Three-year longitudinal motor function and disability level of acute flaccid myelitis
We summarize the long-term motor outcome and disability level in a cluster of pediatric patients with acute flaccid myelitis (AFM) associated with the enterovirus D68 (EV-D68) outbreak in 2015. (Source: Pediatric Neurology)
Source: Pediatric Neurology - December 3, 2020 Category: Neurology Authors: Pin Fee Chong, Ryutaro Kira, Hiroyuki Torisu, Sawa Yasumoto, Akihisa Okumura, Harushi Mori, Keiko Tanaka-Taya, AFM Study Group Tags: Research Paper Source Type: research

The Pediatric Neurology 2020 Research Workforce Survey: Optimism in a Time of Challenge
The past decades have seen a transformational shift in the understanding and treatment for neurological diseases affecting infants and children. These advances have been driven in part by the pediatric neurology physician-scientist workforce and its efforts. However, pediatric neurology research faces significant challenges from internal and external forces including work-life balance demands, COVID-19 pandemic effects, and research funding. Understanding the impact of these challenges on the perceptions, planning, and careers of pediatric neurology physician-scientists is needed to guide the research mission. (Source: Pediatric Neurology)
Source: Pediatric Neurology - December 3, 2020 Category: Neurology Authors: Joshua L. Bonkowsky, Ryan J. Felling, Zachary M. Grinspan, R éjean M. Guerriero, Barry E. Kosofsky, Ariel M. Lyons-Warren, Gabrielle deVeber Tags: Research Paper Source Type: research

Is SARS-CoV-2 infection a risk for potentiation of epileptic seizures in children with pre-existing epilepsy?
Growing reports describing neurologic manifestations in children with COVID-19 are expanding the COVID-19 phenotype (1). Whether seizure worsening might be an issue for children with pre-existing epilepsy and SARS-CoV-2 infection is unknown. (Source: Pediatric Neurology)
Source: Pediatric Neurology - December 2, 2020 Category: Neurology Authors: Giacomo Brisca, Laura Siri, Camilla Olcese, Bernadette Marr è Brunenghi, Daniela Pirlo, Maria Margherita Mancardi Tags: Correspondence Source Type: research

Acute Flaccid Myelitis surveillance amidst COVID-19 pandemic
We read with great interest the article on acute flaccid myelitis (AFM) by Dr. Hopkins et al.1 We agree with the authors on the felt need for vigilance for AFM amidst the coronavirus disease (COVID-19) pandemic. We would like to highlight our perspective in this regard and regarding the problems faced in the diagnosis in the developing countries. (Source: Pediatric Neurology)
Source: Pediatric Neurology - December 2, 2020 Category: Neurology Authors: Bhanudeep Singanamalla, Priyanka Madaan, Lokesh Saini Tags: Correspondence Source Type: research

Epilepsy with Eyelid Myoclonia (Jeavons Syndrome): A comprehensive update
The purpose of this review is to provide a comprehensive update and highlight the distinct electro-clinical features and discuss recent advances in etiology, pathophysiology and management strategies of epilepsy with eyelid myoclonias. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 30, 2020 Category: Neurology Authors: Ifrah Zawar, Elia Pestana Knight Tags: Review Article Source Type: research

Clinical Features, Treatment Strategies and Outcomes in Hospitalized Children with Immune-Mediated Encephalopathies
Autoimmune encephalitis (AE) and acute disseminated encephalomyelitis (ADEM) are immune-mediated brain conditions which can result in significant neurological sequalae. Data describing the clinical characteristics, treatment strategies and discharge neurologic outcomes for these rare conditions are needed. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 27, 2020 Category: Neurology Authors: Molly E. McGetrick, Natasha A. Varughese, Darryl K. Miles, Cynthia X. Wang, Morgan McCreary, Nancy L. Monson, Benjamin M. Greenberg Tags: Research Paper Source Type: research

