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Biomedical subjects

I Jambaque

Publications and source records attributed to I Jambaque.

10 recordsLinked to original sources

Epileptic syndromes, cognitive assessment and school placement: a study of 251 children.

Two-hundred and fifty-one children (98 girls and 153 boys, aged from 3 to 17 years) with documented diagnosis of epileptic syndrome, IQ measurement, and information on school placement were included in this retrospective study. The relations between these three parameters as well as effects of age at onset and duration of epilepsy, seizure frequency, and number of antiepileptic drugs (AEDs) were analysed. Both IQ and schooling were univariately related to epileptic syndrome, age at onset and duration of epilepsy, and number of AEDs; seizure frequency was related to IQ but not to school placement. Multiple regression showed that IQ was independently related to epileptic syndrome and AED; multiple logistic regression showed that type of school (mainstream versus adapted or special) was independently related to IQ and AED. Children with idiopathic generalised or with localisation-related epilepsy had higher IQ scores and higher probability of mainstream schooling than those with symptomatic or cryptogenic generalised epilepsies or epileptic syndromes which were undetermined. Subtests profile of intelligence scale in localisation-related epilepsies showed different specific cognitive deficits, according to the location of the epileptic focus.

Adolescent↗

Patterns of neuropsychological deficits in children with medulloblastoma according to craniospatial irradiation doses.

This study aimed to analyse the relationship between supratentorial irradiation dose and the intellectual outcome in 36 children (aged between 5 and 15 years) treated for medulloblastoma. The supratentorial radiation dose was reduced to 25 Gy in 23 children and given at the standard dose, 35 Gy, in 13 other children. Neuropsychological evaluation was performed at a mean of 4.3 years (SD 4.7 years) after radiotherapy. The supratentorial radiation dose was the principal risk factor associated with impaired intellectual outcome. Verbal fluency, immediate word list recall, block design, and fine motricity of the dominant hand were significantly lower in children irradiated at the standard doses than in those irradiated at reduced doses. These findings suggest that the dose of radiotherapy applied to the brain strongly influences later verbal and non-verbal skills in children with medulloblastoma. This should be taken into account in treatment planning and in rehabilitation programs.

Adolescent↗

The right brain hemisphere is dominant in human infants.

The development of functional brain asymmetry during childhood is confirmed by changes in cerebral blood flow measured at rest using dynamic single photon emission computed tomography. Between 1 and 3 years of age, the blood flow shows a right hemispheric predominance, mainly due to the activity in the posterior associative area. Asymmetry shifts to the left after 3 years. The subsequent time course of changes appear to follow the emergence of functions localized initially on the right, but later on the left hemisphere (i.e. visuospatial and later language abilities). These findings support the hypothesis that, in man, the right hemisphere develops its functions earlier than the left.

Adolescent↗

Infantile spasms: a pathophysiological hypothesis

Clinical and electroencephalogram (EEG) observations permit a hypothesis for the pathophysiology of infantile spasms. The triggering area(s) for spasms is probably cortical. Diffuse hyperexcitability of the immature cortex and/or diffusion of the epileptic process from a focal abnormality would allow development of hypsarrhythmia. Cortical maturation from posterior to anterior might account for the location of causative focal abnormalities. In cryptogenic West syndrome, the predominant pathophysiologic process may be diffuse cortical hyperexcitability, explaining the severe developmental deterioration at the onset of spasms. In symptomatic West syndrome with focal pathology, the initial deterioration is often less striking, suggesting that the predominant effect is diffusion of the epileptic process. The pattern of eventual cognitive deficits follows a similar pattern.

Journal Article↗

[Benign epileptic infantile spasms].

Among 100 infants with infantile spasms studied before treatment, 14 had idiopathic spasms with a favourable outcome. They had a normal development, including reaching for objects before the age of 5 months and moderate regression without loss of eye following. Although it was hysarhythmic, the EEG tracing showed identifiable basic activity and sleep spindles; there was no slow waves focus even after diazepam administration and the spasms were "independent" even during a cluster. This type of infantile spasms seems to be a particular type of non-lesional epilepsy. It contrasts with idiopathic spasms of unfavourable outcome that apparently result from a preexisting and overlooked focal lesion responsible of later cognitive troubles.

Child, Preschool↗

[Reversible frontal syndrome and epilepsy in an 8-year-old boy].

An 8 year-old patient with a frontal lobe syndrome associated with epilepsy is reported. The neuropsychological evaluation showed that the behavioural problems resulted from moderate but specific disorders of the executive system. Evolution was favorable with complete disappearance of the neuropsychological difficulties when the seizures were controlled. This dysfunction, similar to that observed in adults, may occur in the first decade and be functional in origin.

Brain Diseases↗