mohsen javadzadeh

There are many important cognitive issues in patients suffering from epilepsy, including executive functions disorder such as cognitive flexibility and response inhibition. The purpose of this research is to study the effectiveness of the computer-based cognitive rehabilitation program on cognitive flexibility and response inhibition in children with epilepsy.

This was a quasi-experimental study with a pre-test-post-test design with the control group. The statistical society of this research includes all children with epilepsy referred to the Neurology Clinic of Mofid Hospital in Tehran in 2021, in which 30 children were selected by convenient sampling method and allocated to the experimental and control groups randomly (15 in each group). The experimental group was received 12 sessions the computer-based cognitive rehabilitation program and the control group didn’t receive any intervention. The data-gathering methods were the Wisconsin Card Sorting Test (1948) and the Stroop Test (1935). The results were analyzed by SPSS20 and multivariable covariance test.

The results showed that the computer-based cognitive rehabilitation program improves cognitive flexibility (p<0.001) and response inhibition (p<0.001) of children with epilepsy.

Computer-based cognitive rehabilitation program is an effective method for executive functions, which improves cognitive flexibility and response inhibition in children with epilepsy. Consequently, it can be used as a replacement or complement method for common interferences in such children.

 There are important cognitive issues in patients with epilepsy, which can be referred to as impairment in executive functions such as attention.

 This research aims to compare the effectiveness of computer-based cognitive rehabilitation programs and task-oriented cognitive rehabilitation programs on attention in children with epilepsy in Tehran.

 The present research was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into 2 experimental groups and 1 control group (15 people in each group). The Integrated Visual and Auditory Continuous Performance Test (IVA2) of Sohlberg and Mateer (2001) was used for data collection. The experimental groups underwent the intervention of the computerized cognitive rehabilitation program of the Cambridge Neuropsychological Test (1980) (12 sessions of 45 minutes) and the task-oriented cognitive rehabilitation program (12 sessions of 45 minutes). The control group did not receive any intervention. SPSS 20 software was used for data analysis. Univariate covariance analysis (ANCOVA) was performed using a significance level of 0.05.

 The results demonstrated that both computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation were effective in increasing the attention of epileptic children in Tehran (P < 0.001). There was no significant difference between the effectiveness of computer-based cognitive rehabilitation programs and task-based cognitive rehabilitation in increasing the attention of epileptic children (P = 0.67).

 It can be concluded that computer-based and task-oriented cognitive rehabilitation programs can be used to increase attention and executive functions in children with epilepsy.

Epilepsy can impact cognitive ability in children. This study aimed to compare the effectiveness of task-oriented cognitive rehabilitation programs and computer-based cognitive rehabilitation programs on cognitive flexibility in children suffering from epilepsy.

This study was a semi-experimental study with a pre-test and post-test design with a control group. The statistical population of the study included all children with epilepsy who were referred to the neurology clinic of Mofid Children's Hospital, Tehran in 2021. Using the purposeful sampling method, 45 eligible children were included in the study and were randomly divided into two experimental groups and one control group (15 people in each group). In order to collect data, the Wisconsin cards test from Grant and Berg (1948) was used.

The results showed that both task-oriented cognitive rehabilitation programs and computer-based cognitive rehabilitation programs significantly increased cognitive flexibility in children with epilepsy compared with the control group. There was no significant difference in the computer-based cognitive section on the increase of cognitive flexibility in children with epilepsy.

Task-based cognitive rehabilitation programs and computer-based cognitive rehabilitation programs can be a useful approach to increase the cognitive flexibility of children with epilepsy.

Serious, and sometimes, deadly complications of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are devastating. Whereas most manifestations of COVID-19 are respiratory (fever, dry cough, fatigue, pneumonia), it is getting to be progressively recognized that numerous organ functions can be affected by this disease, and the nervous system is one of them as neurological complications can affect up to 36% of adult patients. However, the prevalence and pathophysiology of these complications have yet to be fully elucidated in children. Here, we discuss an infant with neurological symptoms manifested as chronic isolated aseptic meningitis associated with COVID-19, which was unresponsive to ordinary treatments and dramatically responsive to dexamethasone. Immune-mediated reactions may have had a major pathophysiologic role in this case.

