COAS
Center for Open Access in Science (COAS)
OPEN JOURNAL FOR PSYCHOLOGICAL RESEARCH (OJPR)

ISSN (Online) 2560-5372 * ojpr@centerprode.com

OJPR Home

2020 - Volume 4 - Number 2


Exploring the Psychological Risk Factors in Children with Epilepsy

Mimoza Maloku Kuqi
University Clinical Center of Kosovo, Pediatric Clinic, Pristina, KOSOVO

Hazir Elshani
Office for Psychological Issues, Municipal Directorate of Education, ALBANIA

Eglantina Dervishi * egladervishi@yahoo.com * ORCID: 0000-0003-1015-1948 * ResearcherID: T-6964-2018
University of Tirana, Faculty of Social Sciences, Department of Psychology and Pedagogy, ALBANIA

Silva Ibrahimi ibrahimi.silva@gmail.com * ORCID: 0000-0003-3233-1157 * ResearcherID: N-5693-2018
Albanian University, Department of Psychology, Tirana, ALBANIA

Open Journal for Psychological Research, 2020, 4(2), 109-122 * https://doi.org/10.32591/coas.ojpr.0402.04109m
Received: 7 July 2020 ▪ Accepted: 18 November 2020 ▪ Published Online: 9 December 2020

LICENCE: Creative Commons Attribution 4.0 International License.

ARTICLE (Full Text - PDF)


ABSTRACT:
There are many factors that aggravate the clinical picture of children diagnosed with epilepsy. Through this study we will explore risk factors related to disease characteristics, cognitive impairments, intelligence and behavioral problems in children with epilepsy. Methods: Based on the medical data of children diagnosed with epilepsy being treated at the Pediatric Neurology Unit, University Hospital of Pristina, and the “Hope” Psychological Outpatient Center in Kosovo, about 100 epileptic children, 55 female and 45 male, aged between 6 and 11 years of school age were administered the Montreal Cognitive Assessment scale (MoCA), Raven’s Standard Progressive Matrices (IQ), and Child Behavior Checklist (CBCL) tests. Results: Children participating in the study reveals a predomination of the generalized epilepsy, which continue to be treated with anti-epileptics for more than 3 years. From them 67% did not show the presence of another co-neurological deficit. Neurological tests show evidences of moderate EEG changes in some children and MRI registrations in 65% of children are unchanged and continue to be treated with 1 or 2 antiepileptic drugs for being under control. Intelligence, cognitive and behavioral problems in cases where they were associated with a number of neuropsychological characteristics increase the risk of a disease aggravation and compromise their overall development. Discussion: We can imply that based on the severity of these concomitant factors of the epileptic conditions, they will constitute a high-risk factor for cognitive problems, low intelligence and the emergence of a number of internalizing and externalizing problems of the child with epilepsy. Conclusions: As a risk factor that increases the level of difficulty of epileptic children in some contexts, including general functioning, school, family and social context, the presence of neurobiological and neuropsychological factors such as issues in internalizing and externalizing behaviors, problems in the cognitive field and the IQ are seen, which is also expected to affect the overall development of children’s quality of life.

KEY WORDS: epilepsy, children, cognitive impairments, general intelligence, behavioral problems, EEG, MRI.

CORRESPONDING AUTHOR:
Eglantina Dervishi, University of Tirana, Department of Psychology and Pedagogy, Faculty of Social Science, Tirana, ALBANIA. E-mail: egladervishi@yahoo.com.


REFERENCES:

Abstracts from the 51st European Society of Human Genetics Conference: Posters. (2019). European Journal of Human Genetics27(Suppl 1), 1-688. https://doi.org/10.1038/s41431-019-0404-7

Aicua-Rapun, I., André, P., & Novy, J. (2019). Closed-loop neuropharmacology for epilepsy: Distant dream or future reality? Current Neuropharmacology17(5), 447-458. https://doi.org/10.2174/1570159X16666180308154646

Aliyu, M. H., Abdullahi, A. T., Iliyasu, Z., Salihu, A. S., Adamu, H., Sabo, U., Garcia, J. P., Abdullahi, S. U., Mande, A., Xian, H., Yakasai, H. M., Schootman, M., Ingles, D. J., Patel, A. A., Yakasai, A., Curry-Johnson, S., Wudil, U. J., DeBaun, M. R., Trevathan, E., & BRIDGE Advisory Panel (2019). Bridging the childhood epilepsy treatment gap in northern Nigeria (BRIDGE): Rationale and design of pre-clinical trial studies. Contemporary Clinical Trials Communications15, 100362. https://doi.org/10.1016/j.conctc.2019.100362

