scholarly journals Pathophysiological mechanisms of development of epilepsy and special features of epileptogenesis in the immature brain

2021 ◽  
pp. 29-39
Author(s):  
V.Yu. Martyniuk ◽  
◽  
T.K. Znamenska ◽  
V.B. Shveikina ◽  
◽  
...  
Keyword(s):  
Ion Channels ◽  
Young Children ◽  
Clinical Manifestations ◽  
Fetal Brain ◽  
Brain Structures ◽  
Kainate Receptors ◽  
Gamma Aminobutyric Acid ◽  
Neural Organization ◽  
Newborn Brain ◽  
Key Words Newborn

The article is devoted to the urgent problem of neonatology and pediatric neurology — seizures in newborns and young children. The work analyzes the scientific literature on the pathogenetic mechanisms of the development of the epileptic process, which is based on the anatomical and physiological mechanisms of the functioning of brain cells, in particular, in newborns and young children. New pathophysiological data on the increased excitability of the developing brain are described. It has been shown that the implementation of the mechanism of increased excitability of the fetal brain may be due to the peculiarities of the functioning of NMDA, AMPA, kainate receptors, and the peculiarities of the localization of ion channels in different brain structures. The paradoxical (exciting, depolarizing) role of gamma-aminobutyric acid, which is due to the peculiarities of the activation of chlorine co-transporters, is emphasized. The features of the epileptic process in newborns and young children have been determined. The reasons for the development of seizures in newborns are emphasized. The classification and clinical phenotypes of neonatal seizures are considered. It is emphasized that the convulsions in newborns rarely have a deployed clinical picture and are often represented by abortive or focal seizures, which is associated with the ontogenetic features of the fetal brain, namely: incomplete by the time of the birth of a cortical-neural organization, synaptogenesis and myelination of its structures, insufficiency of the development of commulectral intermetrous bonds , uneven representation in the cortex of ion channels with a relatively well-formed limbico-reticular system and its bond with a brain barrel. It was noted that despite various clinical manifestations, the newborn has four main types of seizures: subtitle (erased, abortive, fragmentary), tonic, clonic and myocloniс. No conflict of interest was declared by the authors. Key words: newborn, brain, pathophysiology, seizures, epilepsy, review.

scholarly journals Postoperative agitation syndrome in young children with perinatal damage to the central nervous system

2021 ◽  
Vol 16 (5) ◽  
pp. 355-360
Author(s):  
V.I. Snisar ◽  
O.S. Pavlysh
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Young Children ◽  
Postoperative Period ◽  
Anesthetic Management ◽  
Clinical Manifestations ◽  
Postoperative Recovery ◽  
Inhalation Anesthesia ◽  
Ventriculoperitoneal Shunting ◽  
The Central Nervous System

One of the complications of the postoperative period in children is postanesthetic agitation, a significant emotional and uncontrollable worry, clouding of consciousness, feeling of anxiety and fear, inappropriate behavior, irritability, inconso­lable crying, aggressive and negative attitude towards parents and medical staff. Postoperative agitation is very important for clinicians and hospitals, it has a risk of harming a patient, staying longer in the ward after anesthesia, and increasing the period of postoperative recovery. The frequency of postoperative agitation depends on age group. Most often agitation occurs in young children. There is evidence that agitation can also be due to the immature nervous system and a consequence of pathological conditions of the central nervous system (asthenoneurotic syndrome, encephalopathy, hyperactivity syndrome, perinatal posthypoxic and organic brain lesions, history of prematurity, epilepsy, psychophysical and speech delay, etc.). That is why the goal of our research was to study the patterns of clinical manifestations of postoperative agitation syndrome in children with prenatal da­mage to the central nervous system. The work was performed based on the analysis of the postoperative period in 109 young children: 59 patients with acquired hydrocephalus, who underwent ventriculoperitoneal shunting, and 50 children without neurological disorders in whom reconstructive surge­ries were carried out. Depending on the type anesthetic management, each group was divided into two subgroups: children, who received inhalation anesthesia with sevoflurane, and those, who received total intravenous anesthesia using propofol. In the postoperative period, the behavior of children was assessed on a Pediatric Ane­sthesia Emergence Delirium scale 30 minutes after anesthesia was completed. Criterion for the development of agitation was the presence of excitement in a child with a score of ≥ 10 points. Study showed that young children with perinatal damage to the central nervous system and children whose anesthetic provision is carried out using sevoflurane are the most vulnerable to the development of agitation syndrome. Agitation in such children is more pronounced and longer. These cases require prediction, detection and active surveillance.

scholarly journals Automatic linear measurements of the fetal brain on MRI with deep neural networks