MRI Score Ability to Detect Abnormalities in Mild Hypoxic Ischemic Encephalopathy
MRI scores have been well validated in moderate/severe HIE. Infants with mild HIE can have different patterns of injury, yet different scores have not been compared in this group of infants. Our objective was to compare the ability of 3 MRI scores to detect abnormalities in infants with mild HIE, and infants with moderate/severe HIE were included for comparison. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 27, 2020 Category: Neurology Authors: Michelle Machie, Lauren Weeke, Linda S. de Vries, Nancy Rollins, Larry Brown, Lina Chalak Tags: Research Paper Source Type: research

Prevent hyperglycemia in MELAS by measuring HbA1c values and by avoiding triggering events
With interest we read the article by Toki et al. about three patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episode (MELAS), who experienced a fulminant-onset hyperglycemic crisis as first manifestation of mitochondrial diabetes.[1] Hyperglycemic events occurred after surgery, infection, and status epilepticus, respectively.[1] It was concluded that MELAS-patients should routinely undergo measurement for glycated haemoglobin (HbA1c) regardless of age and lack of symptoms.[1] We have the following comments and concerns. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 27, 2020 Category: Neurology Authors: Josef Finsterer Tags: Correspondence Source Type: research

Pediatric cerebral cavernous malformations: a review
We present several cases of cerebral cavernous malformations in children from a tertiary pediatric neurosciences center and explore the challenges of diagnosing CCMs in children, their key imaging features, the role of follow-up imaging, and their subsequent management including stereotactic radiosurgery and microsurgical resection. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 27, 2020 Category: Neurology Authors: Michael Paddock, Sarah Lanham, Kanwar Gill, Saurabh Sinha, Daniel JA. Connolly Tags: Topical Review Source Type: research

Repairing the World One Patient at a Time
People sometimes ask why I became a doctor. Certainly, there was the cultural expectation to succeed in one of the big three – medicine, law or the rabbinate – compounded by the firstborn dutifully following parental direction. But there was no personal exposure to illness or special role model. Rather, it started as a 12-year-old at summer camp as sports suddenly went beyond softball to include archery, canoeing and rock climbing; arts and crafts also meant photography, electronics and theatre. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 26, 2020 Category: Neurology Authors: Lawrence W. Brown Tags: Correspondence Source Type: research

Objective and clinically-feasible analysis of diffusion MRI data can help predict dystonia after neonatal brain injury
Dystonia in cerebral palsy (CP) is debilitating but underdiagnosed. This precludes targeted treatment which is most effective if instituted early. Deep grey matter injury is associated with dystonic CP but can be challenging to quantify. Objective and clinically-feasible identification of injury that typically precedes dystonia could help determine which children are at highest risk for developing dystonia and thus facilitate early dystonia detection. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 22, 2020 Category: Neurology Authors: Keerthana Chintalapati, Hanyang Miao, Amit Mathur, Jeff Neil, Bhooma R. Aravamuthan Tags: Research Paper Source Type: research

Increased intracranial pressure in the setting of Multisystem Inflammatory Syndrome in Children, associated with COVID-19
We describe two children who presented with MIS-C and were found to have evidence of increased intracranial pressure (ICP). (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 21, 2020 Category: Neurology Authors: Alyssa Baccarella, Alexandra Linder, Robert Spencer, Alexander Jonokuchi, Paul Benjamin King, Angel Maldonado-Soto, Alexis Boneparth, Benjamin S. Hooe, Adam J. Schweickert, Rebecca Carlin, Francesca Kingery, Wendy S. Vargas, Taylor B. Sewell, Wendy G. Sil Tags: Research Letter Source Type: research

Reducing prescribing errors in hospitalized children on the ketogenic diet
Children on ketogenic diet must limit carbohydrate intake to maintain ketosis and reduce seizure burden. Ketogenic diet patients are vulnerable to harm in the hospital setting where carbohydrate-containing medications are commonly prescribed. We developed clinical decision support (CDS) to reduce inappropriate prescription of carbohydrate-containing medications in hospitalized children on ketogenic diet. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 21, 2020 Category: Neurology Authors: Benjamin I. Siegel, Meredith Johnson, Thomas E. Dawson, Emily Kurzen, Philip J. Holt, David S. Wolf, Evan W. Orenstein Tags: Research Paper Source Type: research