Andresen, E. N., Ramirez, M. J., Kim, K. H., Dorfman, A. B., Haut, J. S., Klaas, P. A., Jehi, L. E., Shea, K., Bingaman, W. E., & Busch, R. M. (2014). Effects of surgical side and site on mood and behavior outcome in children with pharmacoresistant epilepsy. Frontiers in Neurology5, 18. https://doi.org/10.3389/fneur.2014.00018

Berg, A. T., Zelko, F. A., Levy, S. R., & Testa, F. M. (2012). Age at onset of epilepsy, pharmacoresistance, and cognitive outcomes: A prospective cohort study. Neurology79(13), 1384-1391. https://doi.org/10.1212/WNL.0b013e31826c1b55

Boshuisen, K., Lamberink, H. J., van Schooneveld, M. M., Cross, J. H., Arzimanoglou, A., van der Tweel, I., Geleijns, K., Uiterwaal, C. S., & Braun, K. P. (2015). Cognitive consequences of early versus late antiepileptic drug withdrawal after pediatric epilepsy surgery, the TimeToStop (TTS) trial: study protocol for a randomized controlled trial. Trials16, 482. https://doi.org/10.1186/s13063-015-0989-2

Brooks-Kayal, A. R., Bath, K. G., Berg, A. T., Galanopoulou, A. S., Holmes, G. L., Jensen, F. E., Kanner, A. M., O'Brien, T. J., Whittemore, V. H., Winawer, M. R., Patel, M., & Scharfman, H. E. (2013). Issues related to symptomatic and disease-modifying treatments affecting cognitive and neuropsychiatric comorbidities of epilepsy. Epilepsia54 Suppl 4(0 4), 44-60. https://doi.org/10.1111/epi.12298

Bulaj, G., Ahern, M. M., Kuhn, A., Judkins, Z. S., Bowen, R. C., & Chen, Y. (2016). Incorporating natural products, pharmaceutical drugs, self-care and digital/mobile health technologies into molecular-behavioral combination therapies for chronic diseases. Current Clinical Pharmacology11(2), 128-145. https://doi.org/10.2174/1574884711666160603012237

Burke, S. L., Naseh, M., Rodriguez, M. J., Burgess, A., & Loewenstein, D. (2019). Dementia-related neuropsychological testing considerations in non-Hispanic white and Latino/Hispanic populations. Psychology & Neuroscience12(2), 144-168. https://doi.org/10.1037/pne0000163

Cacabelos R. (2020). Pharmacogenomics of cognitive dysfunction and neuropsychiatric disorders in dementia. International Journal of Molecular Sciences21(9), 3059. https://doi.org/10.3390/ijms21093059

Chang, B. S., Krishnan, V., Dulla, C. G., Jette, N., Marsh, E. D., Dacks, P. A., Whittemore, V., Poduri, A., & NINDS/AES Epilepsy Research Benchmark Stewards Committee (2020). Epilepsy benchmarks area I: Understanding the causes of the epilepsies and epilepsy-related neurologic, psychiatric, and somatic conditions. Epilepsy Currents20(1_suppl), 5S-13S. https://doi.org/10.1177/1535759719895280, E. D., Dacks, P. A., Whittemore, V., Poduri, A., & NINDS/AES Epilepsy Research Benchmark Stewards.

Coryell, J., Gaillard, W. D., Shellhaas, R. A., Grinspan, Z. M., Wirrell, E. C., Knupp, K. G., Wusthoff, C. J., Keator, C., Sullivan, J. E., Loddenkemper, T., Patel, A., Chu, C. J., Massey, S., Novotny, E. J., Jr, Saneto, R. P., & Berg, A. T. (2018). Neuroimaging of early life epilepsy. Pediatrics142(3), e20180672. https://doi.org/10.1542/peds.2018-0672

Crudgington, H., Rogers, M., Morris, H., Gringras, P., Pal, D. K., & Morris, C. (2020). Epilepsy-specific patient-reported outcome measures of children’s health-related quality of life: A systematic review of measurement properties. Epilepsia61(2), 230-248. https://doi.org/10.1111/epi.16430

