Shannon M. Standridge

Idiopathic Intracranial Hypertension in Children: A Review and Algorithm

This updated review of pediatric idiopathic intracranial hypertension focuses on epidemiology, clinical presentations, diagnostic criteria, evaluation, clinical course, and treatment. General guidelines for the clinical management of idiopathic intracranial hypertension are discussed. A new algorithm outlines an efficient management strategy for the initial diagnostic evaluation of children with signs or symptoms of intracranial hypertension. This algorithm provides a systematic approach to initial evaluation and management, and identifies important decision-making factors. The risk of permanent visual loss with idiopathic intracranial hypertension necessitates a prompt, thorough collaborative approach in the management of patients. Although idiopathic intracranial hypertension has been recognized for over a century, the need remains for prospectively collected data to promote a better understanding of the etiology, risk factors, evaluative methods, and effective treatments for children with this syndrome.

Inflammatory Bowel Disease and Cerebrovascular Arterial and Venous Thromboembolic Events in 4 Pediatric Patients: A Case Series and Review of the Literature

Inflammatory bowel disease has been linked to cerebrovascular lesions, but the mechanisms of these vascular complications and their frequency among children with inflammatory bowel disease are unclear. We present 4 children with inflammatory bowel disease who developed ischemic or hemorrhagic stroke or cerebral sinovenous thrombosis. All 4 patients were female; 3 had Crohns disease and 1 had indeterminate colitis. All of the patients had additional risk factors for thrombosis including thrombocytosis, severe dehydration attributable to an inflammatory bowel disease exacerbation, and, in 2 instances, genetically mediated coagulation defects. It is believed that the occurrence of thrombotic complications in individuals with inflammatory bowel disease is attributable to multifactorial causes. The current literature on cerebrovascular complications and treatment in the setting of pediatric inflammatory bowel disease is reviewed.

Idiopathic intracranial hypertension in a pediatric population: a retrospective analysis of the initial imaging evaluation.

There are few studies in the pediatric population regarding the use of magnetic resonance venography to rule out cerebral venous sinus thrombosis in patients presenting with signs and symptoms of idiopathic intracranial hypertension. The purpose of this study was to compare the clinical characteristics of children with presumed idiopathic intracranial hypertension who did and did not undergo venography during their evaluation at a single childrens hospital. The authors found that 45 of 68 (66%) patients underwent magnetic resonance venography. Five of 45 (11%) venography studies revealed a thrombosis. There were no significant clinical differences within patients based on the completion of venography or the presence of thrombosis. Larger studies are needed to identify risk factors for thrombosis in children with presumed idiopathic intracranial hypertension, as well as factors influencing physician decision making in the use of magnetic resonance venography in this evaluation.

Costs and Clinical Outcomes of Epilepsy Surgery in Children With Drug-Resistant Epilepsy

PURPOSE Approximately 20% of children with epilepsy are drug-resistant, incurring considerable costs. Epilepsy surgery has been shown to be an effective intervention in this population. This study provides an initial look at the costs associated with surgical management of children with drug-resistant epilepsy as compared with medical management alone. PROCEDURES In a retrospective cohort study of children with drug-resistant epilepsy referred for possible surgical intervention, we compared direct costs of those treated surgically versus those offered surgery but managed medically instead. We also assessed the difference in seizure frequency between the two groups. FINDINGS There were 94 total patients, 78 (83%) in the surgical group and 16 (17%) in the medical group. The median (25th-75th percentile) cost of the epilepsy surgery hospitalization was

Cardiac Arrhythmias and Ictal Events Within an Epilepsy Monitoring Unit

118,400 (

Assessing the similarity of surface linguistic features related to epilepsy across pediatric hospitals

101,900-

Selecting anti-epileptic drugs: a pediatric epileptologist's view, a computer's view

143,800). Total median annual follow-up costs, not including the cost of surgical hospitalization, were not significantly different between the two groups at 1- or 2-year follow-up. However, the surgical patients who were seizure-free at 1-year follow-up, and those that remained seizure-free at 2-year follow-up, had significantly lower costs compared with the medical group (

Presentation, diagnosis and treatment of bilateral Rasmussen's encephalitis in a 12-year-old female

8000 versus

Variations in Hospitalization Outcomes in Children Admitted With Seizures Between 2003 and 2006

16,200, P = 0.04 and

The Clinical Utility of a Single-Nucleotide Polymorphism Microarray in Patients With Epilepsy at a Tertiary Medical Center.

4300 versus