inflammatory bowel disease (IBD) has both intestinal and extra intestinal manifestations. Inflammatory bowel disease (IBD) is a known risk factor for cerebral venous thrombosis (CVT) event in adult and children. The precise mechanism of thrombotic event is not known in patient with IBD. We report a case of ulcerative colitis with CVT during admission for acute relapse. 12 years old boy known case of ulcerative colitis since 12 months ago admitted in children hospital because of bloody diarrhea, recurrent colicky abdominal pain. At the third day of admission patient had severe headache. Level of consciousness has decreased gradually during 12 hours. Child has been aphasic later. One episode of tonic clonic seizure has happened 18 hours after the onset of headache. Neurologic examination showed right hemiparesis. Physical examinations including blood pressure and fundoscopy were unremarkable in last admission. Brain CT shows intraparanchymal hemorrhage in left temporal lobe with asymmetric increased density in left lateral sinus.  The results of MRI has shown abnormal hyperintense signal in left lateral sinus in T1WI and T2WI that is compatible with thrombosis (loss of signal) in MRV. LMW heparin was administered according to consultation with hematologist and continued post discharge. Child condition has improved slowly and neurologic evaluation was normal after 3months. Cerebrovascular events, such as cerebral venous thrombosis (CVT) or cerebral arterial infarction (CAI), are rare extraintestinal manifestations of PIBD but probably the most common forms of thromboembolism in children. Probably, treatment of CVT with anticoagulants is the best way of management. A comprehensive study is essential to understand the choice, efficacy, duration, and primary and secondary prophylaxis protocol with anticoagulants.

Movement disorders are common neurologic disturbances in childhood. There are two major types movement disorders. Hypokinetic disorders are with paucity of voluntary movements and are very uncommon in pediatric age group. Hyperkinetic movement abnormalities are very common in children and defined as abnormal repetitive involuntary movements. Movement disorders in childhood and even in adolescents are different in etiology, timing, treatment and prognosis versus adulthood movement abnormalities. In this brief article, we reviewed common types of hyperkinetic abnormal movements in children and adolescents with emphasis on etiologies, new classifications and recent treatment strategies.

Predicting the response to treatment in patients treated with anti-epilepsy drugs are always a major challenge. This study was conducted to predict the response to treatment in patients with epilepsy.
Material and This analytical questionnaire-based study was conducted in 2014 among patients with epilepsy admitted to Mofid Children's Hospital. The inclusion criteria were children 2 months to 12 years of age with epilepsy and patients who experienced fever and seizure attacks at least once were excluded from the study. After the initial recording of patient information, patients were followed up for 6 months and the response to their treatment was recorded. The response to good treatment was defined as the absence of maximum seizure with two drugs during follow up.
This study was conducted among 128 children with seizure. 72 patients (56.3%) were boys. The age of the first seizure was under 2 years old in 90 patients (70.3%). History of febrile convulsion, family history of seizure and history of asphyxia was found in 16 patients (12.5%), 41 patients (32%), 27 (21.1%), respectively. IQ was decreased in 79 patients (61.7%). Seizure etiology was idiopathic in 90 patients (70.3%), and the number of seizures was 1 - 2 in 36 patients (28.1%). 57 patients (44.5%) had cerebral lesion according to CT scan or MRI, and EEG was normal in 21 patients (16.4%) and abnormal in 101 patients (78.9%). In 6-month follow-up, 40 patients (31.3%) responded well to the treatment and 88 patients (68.8%) responded poorly to the treatment. The results of multivariate analysis demonstrated that history of asphyxia (OR = 6.82), neonatal jaundice (OR = 2.81) and abnormal EEG (OR = 0.19) were effective factors in response to treatment.
Results of univariate and multivariate analysis indicated that abnormal EEG is an effective factor in treatment response in the children studied.

Parental pain catastrophizing is a construct which is recognized to have a significant impact on experience and report of pain in both children and parents. The main aim of the current research is to investigate the probable relationship of parental pain catastrophizing with the parent reports of children’s anxiety, depression and headache severity amongst Iranian parents of children with chronic or recurrent headache.
In this study 212 parents (120 mothers and 92 fathers) of children with chronic or recurrent pain participated and completed the Pain Catastrophizing Scale; Numeric Pain Rating Scale, asking for the average of pain severity in last three months before the research, and the Anxiety and Depression subscales of the Children Behavioral Check List.
Findings: The mean age of parents was 35.41 (SD= 5.58) and the mean age of children were 9.83 (SD= 2.77). A total of 72 girls and 60 boys participated in this study with a mean pain severity for headache in last three months before the research of 4.99 (SD=2.63). Probable sex differences according to pain catastrophizing, pain severity, anxiety and depression were assessed. In the next step, the predictability of pain severity from parental pain catastrophizing was evaluated. Results indicated a significant relationship in maternal pain catastrophizing and estimates of pain intensity by mothers.
These findings represent the importance of parent’s cognitive factors affecting their reports of their children’s pain and related emotional disturbances.

Background and One of the factors that are important in interpersonal relationships and the psychosocial context of children and parents in the field of chronic pain is the catastrophic thinking model. The aim of this study was to investigate the gender-related differences in the rate of catastrophizing of mothers and fathers by controlling the effect of headache in children.
This research was a causal comparative design. The statistical population included all parents of children with headache in Tehran in 2016. In this study 210 parents (117 mothers and 93 fathers) of 132 children with chronic or recurrent pain participated and answered to the Pain Catastrophizing Scale (Goubert et al, 2006) and Numeric Pain Rating Scale, asking for the average of pain severity in last three months before the research. Data analysis was performed using independent T-test, multivariate analysis and one-way variance analysis as well as covariance analysis.
Results indicated a significant difference between mothers and fathers according to their levels of pain catastrophizing (P = 0.018). Multivariate variance analysis showed no statistical significant difference in subscales of catastrophizing (rumination and magnification/ helplessness) according to the sex of parents; but univariate variance analysis showed a significant difference in using magnification/helplessness thinking patterns between mothers and fathers (P = 0.02). Covariance analyses demonstrated that, by controlling the effects of pain severity, still mothers were significantly higher in catastrophizing about their children’s pain (P = 0.037).
Results of this study indicated that the difference in levels of parental pain catastrophizing between mothers and fathers can be due to other than child's pain intensity.