Dabbs, K., Jones, J. E., Jackson, D. C., Seidenberg, M., & Hermann, B. P. (2013). Patterns of cortical thickness and the Child Behavior Checklist in childhood epilepsy. Epilepsy & Behavior: E&B29(1), 198-204. https://doi.org/10.1016/j.yebeh.2013.07.008

de Bruijn, M., van Sonderen, A., van Coevorden-Hameete, M. H., Bastiaansen, A., Schreurs, M., Rouhl, R., van Donselaar, C. A., Majoie, M., Neuteboom, R. F., Sillevis Smitt, P., Thijs, R. D., & Titulaer, M. J. (2019). Evaluation of seizure treatment in anti-LGI1, anti-NMDAR, and anti-GABABR encephalitis. Neurology92(19), e2185-e2196. https://doi.org/10.1212/WNL.0000000000007475

de Bruijn, M., van Sonderen, A., van Coevorden-Hameete, M. H., Bastiaansen, A., Schreurs, M., Rouhl, R., van Donselaar, C. A., Majoie, M., Neuteboom, R. F., Sillevis Smitt, P., Thijs, R. D., & Titulaer, M. J. (2019). Evaluation of seizure treatment in anti-LGI1, anti-NMDAR, and anti-GABABR encephalitis. Neurology92(19), e2185-e2196. https://doi.org/10.1212/WNL.0000000000007475

Dugger, S. A., Platt, A., & Goldstein, D. B. (2018). Drug development in the era of precision medicine. Nature reviews. Drug discovery17(3), 183-196. https://doi.org/10.1038/nrd.2017.226

E-Poster Viewing. (2019). European Stroke Journal4(1 Suppl), 150-276. https://doi.org/10.1177/2396987319845581

Fleming, M., Fitton, C. A., Steiner, M., McLay, J. S., Clark, D., King, A., Mackay, D. F., & Pell, J. P. (2019). Educational and health outcomes of children and adolescents receiving antiepileptic medication: Scotland-wide record linkage study of 766,244 schoolchildren. BMC Public Health19(1), 595. https://doi.org/10.1186/s12889-019-6888

Galanopoulou, A. S., & Moshé, S. L. (2015). Pathogenesis and new candidate treatments for infantile spasms and early life epileptic encephalopathies: A view from preclinical studies. Neurobiology of Disease79, 135-149. https://doi.org/10.1016/j.nbd.2015.04.015

Greaves, D., Psaltis, P. J., Ross, T. J., Davis, D., Smith, A. E., Boord, M. S., & Keage, H. (2019). Cognitive outcomes following coronary artery bypass grafting: A systematic review and meta-analysis of 91,829 patients. International Journal of Cardiology289, 43-49. https://doi.org/10.1016/j.ijcard.2019.04.065

Greenberg, D. A., & Subaran, R. (2011). Blinders, phenotype, and fashionable genetic analysis: A critical examination of the current state of epilepsy genetic studies. Epilepsia52(1), 1-9. https://doi.org/10.1111/j.1528-1167.2010.02734.x

Grinspan, Z. M., Shellhaas, R. A., Coryell, J., Sullivan, J. E., Wirrell, E. C., Mytinger, J. R., Gaillard, W. D., Kossoff, E. H., Valencia, I., Knupp, K. G., Wusthoff, C., Keator, C., Ryan, N., Loddenkemper, T., Chu, C. J., Novotny, E. J., Jr, Millichap, J., & Berg, A. T. (2018). Comparative effectiveness of levetiracetam vs phenobarbital for infantile epilepsy. JAMA Pediatrics172(4), 352-360. https://doi.org/10.1001/jamapediatrics.2017.5211

Hamed S. A. (2009). The aspects and mechanisms of cognitive alterations in epilepsy: The role of antiepileptic medications. CNS Neuroscience & Therapeutics15(2), 134-156. https://doi.org/10.1111/j.1755-5949.2008.00062.x

Hermann, B., Loring, D. W., & Wilson, S. (2017). Paradigm shifts in the neuropsychology of epilepsy. Journal of the International Neuropsychological Society: JINS23(9-10), 791-805. https://doi.org/10.1017/S1355617717000650

Hessen, E., Alfstad, K. Å., Torgersen, H., & Lossius, M. I. (2018). Tested and reported executive problems in children and youth epilepsy. Brain and Behavior8(5), e00971. https://doi.org/10.1002/brb3.971

Hirosawa, T., Kikuchi, M., Fukai, M., Hino, S., Kitamura, T., An, K. M., Sowman, P., Takahashi, T., Yoshimura, Y., Miyagishi, Y., & Minabe, Y. (2018). Association between magnetoencephalographic interictal epileptiform discharge and cognitive function in young children with typical development and with autism spectrum disorders. Frontiers in Psychiatry9, 568. https://doi.org/10.3389/fpsyt.2018.00568

