Neurobiologic Considerations in Early Surgery for Epilepsy

1994 ◽  
Vol 9 (2_suppl) ◽  
pp. 2S42-2S49 ◽  
Author(s):  
Michael Duchowny ◽  
Bonnie Levin ◽  
Prasanna Jayakar ◽  
Trevor J. Resnick
Keyword(s):  
Selection Process ◽  
Early Years ◽  
Early Surgery ◽  
Onset Seizure ◽  
Dynamic Changes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Developmental Arrest ◽  
Long Term Prognosis

Children with well-localized medically resistant seizures are often referred for surgical therapy. In young children, at least three maturational issues playa significant role in the selection process and long-term outcome. First, the early years are a time of exceptionally rapid brain development leading to dynamic changes in the electroencephalogram and the clinical expression of seizures. Many early-onset seizure presentations are also associated with catastrophic outcomes, developmental arrest, or regression. Second, the immature limbic system may be vulnerable to stresses operating in early life, although the consequences may not become apparent for many years. Third, in comparison to the adult, the child's nervous system typically exhibits superior functional recovery after lesioning, but the process of sparing and recovery is often incomplete. An understanding of how these neurobiologic factors influence developmental outcome will ultimately lead to greater selectivity of candidates for early surgery and to improved long-term prognosis. (J Child Neurol 1994;9(Suppl):2S42-2S49).

scholarly journals Diagnosis, Treatment and Long-term Outcome in Fetal Hydrocephalus(Pediatric Neurosurgery and Long-term Prognosis)

2011 ◽  
Vol 20 (5) ◽  
pp. 322-329
Author(s):  
Mami Yamasaki ◽  
Masahiro Nonaka ◽  
Yohei Bamba ◽  
Chika Teramoto ◽  
Chiaki Ban ◽  
...  
Keyword(s):  
Pediatric Neurosurgery ◽  
Special Issue ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fetal Hydrocephalus ◽  
Long Term Prognosis

The Ethics of Infant Dialysis

1996 ◽  
Vol 16 (1_suppl) ◽  
pp. 505-509 ◽  
Author(s):  
Timothy E. Bunchman
Keyword(s):  
Standard Of Care ◽  
Health Care Team ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Number Of Factors ◽  
Long Term Prognosis ◽  
Infant Dialysis ◽  
Stage Renal Disease ◽  
End Stage

The proper treatment of an infant with end-stage renal disease depends upon a number of factors including parental willingness to take on the task, experience of the health-care team, local and regional resources, and society's willingness to accept this support as a standard of care. Whereas the abilityto keep infants aliveon peritoneal dialysis (PD) is obtainable, it is not without physical, financial, as well as emotional cost. In order for a family to agree to take on such a task, an understanding of the risks and long-term prognosis should be offered. This “informed consent” is difficult to obtain in such a highly charged situation when emotions often dictate choice independently of logic. Long-term outcome of infants on PD has improved over time, yet is still fraught with complications. Options of treatment or nontreatment are explored.

Long-term outcome of anterior decompression and spinal fixation after placement of the Wellesley Wedge for thoracic and lumbar spinal metastasis

2002 ◽  
Vol 96 (1) ◽  
pp. 6-9 ◽  
Author(s):  
David Yen ◽  
Vikas Kuriachan ◽  
Jeff Yach ◽  
Andrew Howard
Keyword(s):  
Selection Process ◽  
Spinal Metastasis ◽  
Neurological Status ◽  
Long Term Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Content Type ◽  
Lumbar Spinal ◽  
Fine Print

Object. The authors assessed the long-term results of anterior decompressive and vertebral body reconstructive surgery in which the Wellesley Wedge was applied in patients with metastatic spinal lesions over the life span of these individuals. Methods. The authors performed a retrospective review of the outcome of 27 consecutively treated patients who underwent surgery for thoracic or lumbar spine metastases. Decompressive surgery was performed via an anterior thoracotomy and/or retroperitoneal approach depending on the level of the lesion. The spine was reconstructed using a U-shaped plate with an interposed methylmethacrylate strut known as the Wellesley Wedge. Results. Thirty percent of patients suffered medical complications whereas 22% experienced postoperative improvement, as reflected by an improved Frankel grade. Used in patients with a variety of primary tumor types, a spectrum of ages and neurological status, and extensive preoperative osseous spinal involvement and deformity, the Wellesley Wedge resulted in spinal stability for the duration of patients' lives in 92%. Conclusions. In this series the patient selection process for surgery was a challenge yet to be solved; however, considering the durability of the Wellesley Wedge itself, the authors will continue to use it in selected patients.

scholarly journals Long-term outcome of Hurler syndrome patients after hematopoietic cell transplantation: an international multicenter study