Barriers to implementation of dietary therapy for pediatric epilepsy in resource limited countries: Ethiopian experience
There are dramatic worldwide disparities in access to effective epilepsy treatments. Availability of antiseizure medications (ASMs), dietary therapies, surgical, and neurostimulation options is limited in low and middle income countries (LMICs), reducing opportunities to achieve seizure freedom. Ketogenic diet (KD) therapy can result in at least a 50% reduction in seizures in about half of children with drug-resistant epilepsy [1]. The International League Against Epilepsy (ILAE) emphasize the importance of expanding this treatment globally [2]. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 21, 2020 Category: Neurology Authors: Erin Fedak Romanowski, Abate Yeshidinber Weldetsadik Tags: Opinion Paper Source Type: research

Association of sleep apnea with development and behavior in Down syndrome: A prospective clinical and polysomnographic study
This study assesses the relationship between the severity of sleep apnea and development and behavioral abnormalities in Down syndrome. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 18, 2020 Category: Neurology Authors: Vaishakh Anand, Madhulika Kabra Tags: Research Paper Source Type: research

New-onset dizziness associated with pediatric COVID-19
We report two confirmed pediatric COVID-19 cases presenting with dizziness. Both were in good medical condition and vitals were within normal limits. First was a 12 years old girl who was admitted to hospital with fever, cough, headache and dizziness. Physical and comprehensive neurological examination was normal other than crackles limited to the lung bases. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 17, 2020 Category: Neurology Authors: Erdal Sar ı, Nihan Uygur Külcü, Ozlem Erdede, Emek Uyur Yalçın, Rabia Gönül Sezer Yamanel Tags: Correspondence Source Type: research

Neurological manifestations of COVID-19 in children: Time to be more vigilant
We read with great interest the article by Burr et al on NMDA- receptor encephalitis associated with COVID-19 infection.1 Although Anti-NMDAR encephalitis has been associated with COVID-19 in adults, this is the first report in a child.2 With initial evidence for COVID-19 in children suggesting an asymptomatic or mild course in most, the identification and management of novel clinical presentations become even more relevant. We would like to highlight the para/post-infectious immune-mediated neurological presentations in children where identification of associated COVID-19 is important. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 16, 2020 Category: Neurology Authors: Priyanka Madaan, Bhanudeep Singanamalla, Lokesh Saini Tags: Correspondence Source Type: research

Focal cortical dysplasia – relevant for seizures in Phelan McDermid syndrome?
Phelan McDermid syndrome (PMS) is a neurogenetic disorder characterized by global developmental delay, intellectual disability, absent or severely impaired language, and hypotonia, combined with a broad spectrum of other clinical symptoms and variable dysmorphic features.Epilepsy is present or develops in a substantial number of these patients but it is origin is still unclear, especially whether there are perhaps subtle malformations in this developmental disorder that have so far not been identified by conventional MRI. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 13, 2020 Category: Neurology Authors: Sarah Jesse, Hans-J ürgen Huppertz, Albert Christian Ludolph, Jan Kassubek Tags: Research Letter Source Type: research

Editorial Board and Masthead
(Source: Pediatric Neurology)
Source: Pediatric Neurology - November 11, 2020 Category: Neurology Source Type: research

Table of Contents
(Source: Pediatric Neurology)
Source: Pediatric Neurology - November 11, 2020 Category: Neurology Source Type: research

EEG Technologist Interrater Agreement and Interpretation of Pediatric Critical Care EEG
EEG technologists commonly screen continuous EEG. Until now, the interrater agreement or sensitivity for important EEG findings has been unknown in this group. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 9, 2020 Category: Neurology Authors: Stephanie Ahrens, Jaime D. Twanow, Jorge Vidaurre, Satyanarayana Gedela, Melissa Moore-Clingenpeel, Adam P. Ostendorf Tags: Research Paper Source Type: research