Holmes G. L. (2014). What is more harmful, seizures or epileptic EEG abnormalities? Is there any clinical data? Epileptic Disorders: International Epilepsy Journal with Videotape16 Spec No 1(Spec No 1), S12-S22. https://doi.org/10.1684/epd.2014.0686

Holmes G. L. (2016). Effect of seizures on the developing brain and cognition. Seminars in Pediatric Neurology23(2), 120-126. https://doi.org/10.1016/j.spen.2016.05.001

Izadi, A., Ondek, K., Schedlbauer, A., Keselman, I., Shahlaie, K., & Gurkoff, G. (2018). Clinically indicated electrical stimulation strategies to treat patients with medically refractory epilepsy. Epilepsia Open3(Suppl Suppl 2), 198-209. https://doi.org/10.1002/epi4.12276

Jacobs, C. S., Willment, K. C., & Sarkis, R. A. (2019). Non-invasive cognitive enhancement in epilepsy. Frontiers in Neurology10, 167. https://doi.org/10.3389/fneur.2019.00167

Jones, J. E., Asato, M. R., Brown, M. G., Doss, J. L., Felton, E. A., Kearney, J. A., Talos, D., Dacks, P. A., Whittemore, V., Poduri, A., & NINDS/AES Benchmarks Stewards Committee (2020). Epilepsy benchmarks area IV: Limit or prevent adverse consequence of seizures and their treatment across the life span. Epilepsy Currents20(1_suppl), 31S-39S. https://doi.org/10.1177/1535759719895277

Kalaria, R. N., Akinyemi, R., & Ihara, M. (2016). Stroke injury, cognitive impairment and vascular dementia. Biochimica et biophysica acta1862(5), 915-925. https://doi.org/10.1016/j.bbadis.2016.01.015

Kaushik, S., Chopra, D., Sharma, S., & Aneja, S. (2019). Adverse drug reactions of anti-epileptic drugs in children with epilepsy: A cross-sectional study. Current Drug Safety14(3), 217-224. https://doi.org/10.2174/1574886314666190311112710

Kim, E. H., & Ko, T. S. (2016). Cognitive impairment in childhood onset epilepsy: Up-to-date information about its causes. Korean Journal of Pediatrics59(4), 155-164. https://doi.org/10.3345/kjp.2016.59.4.155

Korthauer, L. E., Awe, E., Frahmand, M., & Driscoll, I. (2018). Genetic risk for age-related cognitive impairment does not predict cognitive performance in middle age. Journal of Alzheimer’s Disease: JAD64(2), 459-471. https://doi.org/10.3233/JAD-171043

Kossoff, E. H., Zupec-Kania, B. A., Auvin, S., Ballaban-Gil, K. R., Christina Bergqvist, A. G., Blackford, R., Buchhalter, J. R., Caraballo, R. H., Cross, J. H., Dahlin, M. G., Donner, E. J., Guzel, O., Jehle, R. S., Klepper, J., Kang, H. C., Lambrechts, D. A., Liu, Y., Nathan, J. K., Nordli, D. R., Jr, Pfeifer, H. H., … Practice Committee of the Child Neurology Society (2018). Optimal clinical management of children receiving dietary therapies for epilepsy: Updated recommendations of the International Ketogenic Diet Study Group. Epilepsia Open3(2), 175-192. https://doi.org/10.1002/epi4.12225

Kynast, J., Lampe, L., Luck, T., Frisch, S., Arelin, K., Hoffmann, K. T., Loeffler, M., Riedel-Heller, S. G., Villringer, A., & Schroeter, M. L. (2018). White matter hyperintensities associated with small vessel disease impair social cognition beside attention and memory. Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism38(6), 996-1009. https://doi.org/10.1177/0271678X17719380

Lenck-Santini, P. P., & Scott, R. C. (2015). Mechanisms Responsible for Cognitive Impairment in Epilepsy. Cold Spring Harbor Perspectives in Medicine5(10), a022772. https://doi.org/10.1101/cshperspect.a022772

Makale, M. T., McDonald, C. R., Hattangadi-Gluth, J. A., & Kesari, S. (2017). Mechanisms of radiotherapy-associated cognitive disability in patients with brain tumors. Nature Reviews. Neurology13(1), 52-64. https://doi.org/10.1038/nrneurol.2016.185

