Neurologically Impaired Children Dependent On Children's Hospitals: Researchers Point To Need For Better Care Coordination In The Community
Because of care advances, more infants and children with previously lethal health problems are surviving. Many, however, are left with lifelong neurologic impairment. A Children's Hospital Boston study of more than 25 million pediatric hospitalizations in the U.S. now shows that neurologically impaired children, though still a relatively small part of the overall population, account for increasing hospital resources, particularly within children's hospitals. Their analysis, based on data from the Agency for Healthcare Research and Quality Kids' Inpatient Database (KID), was published online in PLoS Medicine. The researchers analyzed KID data from 1997, 2000, 2003 and 2006, encompassing 25.7 million hospitalizations of children age 0 to 18. Of these, 1.3 million hospitalizations were for children with neurologic conditions, primarily cerebral palsy and epilepsy.
Benign familial infantile epilepsy (BFIE) has been recognised for some time as infantile seizures, without fever, that run in families but the cause has so far eluded researchers. However clinical researchers at the University of Melbourne and Florey Neurosciences Institute and molecular geneticists at the University of South Australia have discovered a gene. BFIE is a disorder that occurs in previously healthy infants who are developing normally. Seizures commence when a baby is about six months old and stop by the age of two years. BFIE is a rare form of epilepsy with the Australian researchers having studied about 40 families from around the world. Some of the children with this gene abnormality develop an unusual movement disorder later in childhood or adolescence called Paroxysmal Kinesigenic Choreoathetosis (PKC).
Colin Saldanha, a biology professor at American University in Washington, D.C., has always been intrigued by the hormone estrogen. Specifically, how the hormone that does so much (for example, it promotes sexual behavior in women but can also increase susceptibility to seizures) does not cause major cross circuit meltdowns. "In the extreme case, once every 28 days, women should be having seizures - and when they do, it's a condition called Catamenial Epilepsy - but that's obviously not the norm and there's the mystery, " Saldanha said. "Somehow, the vertebrate body has figured out a way to produce and provide estrogen to precisely the right part of the body at precisely the right time." To attempt to find out how the bodies of animals and humans can do this, Saldanha has been studying the brains of songbirds - specifically, adult male zebra finches.
New guidelines from the American Academy of Neurology will help physicians better choose seizure drugs for people on HIV/AIDS medication, avoiding deadly drug interactions and preventing critical anti-HIV drugs from becoming less effective, possibly leading to a more virulent strain of the disease. Michigan State University's Gretchen Birbeck - who spends several months each year in the sub-Sahara African nation of Zambia researching epilepsy, HIV /AIDS and cerebral malaria - is the lead author of the medical guideline, which was co-developed with the World Health Organization through the International League Against Epilepsy. The research is published in Neurology, the medical journal of the academy, and Epilepsia, the medical journal of the league. According to the World Health Organization, more than 33 million people worldwide were living with HIV in 2009.
According to a large Swedish investigation published in PloS Medicine, epilepsy is not directly linked to an increased risk of committing violent crime. Although, individuals who previously experienced traumatic brain injury (TBI) have an increased risk of committing violent crime. The investigation was led by Seena Fazel, from the University of Oxford, UK, and colleagues at the Karolinska Institutet, Sweden, and Swedish Prison and Probation Service. The researchers explain: "The implications of these findings will vary for clinical services, the criminal justice system, and patient charities." The team identified all individuals in Sweden recorded with TBI and epilepsy between 1973 and 2009. They then matched 10 individuals without these conditions from the general population to each case.