Ghassan Hmaimess

Impact of early hemispherotomy in a case of Ohtahara syndrome with left parieto-occipital megalencephaly.

This report illustrates the usefulness and safety of very early hemispherotomy in an infant with Ohtahara syndrome (OS) secondary to left parieto-occipital megalencephaly. It provides evidence that surgical intervention might provide promising results in selected cases, and that young age is not a contraindication for this type of surgery.

Cat scratch disease presenting as meningomyeloradiculopathy

We report meningomyeloradiculitis as a presenting picture in a child with cat scratch disease (CSD) and identify the need to include this infection in the differential diagnosis of meningomyeloradiculopathies. We also show the likely benefit of antibiotherapy. An 11 year old girl presented three months prior to hospitalisation with low back pain radiating to the lower limbs with paresthesia, limping, and a progressively decreasing strength in the right lower limb. She had sphincter disturbances with frequency …

Valproate-induced enuresis: a prospective study

The aim of this study was to determine the frequency and characteristics of secondary enuresis in children initiated on valproate treatment.

Early bifrontal brain injury: disturbances in cognitive function development.

We describe six psychomotor, language, and neuropsychological sequential developmental evaluations in a boy who sustained a severe bifrontal traumatic brain injury (TBI) at 19 months of age. Visuospatial, drawing, and writing skills failed to develop normally. Gradually increasing difficulties were noted in language leading to reading and spontaneous speech difficulties. The last two evaluations showed executive deficits in inhibition, flexibility, and working memory. Those executive abnormalities seemed to be involved in the other impairments. In conclusion, early frontal brain injury disorganizes the development of cognitive functions, and interactions exist between executive function and other cognitive functions during development.

Early Modified Functional Hemispherectomy in a Young Infant with Ohtahara Syndrome and Hemimegalencephaly

We report on the youngest infant treated with modified functional hemispherectomy at the age of 5 months for Ohtahara syndrome and hemimegalencephaly as underlying pathology, and we depict the favorable outcome regarding seizure control and psychomotor development. These results highlight the potential usefulness of early surgery in such conditions.

Paradoxical exacerbation of myoclonic-astatic seizures by levetiracetam in myoclonic astatic epilepsy

BackgroundLevetiracetam is a broad spectrum antiepileptic drug (AED) with proven efficacy when used as adjunctive therapy against myoclonic seizures. We report two patients suffering from epilepsy with myoclonic-astatic epilepsy (MAE) who experienced a paradoxical worsening of seizures after initiation of treatment with LEV, a finding not previously described.Case presentationPatients included were enrolled in an ongoing large prospective study evaluating children and adults with new onset epilepsy in Lebanon conducted at the American University of Beirut Medical Center in association with the Lebanese Chapter of the International League against Epilepsy. Based on an extensive evaluation, these patients were stratified into idiopathic partial, idiopathic generalized, symptomatic partial or symptomatic generalized epilepsies. Whenever possible the electroclinical syndrome was identified according to the ILAE classification of epilepsy syndromes. Patients were subsequently followed up on regular intervals and were assessed for adverse events, and seizure recurrence.MAE was diagnosed in five (1.6%) out of 307 consecutive children enrolled in this study. LEV was used as adjunctive therapy in four of those children with two experiencing a substantial and dose related worsening in the frequency of their myoclonic and atonic seizures.ConclusionLEV should be used with caution in children with MAE and an exacerbation of seizure frequency temporally related to the introduction of LEV should alert the clinician to the possibility of a paradoxical seizure exacerbation.