McTague, A., Martland, T., & Appleton, R. (2018). Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children. The Cochrane Database of Systematic Reviews1(1), CD001905. https://doi.org/10.1002/14651858.CD001905.pub3

Mollon, J., Mathias, S. R., Knowles, E., Rodrigue, A., Koenis, M., Pearlson, G. D., Reichenberg, A., Barrett, J., Denbow, D., Aberizk, K., Zatony, M., Poldrack, R. A., Blangero, J., & Glahn, D. C. (2020). Cognitive impairment from early to middle adulthood in patients with affective and nonaffective psychotic disorders. Psychological Medicine50(1), 48-57. https://doi.org/10.1017/S0033291718003938

Munger Clary, H. M., Snively, B. M., & Hamberger, M. J. (2018). Anxiety is common and independently associated with clinical features of epilepsy. Epilepsy & Behavior: E&B85, 64-71. https://doi.org/10.1016/j.yebeh.2018.05.024

Nevitt, S. J., Sudell, M., Weston, J., Tudur Smith, C., & Marson, A. G. (2017). Antiepileptic drug monotherapy for epilepsy: A network meta-analysis of individual participant data. The Cochrane Database of Systematic Reviews12(12), CD011412. https://doi.org/10.1002/14651858.CD011412.pub3

Noebels J. L. (2015). Single-gene determinants of epilepsy comorbidity. Cold Spring Harbor Perspectives in Medicine5(11), a022756. https://doi.org/10.1101/cshperspect.a022756

O’Brien, F., Clapham, D., Krysiak, K., Batchelor, H., Field, P., Caivano, G., Pertile, M., Nunn, A., & Tuleu, C. (2019). Making medicines baby size: The challenges in bridging the formulation gap in neonatal medicine. International Journal of Molecular Sciences20(11), 2688. https://doi.org/10.3390/ijms20112688

Panebianco, M., Al-Bachari, S., Weston, J., Hutton, J. L., & Marson, A. G. (2018). Gabapentin add-on treatment for drug-resistant focal epilepsy. The Cochrane Database of Systematic Reviews10(10), CD001415. https://doi.org/10.1002/14651858.CD001415.pub3

Pardo, C. A., Nabbout, R., & Galanopoulou, A. S. (2014). Mechanisms of epileptogenesis in pediatric epileptic syndromes: Rasmussen encephalitis, infantile spasms, and febrile infection-related epilepsy syndrome (FIRES). Neurotherapeutics: The Journal of the American Society for Experimental Neurotherapeutics11(2), 297-310. https://doi.org/10.1007/s13311-014-0265-2.

Parrish, J. B, & Fields, E. (2019). Cognitive functioning in patients with pediatric-onset multiple sclerosis, an updated review and future focus. Children (Basel, Switzerland) vol. 6, 2 21. 4 Feb. 2019, https://doi.org/10.3390/children6020021

 Paudel, Y. N., Shaikh, M. F., Chakraborti, A., Kumari, Y., Aledo-Serrano, Á., Aleksovska, K., Alvim, M., & Othman, I. (2018). HMGB1: A common biomarker and potential target for TBI, neuroinflammation, epilepsy, and cognitive dysfunction. Frontiers in Neuroscience12, 628. https://doi.org/10.3389/fnins.2018.00628

Perry, W., Lacritz, L., Roebuck-Spencer, T., Silver, C., Denney, R. L., Meyers, J., McConnel, C. E., Pliskin, N., Adler, D., Alban, C., Bondi, M., Braun, M., Cagigas, X., Daven, M., Drozdick, L., Foster, N. L., Hwang, U., Ivey, L., Iverson, G., Kramer, J., … Golden, T. (2018). Population health solutions for assessing cognitive impairment in geriatric patients. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists33(6), 655-675. https://doi.org/10.1093/arclin/acy052

Ping, X., Qin, S. K., Liu, S. N., Lu, Y., Zhao, Y. N., Cao, Y. F., Zhang, Y. H., Zhang, S. D., Chu, L., & Pei, L. (2019). Effects of Huazhuo Jiedu Shugan decoction on cognitive and emotional disorders in a rat model of epilepsy: Possible involvement of AC-cAMP-CREB signaling and NPY expression. Evidence-Based Complementary and Alternative Medicine: eCAM2019, 4352879. https://doi.org/10.1155/2019/4352879

Proceedings of Réanimation 2020, the French Intensive Care Society International Congress. (2020). Annals of Intensive Care10(Suppl 1), 16. https://doi.org/10.1186/s13613-020-0623-7