The phenotype and genotype of congenital myopathies based on a large pediatric cohort
Congenital myopathies (CMs) are a clinically and genetically heterogeneous group of hereditary muscular disorders. The distribution of genetic and histologic subtypes has been addressed in only a few cohorts and the relationship between phenotypes and genotypes is only partially understood. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 5, 2020 Category: Neurology Authors: Daniel Natera-de Benito, Carlos Ortez, Cristina Jou, Cecilia Jimenez-Mallebrera, Anna Codina, Laura Carrera-Garc ía, Jessica Expósito-Escudero, Sergi Cesar, Loreto Martorell, Pia Gallano, Lidia Gonzalez-Quereda, Daniel Cuadras, Jaume Colomer, Delia Yube Tags: Research Paper Source Type: research

Approach to preventive epilepsy treatment in tuberous sclerosis complex and current clinical practice in 23 countries
Tuberous sclerosis complex (TSC) is associated with high risk of early-onset epilepsy and developmental delay. Recently, EEG monitoring in infants with TSC and preventive antiepileptogenic treatment have been proposed to improve epilepsy and neurodevelopmental outcome. We aimed to explore how recent studies and recommendations regarding EEG monitoring and preventive epilepsy treatment have influenced the clinical practice of epilepsy management among children with TSC. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 5, 2020 Category: Neurology Authors: Monika S łowińska, Katarzyna Kotulska, Sylwia Szymańska, Steven L. Roberds, Carla Fladrowski, Sergiusz Jóźwiak Tags: Research Paper Source Type: research

Excitatory/Inhibitory Synaptic Ratios in Polymicrogyria and Down Syndrome help explain epileptogenesis in malformations
The ratio between excitatory (glutamatergic) and inhibitory (GABAergic) inputs into maturing individual cortical neurons influences their epileptic potential. Structural factors during development that alter synaptic inputs can be demonstrated neuropathologically. Increased mitochondrial activity identifies neurons with excessive discharge rates. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 4, 2020 Category: Neurology Authors: Harvey B. Sarnat, Laura Flores-Sarnat Tags: Review Article Source Type: research

Assessments and interventions for spasticity in infants with or at high risk for cerebral palsy: A systematic review
The majority of children with cerebral palsy (CP) develop spasticity, which interferes with motor development, function, and participation. This systematic review appraised current evidence regarding assessments and interventions for spasticity in children under age two with or at high risk for CP and integrated findings with parent preferences. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 3, 2020 Category: Neurology Authors: Lauren Ayala, Sarah Winter, Rachel Byrne, Darcy Fehlings, Alison Gehred, Lisa Letzkus, Garey Noritz, Madison CB. Paton, Lindsay Pietruszewski, Nathan Rosenberg, Kelly Tanner, Jilda Vargus-Adams, Iona Novak, Nathalie L. Maitre Tags: Review Article Source Type: research

Sirolimus Treatment in Sturge-Weber Syndrome
Sturge-Weber syndrome is a rare neurovascular disorder associated with capillary malformation, seizures, cognitive impairments, and stroke-like episodes (SLE), arising from a somatic activating mutation in GNAQ. Studies suggest this mutation may cause hyperactivation of the mTOR pathway. Sirolimus is an mTOR inhibitor studied in other vascular anomalies, and a potentially promising therapy in Sturge-Weber syndrome. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 2, 2020 Category: Neurology Authors: Alison J. Sebold, Alyssa M. Day, Joshua Ewen, Jack Adamek, Anna Byars, Bernard Cohen, Eric H. Kossoff, Tomoyuki Mizuno, Matthew Ryan, Jacqueline Sievers, Lindsay Smegal, Stacy J. Suskauer, Cameron Thomas, Alexander Vinks, T. Andrew Zabel, Adrienne M. Hamm Tags: Research Paper Source Type: research

