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Maria Iliescu

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Articole semnate de acelasi autor in Revista Romana de Pediatrie:

Neurological manifestations in children with autism

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Neurological manifestations in children with autism

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ABSTRACT

The autism is a pervasive developmental disorder that can be associated with various neurological disorders. The aim of this study is to evaluate the incidence and characteristics of neurological abnormalities, the presence of epileptic seizures and/or EEG abnormalities in children with autism. Our study included 34 children (aged 2.5 to 13 years) diagnosed with autism. The study protocol included: general physical and neurological examination, IQ, tests of language, behavior, auditory attention, social skills and play, clinical features of epileptic seizures, EEG recordings. Neurological exam revealed mild hypotonia in 19 (55.88%) patients with autism, hyporeflexia in 21 (61.76%), the presence of stereotype movements in 24 (70.58%) and abnormalities of gait in 5 (14,80%) cases. Epileptic seizures were present in 9 children. EEG changes were present in all children diagnosed with autism and epilepsy, but also in those with no clinically critical episodes; they were represented by nonepileptic type in 29.41% cases and epileptic abnormalities in 44.12%. The changes of tone and reflexes, seizures and epileptic discharges were particularly common in children studied with autism. Our data suggests that EEG evaluation is important for these patients. The management of epilepsy in autism consists in the administration of antiepileptic drugs that, in addition to seizures control, also interfere with mood and behavioral disturbance observed in autism.

Key words: autism, child, epilepsy, EEG abnormalities, neurological abnormalities

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MANIFESTARI NEUROLOGICE LA COPIII CU AUTISM

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Revista Romana de PEDIATRIE | Volumul LX, Nr. 2, An 2011
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
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ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

MANIFESTARI NEUROLOGICE LA COPIII CU AUTISM

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REZUMAT

Autismul este o afecţiune pervazivă de dezvoltare care se poate asocia cu diferite probleme neurologice. Scopul acestui studiu a fost de a evalua incidenţa şi caracteristicile anomaliilor evidenţiate la examenul neurologic, prezenţa crizelor epileptice şi/sau anomaliile EEG la copiii cu autism. În studiu au fost incluşi 34 de copii cu vârste cuprinse între 2 ani şi 5 luni-13 ani, diagnosticaţi cu autism. Protocolul de studiu a inclus: examenul clinic general şi neurologic, QI, evaluarea limbajului, comportamentului, atenţiei, abilităţilor sociale şi a jocului, caracteristicile clinice ale crizelor epileptice, înregistrarea EEG. Examenul neurologic a evidenţiat hipotonie musculară la 19 (55,88%) pacienţi, diminuarea reflexelor osteotendinoase la 21 (61,76%), prezenţa mişcărilor stereotipe la 24 (70,58%) şi anomalii ale mersului la 5 (14,70%) dintre copiii cu autism evaluaţi. Crize epileptice au prezentat 9 copii. Modificările EEG au fost prezente la toţi copiii diagnosticaţi cu autism şi epilepsie, dar şi la cei care nu prezentau clinic episoade critice, fiind reprezentate de anomalii neepileptice în 29,41% din cazuri şi de tip epileptic în 44,12%. Modificările de tonus muscular şi de reflexe, crizele şi descărcările epileptice au fost comune la copiii cu autism. Rezultatele studiului actual demonstrează că evaluarea EEG este importantă la aceşti pacienţi. Abordarea terapeutică a epilepsiei în autism a constat în administrarea de medicamente antiepileptice care, pe lângă controlul crizelor, au influenţat favorabil atât dispoziţia, cât şi comportamentul.