2021 ◽  
Author(s):  
Netanell Avisdris ◽  
Bossmat Yehuda ◽  
Ori Ben-Zvi ◽  
Daphna Link-Sourani ◽  
Liat Ben-Sira ◽  
...  
Keyword(s):  
Human Error ◽  
Brain Mri ◽  
Fetal Brain ◽  
Region Of Interest ◽  
Fetal Mri ◽  
Brain Structures ◽  
Automatic Method ◽  
Linear Measurements ◽  
Biparietal Diameter ◽  
Reliable Assessment

Abstract Purpose: Timely, accurate and reliable assessment of fetal brain development is essential to reduce short and long-term risks to fetus and mother. Fetal MRI is increasingly used for fetal brain assessment. Three key biometric linear measurements important for fetal brain evaluation are Cerebral Biparietal Diameter (CBD), Bone Biparietal Diameter (BBD), and Trans-Cerebellum Diameter (TCD), obtained manually by expert radiologists on reference slices, which is time consuming and prone to human error. The aim of this study was to develop a fully automatic method computing the CBD, BBD and TCD measurements from fetal brain MRI.Methods: The input is fetal brain MRI volumes which may include the fetal body and the mother's abdomen. The outputs are the measurement values and reference slices on which the measurements were computed. The method, which follows the manual measurements principle, consists of five stages: 1) computation of a Region Of Interest that includes the fetal brain with an anisotropic 3D U-Net classifier; 2) reference slice selection with a Convolutional Neural Network; 3) slice-wise fetal brain structures segmentation with a multiclass U-Net classifier; 4) computation of the fetal brain midsagittal line and fetal brain orientation, and; 5) computation of the measurements. Results: Experimental results on 214 volumes for CBD, BBD and TCD measurements yielded a mean difference of 1.55mm, 1.45mm and 1.23mm respectively, and a Bland-Altman 95% confidence interval (I of 3.92mm, 3.98mm and 2.25mm respectively. These results are similar to the manual inter-observer variability, and are consistent across gestational ages and brain conditions.Conclusions: The proposed automatic method for computing biometric linear measurements of the fetal brain from MR imaging achieves human level performance. It has the potential of being a useful method for the assessment of fetal brain biometry in normal and pathological cases, and of improving routine clinical practice.

Recent Developments in Understanding Barrier Mechanisms in the Developing Brain: Drugs and Drug Transporters in Pregnancy, Susceptibility or Protection in the Fetal Brain?

2019 ◽  
Vol 59 (1) ◽  
pp. 487-505 ◽  
Author(s):  
Norman R. Saunders ◽  
Katarzyna M. Dziegielewska ◽  
Kjeld Møllgård ◽  
Mark D. Habgood
Keyword(s):  
Fetal Brain ◽  
Adult Brain ◽  
Brain Barrier ◽  
Normal Brain ◽  
Developmentally Regulated ◽  
Protective Mechanisms ◽  
Control Drug ◽  
Newborn Brain ◽  
Recent Developments ◽  
In Pregnancy

Efflux mechanisms situated in various brain barrier interfaces control drug entry into the adult brain; this review considers the effectiveness of these protective mechanisms in the embryo, fetus, and newborn brain. The longstanding belief that the blood-brain barrier is absent or immature in the fetus and newborn has led to many misleading statements with potential clinical implications. The immature brain is undoubtedly more vulnerable to damage by drugs and toxins; as is reviewed here, some developmentally regulated normal brain barrier mechanisms probably contribute to this vulnerability. We propose that the functional status of brain barrier efflux mechanisms should be investigated at different stages of brain development to provide a rational basis for the use of drugs in pregnancy and in newborns, especially in those prematurely born, where protection usually provided by the placenta is no longer present.

Enteropathogenic Viruses and Bacteria

PEDIATRICS ◽  
1958 ◽  
Vol 22 (3) ◽  
pp. 606-606
Keyword(s):  
Young Children ◽  
Diarrheal Disease ◽  
Clinical Manifestations ◽  
Double Infection ◽  
Serologic Tests ◽  
Enteropathogenic Bacteria ◽  
Very Young Children ◽  
Infancy And Childhood ◽  
Enteropathogenic Viruses

This is a revealing and definitive study of the role of enteropathogenic viruses and bacteria in summer diarrhea in infancy and childhood. Seventy-five per cent of the 153 patients studied during the summers of 1955-56 were under 1 year of age. It was possible to associate one of the enteropathogenic viruses or bacteria, or both, in 80% of 97 cases studied in 1956. The large variety of organisms isolated and the serologic tests indicate that summer diarrheal disease in very young children is not an entity but rather a consequence of infections with a large variety of organisms, capable of producing diarrhea and vomiting as clinical manifestations. Enteropathogenic bacteria were incriminated in 22%, viruses in 44% and double infection in 15%.

