetiracetam in Children
Pharmacokinetic Study of Levetiracetam in Children Open
Summary: Purpose: The pharmacokinetics of the novel antiepileptic drug (AED) levetiracetam and its major metabolite, ucb L057, were studied in children with partial seizures in a multicenter, open‐label, single‐dose study. Methods: Twenty‐…
View article: Catastrophic Epilepsy in Childhood
Catastrophic Epilepsy in Childhood Open
Summary: Although for most children epilepsy is a relatively benign disorder, for some, epilepsy can be designated as “catastrophic” because the seizures are so difficult to control and because they are strongly associated with mental reta…
View article: Postoperative Seizure Control and Antiepileptic Drug Use in Pediatric Epilepsy Surgery Patients: The UCLA Experience, 1986–1997
Postoperative Seizure Control and Antiepileptic Drug Use in Pediatric Epilepsy Surgery Patients: The UCLA Experience, 1986–1997 Open
Summary: Purpose: Young children with refractory symptomatic epilepsy are at risk for developing neurologic and cognitive disabilities. Stopping the seizures may prevent these disabilities, but it is unclear whether resective surgery is as…
View article: Incidence of Death in Patients with Intractable Epilepsy During Nitrazepam Treatment
Incidence of Death in Patients with Intractable Epilepsy During Nitrazepam Treatment Open
Summary: Purpose: Increased risk of death has been reported in patients with intractable epilepsy (IE) taking nitrazepam (NZP). Methods: Between January 1983 and March 1994, 302 patients with IE were entered into a NZP compassionate‐plea p…
View article: Psychopathology in pediatric complex partial and primary generalized epilepsy
Psychopathology in pediatric complex partial and primary generalized epilepsy Open
Structured psychiatric interviews were administered to 60 children with complex partial seizure disorder (CPS). 40 children with primary generalized epilepsy with absences (PGE), and 48 control children, aged 5 to 16 years. Significantly m…
View article: <scp>l</scp>‐Carnitine Supplementation in Childhood Epilepsy: Current Perspectives
<span>l</span>‐Carnitine Supplementation in Childhood Epilepsy: Current Perspectives Open
Summary: In November 1996, a panel of pediatric neurologists met to update the consensus statement issued in 1989 by a panel of neurologists and metabolic experts on L‐carnitine supplementation in childhood epilepsy. The panelists agreed t…