Cuvinte cheie: autism, copil, epilepsie, modificări EEG, anomalii neurologice

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Efficacy of Levetiracetam in children with drug resistant partial seizures

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Promoting Global Health

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Efficacy of Levetiracetam in children with drug resistant partial seizures

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ABSTRACT

Epilepsy is frequently diagnosed in the pediatric age raising numerous issues related to treatment. Levetiracetam (LEV) is an antiepileptic drug (AED) which is approved as a new combination therapy in different types of drug resistant seizures. The purpose of this study was to evaluate the efficacy and safety of LEV in combination with drug resistant therapy in partial epilepsies children. The study group included 63 children diagnosed with various forms of partial epilepsy. All patients received antiepileptic medication in monotherapy or polytherapy without remission of seizures. Levetiracetam has been associated with MAE initial dose of 10 mg/kg/day (two administrations), the dose was increased up to 40 mg/kg/day within 6 weeks. Patients were studied for a further period of six months. Among children who received associated LEV 34 (53.96%) showed a reduction > 50% of seizures, and 21 (33.35%) reduction was <50%. 8 (12.69%) of patients achieved complete control of critical episodes. Side effects recorded during the study were minimal, being represented by fatigue (12 cases), conduct disorder (7 cases), sleepiness at baseline (three cases), decreased appetite (4 cases), and vomiting (2 cases). Levetiracetam combination treatment in children with drug resistant partial epilepsy is effective with complete control or significant reduction in seizure frequency. Clinical response in the group of studied children was favorable especially in patients with partial motor seizures with or without secondary generalization. Levetiracetam was generally well tolerated, side effects occurred in the study being minimal.

Key words: Levetiracetam, child drug resistance, partial seizures

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EFICACITATEA TRATAMENTULUI CU LEVETIRACETAM LA COPIII CU CRIZE EPILEPTICE PARTIALE FARMACOREZISTENTE

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Revista Romana de PEDIATRIE | Volumul LXI, Nr. 1, An 2012
ISSN 1454-0398  |  e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

Indexed

DOI - Crossref
Similarity Check by iThenticate, worldwide No 1 professional plagiarism checking system
DOAJ
NLM Catalog
Ebsco Host - Medline
Google Academic
Semantic Scholar

HIGHLIGHTS

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

The published medical research literature is a global public good. Medical journal editors have a social responsibility to promote global health by publishing, whenever possible, research that furthers health worldwide.

EFICACITATEA TRATAMENTULUI CU LEVETIRACETAM LA COPIII CU CRIZE EPILEPTICE PARTIALE FARMACOREZISTENTE

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REZUMAT

Epilepsia este frecvent diagnosticată la vârsta pediatrică, ridicând numeroase probleme legate de tratament. Levetiracetamul (LEV) este un medicament antiepileptic (MAE) nou care este aprobat ca tratament de asociere în diferite tipuri de crize epileptice farmacorezistente. Scopul acestui studiu a fost de a evalua eficacitatea şi siguranţa asocierii LEV în tratamentul epilepsiilor parţiale farmacorezistente la copii. Lotul de studiu a cuprins 63 de copii diagnosticaţi cu diferite forme de epilepsie parţială. Toţi pacienţii primeau medicaţie antiepileptică în mono sau politerapie fără remiterea crizelor. Levetiracetamul a fost asociat la MAE iniţială în doză de 10 mg/kg/zi (în două administrări), doză ce a fost crescută până la maxim 40 mg/kg/ zi în decurs de 6 săptămîni. Pacienţii au fost urmăriţi în continuare pe o perioadă de 6 luni. Dintre copiii urmăriţi la care s-a asociat LEV 34 (53,96%) au prezentat o reducere a crizelor cu >50%, iar la 21 (33,35%) reducerea a fost <50%. La 8 (12,69%) dintre pacienţi s-a obţinut controlul complet al episoadelor critice. Efectele secundare înregistrate pe durata studiului au fost minime, fiind reprezentate de fatigabilitate (12 cazuri), tulburări de comportament (7 cazuri), somnolenţă iniţială (3 cazuri), scăderea apetitului (4 cazuri), vărsături (2 cazuri). Asocierea LEV la tratamentul copiilor cu epilepsii parţiale farmacorezistente este eficientă în controlul complet sau în scăderea semnificativă a frecvenţei crizelor. Răspunsul clinic în grupul de copii studiat a fost favorabil în special la pacienţii cu crize parţiale motorii cu sau fără generalizare secundară. Levetiracetamul a fost în general bine tolerat, efectele secundare apărute în studiu fiind minime.

Cuvinte cheie: levetiracetam, crize epileptice parţiale farmacorezistente, copil

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