Assessments and interventions for sleep disorders in infants with or at high risk for cerebral palsy: A systematic review
Children with cerebral palsy (CP) are five times more likely than typically developing children to have sleep problems, resulting in adverse outcomes for both children and their families. The purpose of this systematic review was to gather current evidence regarding assessments and interventions for sleep in children under age two with or at high risk for CP and integrate these findings with parent preferences. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 2, 2020 Category: Neurology Authors: Kelly Tanner, Garey Noritz, Lauren Ayala, Rachel Byrne, Darcy Fehlings, Alison Gehred, Lisa Letzkus, Iona Novak, Nathan Rosenberg, Jilda Vargus-Adams, Sarah Winter, Nathalie L. Maitre Tags: Research Paper Source Type: research

Late-onset Aicardi Gouti ères syndrome: a characterization of presenting clinical features
Aicardi Gouti ères Syndrome (AGS) is a genetic interferonopathy characterized by early onset of severe neurologic injury with intracranial calcifications, leukoencephalopathy, and systemic inflammation. Increasingly, a spectrum of neurologic dysfunction and presentation beyond the infantile period is being recog nized in AGS. The aim of this study was to characterize late-infantile and juvenile onset AGS. (Source: Pediatric Neurology)
Source: Pediatric Neurology - November 1, 2020 Category: Neurology Authors: Cara Piccoli, Nowa Bronner, Francesco Gavazzi, Holly Dubbs, Micaela De Simone, Valentina De Giorgis, Simona Orcesi, Elisa Fazzi, Jessica Galli, Silvia Masnada, Davide Tonduti, Costanza Varesio, Adeline Vanderver, Arastoo Vossough, Laura Adang Tags: Research Paper Source Type: research

Next-generation sequencing of cerebrospinal fluid for the diagnosis of unexplained central nervous system infections
Central nervous system (CNS) infections cause significant morbidity and mortality in pediatric patients. However, in approximately half of clinical cases, the aetiology is unidentified. As an unbiased molecular diagnostic technology, next generation sequencing (NGS) is gradually being applied to investigate CNS infections. This narrative review summarizes and critiques the literature on this new technology for aetiologic identification of unexplained CNS infections in pediatric patients and discusses the future development prospects of this technology in the field of pediatrics. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 29, 2020 Category: Neurology Authors: Zhen Yu Li, Dan Dang, Hui Wu Tags: Review Article Source Type: research

Infantile Spasms associated with a Pathogenic PRRT2 Variant
We read with interest the article by Streff, et al. in the September, 2020 issue of Pediatric Neurology that described a family with a TSC1 variant and members manifesting mild or no clinical manifestations of Tuberous Sclerosis. This observation underscores pleiotropy of known pathogenic variants. We would like to highlight the case of PRRT2 gene, which has been described mostly in association with relatively benign neurological conditions, including paroxysmal kinesigenic dyskinesia, benign familial infantile epilepsy, paroxysmal kinesigenic dyskinesia and infantile convulsions, hemiplegic migraine, paroxysmal torticolli...
Source: Pediatric Neurology - October 23, 2020 Category: Neurology Authors: Saba Jafarpour, Jay Desai Tags: Correspondence Source Type: research

Developing a New Set of ACGME Milestones for Child Neurology Residency
The Educational Milestones developed by the Accreditation Council for Graduate Medical Education (ACGME) are a construct used to evaluate the development of core competencies during residency and fellowship training. The milestones were developed to create a framework for professional development during graduate medical education. The first iteration of milestones for the child neurology residency were implemented in 2015. In the years that followed, the ACGME received and reviewed feedback about the milestones and set out to revise them. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 23, 2020 Category: Neurology Authors: Dara VF. Albert, Nancy Bass, John Bodensteiner, Crys Draconi, Elizabeth S. Duke, Marcia Felker, Andrea Gropman, Timothy Lotze, Jonathan W. Mink, James J. Reese, Mary Spiciarich, David K. Urion, Laura Edgar Tags: Research Paper Source Type: research

Fatal Cerebral Edema in a Child with COVID-19
We present a pediatric patient with COVID-19 who experienced rapid neurologic deterioration, diffuse cerebral edema, and ultimately brain death secondary to PMIS. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 22, 2020 Category: Neurology Authors: Michael G. Kim, Alan A. Stein, Philip Overby, George Kleinman, Rolla Nuoman, Edwin Gulko, Fawaz Al-Mufti, Jared M. Pisapia, Carrie R. Muh Tags: Short Communication Source Type: research