scholarly journals Evidence in cortical folding patterns for prenatal predispositions to hallucinations in schizophrenia

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Colleen P. E. Rollins ◽  
Jane R. Garrison ◽  
Maite Arribas ◽  
Aida Seyedsalehi ◽  
Zhi Li ◽  
...  
Keyword(s):  
Brain Development ◽  
Large Scale ◽  
Fetal Brain ◽  
Brain Structures ◽  
Physical Reality ◽  
Healthy Controls ◽  
Cortical Folding ◽  
Diverse World ◽  
Fetal Brain Development ◽  
The Brain

Abstract All perception is a construction of the brain from sensory input. Our first perceptions begin during gestation, making fetal brain development fundamental to how we experience a diverse world. Hallucinations are percepts without origin in physical reality that occur in health and disease. Despite longstanding research on the brain structures supporting hallucinations and on perinatal contributions to the pathophysiology of schizophrenia, what links these two distinct lines of research remains unclear. Sulcal patterns derived from structural magnetic resonance (MR) images can provide a proxy in adulthood for early brain development. We studied two independent datasets of patients with schizophrenia who underwent clinical assessment and 3T MR imaging from the United Kingdom and Shanghai, China (n = 181 combined) and 63 healthy controls from Shanghai. Participants were stratified into those with (n = 79 UK; n = 22 Shanghai) and without (n = 43 UK; n = 37 Shanghai) hallucinations from the PANSS P3 scores for hallucinatory behaviour. We quantified the length, depth, and asymmetry indices of the paracingulate and superior temporal sulci (PCS, STS), which have previously been associated with hallucinations in schizophrenia, and constructed cortical folding covariance matrices organized by large-scale functional networks. In both ethnic groups, we demonstrated a significantly shorter left PCS in patients with hallucinations compared to those without, and to healthy controls. Reduced PCS length and STS depth corresponded to focal deviations in their geometry and to significantly increased covariance within and between areas of the salience and auditory networks. The discovery of neurodevelopmental alterations contributing to hallucinations establishes testable models for these enigmatic, sometimes highly distressing, perceptions and provides mechanistic insight into the pathological consequences of prenatal origins.

Early life factors related to clinical manifestations of atopic disease but not to skin-prick test positivity in young children

2002 ◽  
Vol 13 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Maria-Antonietta Stazi ◽  
Francesca Sampogna ◽  
GIuseppe Montagano ◽  
Michele E. Grandolfo ◽  
Marie-France Couilliot ◽  
...  
Keyword(s):  
Young Children ◽  
Skin Prick Test ◽  
Early Life ◽  
Clinical Manifestations ◽  
Atopic Disease ◽  
Prick Test ◽  
Early Life Factors

scholarly journals Maternal Inflammation Results in Altered Tryptophan Metabolism in Rabbit Placenta and Fetal Brain

2017 ◽  
Vol 39 (5) ◽  
pp. 399-412 ◽  
Author(s):  
Monica Williams ◽  
Zhi Zhang ◽  
Elizabeth Nance ◽  
Julia L. Drewes ◽  
Wojciech G. Lesniak ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Microglial Activation ◽  
Rabbit Model ◽  
Fetal Brain ◽  
Kynurenine Pathway ◽  
Tryptophan Metabolism ◽  
Maternal Inflammation ◽  
Newborn Brain ◽  
Tryptophan Pathway ◽  
Tryptophan Metabolites

Maternal inflammation has been linked to neurodevelopmental and neuropsychiatric disorders such as cerebral palsy, schizophrenia, and autism. We had previously shown that intrauterine inflammation resulted in a decrease in serotonin, one of the tryptophan metabolites, and a decrease in serotonin fibers in the sensory cortex of newborns in a rabbit model of cerebral palsy. In this study, we hypothesized that maternal inflammation results in alterations in tryptophan pathway enzymes and metabolites in the placenta and fetal brain. We found that intrauterine endotoxin administration at gestational day 28 (G28) resulted in a significant upregulation of indoleamine 2,3-dioxygenase (IDO) in both the placenta and fetal brain at G29 (24 h after treatment). This endotoxin-mediated IDO induction was also associated with intense microglial activation, an increase in interferon gamma expression, and increases in kynurenine and the kynurenine pathway metabolites kynurenine acid and quinolinic acid, as well as a significant decrease in 5-hydroxyindole acetic acid (a precursor of serotonin) levels in the periventricular region of the fetal brain. These results indicate that maternal inflammation shunts tryptophan metabolism away from the serotonin to the kynurenine pathway, which may lead to excitotoxic injury along with impaired development of serotonin-mediated thalamocortical fibers in the newborn brain. These findings provide new targets for prevention and treatment of maternal inflammation-induced fetal and neonatal brain injury leading to neurodevelopmental disorders such as cerebral palsy and autism.

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