Blood ◽  
2015 ◽  
Vol 125 (13) ◽  
pp. 2164-2172 ◽  
Author(s):  
Mieke Aldenhoven ◽  
Robert F. Wynn ◽  
Paul J. Orchard ◽  
Anne O’Meara ◽  
Paul Veys ◽  
...  
Keyword(s):  
Hematopoietic Cell Transplantation ◽  
Residual Disease ◽  
Hurler Syndrome ◽  
Term Outcome ◽  
Early Referral ◽  
Long Term Outcome ◽  
Key Points ◽  
Long Term Prognosis ◽  
International Multicenter Study

Key Points Patients with Hurler syndrome show significant residual disease burden despite HCT. Early referral for HCT, using noncarrier donors and regimens designed to achieve full-donor chimerism, offers the best long-term prognosis.

Mo1357 Long-Term Outcome of Paediatric-Onset Ulcerative Colitis: Early Years Are Shaping the Future

2013 ◽  
Vol 144 (5) ◽  
pp. S-646
Author(s):  
Corinne Gower-Rousseau ◽  
Julia Salleron ◽  
Dominique Turck ◽  
Mathurin Fumery ◽  
Anais Peneau ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Early Years ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Future

scholarly journals Long-term Outcome of Craniopharyngioma in Children: A Review(Pediatric Neurosurgery and Long-term Prognosis)

2011 ◽  
Vol 20 (5) ◽  
pp. 351-362
Author(s):  
Takashi Tamiya ◽  
Masaki Okada ◽  
Keisuke Miyake ◽  
Nobuyuki Kawai
Keyword(s):  
Pediatric Neurosurgery ◽  
Special Issue ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Prognosis

scholarly journals The clinical features and long-term prognosis of asymmetry childhood Guillain-Barré syndrome: a 5-year follow-up.

2020 ◽  
Author(s):  
Rui-Di Sun ◽  
jun Jiang
Keyword(s):  
Infectious Disease ◽  
Clinical Features ◽  
Guillain Barre Syndrome ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Guillain Barré Syndrome ◽  
Motor Nerves ◽  
Long Term Prognosis ◽  
Guillain Barré

Abstract Backgroud: The aim was to investigate clinical features and long-term prognosis of asymmetric childhood Guillain-Barré syndrome (GBS). Methods: In a retrospective cohort study, standardized data from all children with GBS seen at the Wuhan Children’s Hospital were collected regarding clinical presentation, auxiliary examinations and long-term outcome. We compared asymmetry GBS with symmetry GBS. Asymmetry GBS was defined by Medical Research Council (MRC) grade and motor nerves conduction in bilateral limbs. Recovery was defined as a return to normal life with a DSS of 0. Results: GBS was diagnosed in 72 children. 12（16.67%）were asymmetry GBS compared to 60 symmetry GBS . In asymmetry GBS, six children were transient asymmetry weakness and six children were persistent asymmetry weakness. Compared to symmetry weakness GBS, asymmetry weakness GBS had more preschool children (75% vs 25%, P=0.005), longer days on hospital(26.5(15-37) days vs 11(9-15) days, p =0.000), more mechanical ventilation(MV) (50% vs 8.33%, p=0.000), higher Disease severity score(DSS)at nadir of disease(4(3-5) vs 3(1-4), p=0.010), more axonal subtypes(50% vs 15%, p=0.013) and more complications(58.33% vs 8.33%, p=0.000). Eight children had sequelae and sixty-four children had recovery. Compared to recovery group, sequelae group had more axonal subtypes(62.5% vs 15.63%, p=0.002) and more persistent asymmetry weakness(62.5% vs 4.69%, p=0.000). In six persistent asymmetry GBS, 5(83.33%) had abnormal EEG (electroencephalogram) results, 3(50%) children had mild to marked pleocytosis in CSF and 5(83.33%) had sequelae. Conclusions: In conclusion, asymmetry GBS had two types, namely transient and persistent asymmetry weakness. Asymmetry GBS indicated a more complex condition during disease. Most of persistent asymmetry GBS had clinical or subclinical infectious disease and poor prognosis. Inflammatory in anterior horn cells or nerve root by infectious disease may be the possible function in persistent asymmetry GBS.

