Galán, Fernando

AbstractSurgery remains a critical and often necessary intervention for a subset of patients with epilepsy. The overarching objective of surgical treatment has consistently been to enhance the quality of life for these individuals, either by achieving seizure freedom or by eliminating debilitating seizure types. This review specifically examines minimally invasive surgical approaches for epilepsy. Contemporary advancements have introduced a range of treatments that offer increased safety and efficacy compared to traditional open resective epilepsy surgeries. This manuscript provides a comprehensive review of these techniques and technologies.

At the time of graduation from medical school, medical students have been exposed primarily to adult neurology and have limited exposure to child neurology. Child neurology is a unique field that encompasses caring for children with neurological conditions ranging from routine to rare. There are many opportunities for a variety of unique careers in child neurology including both in the inpatient and outpatient setting. This article aims to provide practical advice for the medical student interested in child neurology to best prepare for a successful match and rewarding career.

AbstractThis case of drug resistant focal epilepsy highlights several invaluable teaching points. Hypotheses grounded in seizure semiology provide the best framework to ensure accurate interpretation of diagnostic testing. Without a hypothesis, information gathered from tests can be difficult to linearly piece together and can lead to poor patient outcomes. The case also provides a real‐world conundrum of discordant test results that were ultimately rectified by re‐visiting the initial hypothesis and cross‐testing. Perinatal stroke continues to be a common etiology of drug resistant epilepsy. Patients can achieve seizure freedom and good quality of life with appropriate workup and in appropriate cases, surgery.

AbstractObjectiveThis study sought to understand the amount of misinformation surrounding epilepsy on the social media platform, TikTok.MethodsVideos from TikTok were searched using keyword “epilepsy.” In all, 109 videos were categorized as personal experience videos, event videos, or educational videos. Misinformation surrounding each video was analyzed by two independent reviewers. The number of videos and views of each were tracked.ResultsEvent videos garnered the most attention (80% of total views). Of the event videos, 26/47 contained misinformation in the form of calling a nonepileptic event an epileptic seizure (55%). Videos of nonepileptic events labeled as epileptic seizures amassed 109 956 400 views.SignificanceThis novel study quantifies the amount of misinformation regarding epilepsy on the social media platform, TikTok. The results showcase that misinformation is very prevalent on the application. Most of the misinformation consists of the mislabeling of nonepileptic events as epileptic seizures. Physicians should be aware of cardinal features of nonepileptic events to better treat patients. The medical community must understand the type of misinformation people are exposed to in order to educate patients appropriately.

AbstractMagnetoencephalography (MEG) is a technology used in pediatric and adult epilepsy that records magnetic fields produced from electric currents in the brain. MEG can locate epileptogenic zone(s), lateralize language functions, localize sensorimotor cortex, and identify visually evoked fields. It is a powerful technology with key advantages in pediatrics. The majority of its limitations are resource driven. With advancing technology, MEG will become a more prominent and valuable tool used in pediatric epilepsy and epilepsy surgery in the future. We review MEG and provide illustrative cases to showcase its usage.

Lafora disease is a rare refractory epilepsy that results in death. This report highlights two cases of lafora disease and introduces a novel mutation in the patients. A review of the pathophysiology and future therapies is reviewed.

Neurologic manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pediatric patients have been reported in the acute and postinfectious stages of coronavirus disease 2019. Acute disseminated encephalomyelitis (ADEM) typically presents in children after a viral illness at a mean age of 3 to 7 years. A total of 60% to 90% of literature-reported pediatric patients with ADEM have minimal to no neurologic deficits at long-term follow-up. We present a 17-month-old developmentally typical girl with parental complaints of irritability, upper extremity weakness, and gait disturbance. She presented to the hospital afebrile and irritable with right-sided nasolabial fold flattening, neck stiffness, left upper extremity rigidity, right upper extremity paresis, bilateral lower extremity hyperreflexia, and truncal ataxia. During her hospital course, she became somnolent with autonomic instability and was transferred to intensive care. Contrasted brain MRI revealed diffuse patchy T2 hyperintensities without contrast enhancement. Nasopharyngeal SARS-CoV-2 polymerase chain reaction and serum antibody testing results were positive. Cerebral spinal fluid analysis was unremarkable. Respiratory viral panel and autoimmune encephalitis and demyelinating disorders panel results were negative. She was started on high-dose methylprednisolone and intravenous immunoglobulin, with improvement in mental status, focal deficits, and ambulation. After hospital discharge, she received inpatient rehabilitation for 2 weeks and at 2 month follow-up had a full neurologic recovery. We report the youngest case of postinfectious ADEM due to SARS-CoV-2 in a toddler. Early recognition of autoimmune and inflammatory complications of SARS-CoV-2 is vital for early aggressive immunomodulatory treatment and, consequently, improved morbidity in these patients.