This study was conducted on the demographic data, clinical characteristics, electroencephalography, neuroradiological findings, and their impact on the recurrence of ataxia.
A 3-yr retrospective review of 49 children with ataxia in Mofid Children Hospital, Tehran, Iran was conducted from Apr 2013 to Apr 2016.
The demographic, clinical and paraclinical data were recorded in pre-prepared questionnaires. The patients were also classified in two groups of with or without recurrence and the results were compared. The diagnostic etiologies in our patients were classified as brain tumor, drug ingestion, encephalitis, postinfectious immune-mediated disorders, pseudoataxia, trauma, congenital malformations of the central nervous system and hereditary ataxias.
Forty-nine children with ataxia were enrolled. The mean age of the patients with a recurrence of ataxia was more than those without a recurrence.
Neurodevelopmental delay in patients with recurrence was more frequent than those without a recurrence. Abnormal findings in the neuroimaging were seen more in the patients with recurrence than those without recurrence. The most common cause of ataxia in patients with recurrence was hereditary ataxia and in patients without recurrence was a viral post infectious disorder.
After a mean follow-up period of 16.36 months (range: 2-37 months), 9 cases (18.4%) showed recurrence. Older age, abnormal neuroimaging, and neurodevelopmental delay should be considered as the risk factors of recurrence of ataxia in children.

Some reports have shown the association between Moyamoya syndrome and autoimmune diseases. Herewith, we present a 3.5 yr old girl with Henoch- Schönleinpurpura (HSP) who was treated with steroids because of sever colicky abdominal pain. However, central nervous system manifestations such as headache, ataxia and vision impairment developed during 6 months of her outpatient follow-up. More evaluation using MRA revealed intracranial stenosis of internal carotid artery and arterial collaterals that were in favor of Moyamoya syndrome. To our knowledge, this is the first report of Moyamoya syndrome following henoch-schönleinpurpura.

Seizure is an emergency in pediatrics. It really matters to the parents of the involved child to have information about the causes, management and prognosis.First unprovoked seizures (FUS) are seizures that occur in patients without fever, trauma or infection. Due to the rapid improvement in diagnostic techniques in the last few decades, the etiology will be revealed and this term will no longer exist. This Study was designed to evaluate brain imaging findings in FUS patients. Ninety-six children with FUS, who were admitted in three major children’s hospitals in Tehran, underwent brain imaging and were enrolled into the study.The decision about the type of imaging (CT or MRI) was based on the patient’s medical and financial conditions. An expert radiologist in the field of pediatric neuroimaging interpreted the images.Altogether, 27.1% had abnormal findings of which 29.2% were in the brain MRI group and 14.3% were in the brain CT scan group.Abnormal results were gliosis (10.4%), hemorrhage (4.2%), dysgenesis (2.1%), dysmyelination (7.3%), encephalomalacy (1%), atrophy (5.2%) and infarction (2.1%). In some patients, the lesions were in 2 or 3 sites and some had more than one type of lesion.There was no association between the duration, age and type of seizure and imaging abnormlities. However, we found an association between the location of the lesion and the type of seizure. We recommend brain imaging in all patients with FUS and apart from some exceptions, brain MRI is superior to CT.

Phenobarbital is recommended by WHO as the first line drug for the treatment of partial and generalized tonic clonic epilepsies in developing countries, however several clinical trials have recorded higher frequencies of behavioural problems associated with Phenobarbital than with other drugs or no treatment. We compared the frequency of behavioural problems among epileptic children treated with phenobarbital with epileptic children treated with phenytoin. We conducted a case-control study to comparing of epileptic children treatment with neurological with epileptic children treated with phenytoin. Between November 2006 to March 2007, 74 children referred from child neurologic clinic who treated with phenobarbital or phenytoin for more than 2 months in Zahedan, assessed consecutively by the Rutters behaviour scale for children aged 6 years and older and by the preschool behaviour questionnaire for those 2-5 years. The mean scores on the behaviour scales did not differ significantly between the phenobarbital and phenytoin groups in children aged 6 years and older. Irretability, attention deficit, disobedience and lack of energy in phenobarbital group more than phenytoin group in 2-5 years old children. Several clinical trials have recorded higher frequencies (20-60%) of behavioural problems associated with phenobarbital than with other drugs but in our study evidence supports the acceptability of phenobarbital for epileptic children in developing countries.