Spinal Arachnoid Cysts in 17 Dogs

2003 ◽  
Vol 39 (3) ◽  
pp. 271-282 ◽  
Author(s):  
Todd M. Skeen ◽  
Natasha J. Olby ◽  
Karen R. Muñana ◽  
Nicholas J. Sharp
Keyword(s):  
Cervical Vertebrae ◽  
Clinical Signs ◽  
Neurological Status ◽  
Arachnoid Cysts ◽  
Thoracic Vertebrae ◽  
Term Outcome ◽  
Long Term Outcome ◽  
North Carolina State University ◽  
Long Term Prognosis

The medical records of 17 dogs diagnosed with spinal arachnoid cysts at North Carolina State University Veterinary Teaching Hospital were retrospectively examined to identify trends in signalment, history, neurological status, treatment, and short- and long-term prognosis. The typical case was that of a nonpainful, progressive ataxia frequently characterized by hypermetria and incontinence. Cysts typically occurred in the dorsal subarachnoid space at the first to third cervical vertebrae of young, large-breed dogs or the caudal thoracic vertebrae of older, small-breed dogs. Although 14 of 15 dogs treated surgically did well in the short term, long-term successful outcomes were achieved in only eight of the 12 dogs that were followed for >1 year. Significant predictors of good, long-term outcome were not identified; however, factors associated with a trend toward a good outcome included <3 years of age, <4 months’ duration of clinical signs, and marsupialization as the surgical technique.

Lipid-specific immunoglobulin M in CSF predicts adverse long-term outcome in multiple sclerosis

2008 ◽  
Vol 14 (9) ◽  
pp. 1208-1213 ◽  
Author(s):  
M Thangarajh ◽  
J Gomez-Rial ◽  
AK Hedström ◽  
J Hillert ◽  
JC Alvarez-Cermeño ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Median Time ◽  
Immunoglobulin M ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Relapsing Remitting ◽  
Specific Immunoglobulin ◽  
Long Term Prognosis ◽  
Relapsing Remitting Multiple Sclerosis

Background and Objective The presence of lipid-specific immunoglobulin M bands in the cerebrospinal fluid (CSF) predicts an aggressive course in patients with relapsing–remitting multiple sclerosis (MS) during early stages of the disease. This study examined whether it is also a predictor of long-term prognosis in MS. Methods Eighty-one patients with MS and 22 headache controls were analyzed for anti-lipid IgM reactivity in CSF samples. The correlation between the presence of lipid-specific immunoglobulin M bands in CSF and disease progression was assessed in patients with MS who had been followed longitudinally for, on average, more than 11 years. Results Lipid-specific immunoglobulin M bands were detected in the CSF of 24 of 81 patients with MS and were absent in the CSF of all headache controls. Median time to conversion to a secondary progressive course was 11 years in patients with bands and 22 years in patients without bands. Median time to an Expanded Disability Status Scale score of 4 was 14 years in patients with bands and 24 years in patients without bands. Conclusion The presence of lipid-specific immunoglobulin M bands in CSF predicts a more adverse long-term outcome in patients with MS; it may thus define a subset of patients who might benefit from aggressive treatment during the early phase of the disease.

scholarly journals A Correlation Between Monocyte to Lymphocyte Ratio and Long-Term Prognosis in Patients With Coronary Artery Disease After PCI

2021 ◽  
Vol 27 ◽  
pp. 107602962199971
Author(s):  
Feng-Hua Song ◽  
Ying-Ying Zheng ◽  
Jun-Nan Tang ◽  
Wei Wang ◽  
Qian-Qian Guo ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Cox Regression ◽  
Cardiac Mortality ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
All Cause Mortality ◽  
Long Term Prognosis

Monocyte to lymphocyte ratio (MLR) has been confirmed as a novel marker of poor prognosis in patients with coronary heart disease (CAD). However, the prognosis value of MLR for patients with CAD after percutaneous coronary intervention (PCI) needs further studies. In present study, we aimed to investigate the correlation between MLR and long-term prognosis in patients with CAD after PCI. A total of 3,461 patients with CAD after PCI at the First Affiliated Hospital of Zhengzhou University were included in the analysis. According to the cutoff value of MLR, all of the patients were divided into 2 groups: the low-MLR group (<0.34, n = 2338) and the high-MLR group (≥0.34, n = 1123). Kaplan–Meier curve was performed to compare the long-term outcome. Multivariate COX regression analysis was used to assess the independent predictors for all-cause mortality, cardiac mortality and MACCEs. Multivariate COX regression analysis showed that the high MLR group had significantly increased all-cause mortality (ACM) [hazard ratio (HR) = 1.366, 95% confidence interval (CI): 1.366-3.650, p = 0.001] and cardiac mortality (CM) (HR = 2.379, 95%CI: 1.611-3,511, p < 0.001) compared to the low MLR group. And high MLR was also found to be highly associated with major adverse cardiovascular and cerebrovascular events (MACCEs) (HR = 1.227, 95%CI: 1.003-1.500, p = 0.047) in patients with CAD undergoing PCI. MLR was an independent predictor of ACM, CM and MACCEs in CAD patients who underwent PCI.

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