Ravizza, T., Onat, F. Y., Brooks-Kayal, A. R., Depaulis, A., Galanopoulou, A. S., Mazarati, A., Numis, A. L., Sankar, R., & Friedman, A. (2017). WONOEP appraisal: Biomarkers of epilepsy-associated comorbidities. Epilepsia58(3), 331-342. https://doi.org/10.1111/epi.13652

Reddy, S. D., Younus, I., Sridhar, V., & Reddy, D. S. (2019). Neuroimaging biomarkers of experimental epileptogenesis and refractory epilepsy. International Journal of Molecular Sciences20(1), 220. https://doi.org/10.3390/ijms20010220

Reilly, C., Atkinson, P., Memon, A., Jones, C., Dabydeen, L., Cross, J. H., Das, K. B., Gillberg, C., Neville, B., & Scott, R. C. (2018). Child and parental sleep in young children with epilepsy: A population-based case-control study. Epilepsia Open3(3), 383-391. https://doi.org/10.1002/epi4.12241

Semple, B. D., Zamani, A., Rayner, G., Shultz, S. R., & Jones, N. C. (2019). Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy. Neurobiology of Disease123, 27-41. https://doi.org/10.1016/j.nbd.2018.07.018

Shinnar, R. C., Shinnar, S., Cnaan, A., Clark, P., Dlugos, D., Hirtz, D. G., Hu, F., Liu, C., Masur, D., Weiss, E. F., Glauser, T. A., & Childhood Absence Epilepsy Study Group (2017). Pretreatment behavior and subsequent medication effects in childhood absence epilepsy. Neurology89(16), 1698-1706. https://doi.org/10.1212/WNL.0000000000004514

Silvestro, S., Mammana, S., Cavalli, E., Bramanti, P., & Mazzon, E. (2019). Use of cannabidiol in the treatment of epilepsy: Efficacy and security in clinical trials. Molecules (Basel, Switzerland)24(8), 1459. https://doi.org/10.3390/molecules24081459

Suraev, A., Lintzeris, N., Stuart, J., Kevin, R. C., Blackburn, R., Richards, E., Arnold, J. C., Ireland, C., Todd, L., Allsop, D. J., & McGregor, I. S. (2018). Composition and use of cannabis extracts for childhood epilepsy in the Australian community. Scientific Reports8(1), 10154. https://doi.org/10.1038/s41598-018-28127-0

Vinciguerra, F., Graziano, M., Hagnäs, M., Frittitta, L., & Tumminia, A. (2020). Influence of the Mediterranean and ketogenic diets on cognitive status and decline: A narrative review. Nutrients12(4), 1019. https://doi.org/10.3390/nu12041019

Wang, L., Chen, S., Liu, C., Lin, W., & Huang, H. (2020). Factors for cognitive impairment in adult epileptic patients. Brain and Behavior10(1), e01475. https://doi.org/10.1002/brb3.1475

Wang, T. S., Liu, Q. Z., Liu, M., Zhang, Q., Wang, R. F., Wu, C. W., Zhang, J., Wang, W., Ji, T. Y., Liu, X. Y., Wang, S., Cai, L. X., Jiang, Y. W., & Wu, Y. (2020). Clinical features and surgical outcomes in young children with focal cortical dysplasia type II. CNS Neuroscience & Therapeutics26(2), 270-277. https://doi.org/10.1111/cns.13205

Williams, C. (2020). Reducing the burden of childhood cerebral visual impairment: another step forward. Developmental Medicine and Child Neurology62(1), 15. https://doi.org/10.1111/dmcn.14323

Yoong, M. (2015). Quantifying the deficit-imaging neurobehavioural impairment in childhood epilepsy. Quantitative Imaging in Medicine and Surgery5(2), 225-237. https://doi.org/10.3978/j.issn.2223-4292.2015.01.06

Zelko, F. A., Pardoe, H. R., Blackstone, S. R., Jackson, G. D., & Berg, A. T. (2014). Regional brain volumes and cognition in childhood epilepsy: Does size really matter? Epilepsy Research108(4), 692-700. https://doi.org/10.1016/j.eplepsyres.2014.02.003

Zhou, L., Chen, P., Peng, Y., & Ouyang, R. (2016). Role of oxidative stress in the neurocognitive dysfunction of obstructive sleep apnea syndrome. Oxidative Medicine and Cellular Longevity2016, 9626831. https://doi.org/10.1155/2016/9626831

 

© Center for Open Access in Science