Intracranial and extracranial vascular stenosis as risk factors for stroke in sickle cell disease
Prevalence and contribution of intracranial and extracranial arterial stenosis to stroke risk were assessed prospectively in children and young adults with sickle cell disease (SCD). (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 22, 2020 Category: Neurology Authors: Alyssa A. Schlotman, Manus J. Donahue, Adetola A. Kassim, Chelsea A. Lee, Spencer L. Waddle, Sumit Pruthi, L Taylor Davis, Mark Rodeghier, Michael R. DeBaun, Lori C. Jordan Tags: Research Paper Source Type: research

Successful treatment of pediatric FIRES with anakinra
Febrile infection-related epilepsy syndrome (FIRES) is a rare epileptic syndrome seen primarily in childhood characterized by a febrile infection two weeks to 24 hours prior to the onset of status epilepticus1. The exact pathophysiology is unknown. However, studies have shown increased levels of pro-inflammatory cytokines, suggesting an autoinflammatory-mediated process2. The prognosis of FIRES can be devastating, with rapidly progressive cerebral atrophy and hippocampal sclerosis, poor cognitive outcomes and even death3,4. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 22, 2020 Category: Neurology Authors: Jennifer Yang, Shilpa Nataraj, Shifteh Sattar Tags: Short Communication Source Type: research

Segmental myoclonus following hepatorenal transplant and tacrolimus immunosuppression
A 16-year-old girl with methylmalonic acidemia complicated by chronic kidney disease underwent hepatorenal transplantation with excellent post-operative course. She was discharged on prednisone, mycophenolate mofetil, tacrolimus, trimethoprim-sulfamethoxazole, and valganciclovir. Her peak trough of tacrolimus during initiation was 17.1 ng/mL (goal: 10-15 ng/mL). 1.5 weeks after transplant she developed intermittent “jerking” about her abdominal incision. Soon after, she slumped, developed rightward head version with right face/eyelid twitching, and became unresponsive with generalized tremulousness for 2 minute...
Source: Pediatric Neurology - October 13, 2020 Category: Neurology Authors: A.M. McLaughlin, T.R. Khan, J.M. Lauritsen, K.Y. Batley, J.L. Waugh Tags: Short Communication Source Type: research

COVID-19 pandemic and child neurology training: a bumpy road ahead
We read with great interest the recently published article “Pediatric Neurology Research in the 21st Century: Status, Challenges, and Future Directions Post-COVID-19” by Bonkowsky et al. The authors have reiterated the difficulties faced in the field of pediatric neurology research and the funding post COVID-19 in the developed countries.1 We would like to address the setbacks in the training of pediatric neurology residents and fellows and research activities in the teaching hospitals from developing countries. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 13, 2020 Category: Neurology Authors: Bhanudeep Singanamalla, Priyanka Madaan, Lokesh Saini Tags: Correspondence Source Type: research

Editorial Board and Masthead
(Source: Pediatric Neurology)
Source: Pediatric Neurology - October 9, 2020 Category: Neurology Source Type: research

Table of Contents
(Source: Pediatric Neurology)
Source: Pediatric Neurology - October 9, 2020 Category: Neurology Source Type: research

NMDA-receptor encephalitis associated with COVID-19 infection in a toddler
Anti-NMDA receptor (NMDAR) encephalitis is characterized by mood and behavior changes, seizures, abnormal movements, autonomic instability, and encephalopathy. It occurs most commonly in young adults. A paraneoplastic association has been made with ovarian teratoma, though this is rare in children1. More recently, cases of anti-NMDAR encephalitis following viral infections have been reported, including herpes simplex virus (HSV), Japanese encephalitis virus (JEV), and now the 2019 novel coronavirus (SARS-CoV-2)2-5. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 9, 2020 Category: Neurology Authors: Tyler Burr, Christopher Barton, Elizabeth Doll, Arpita Lakhotia, Michael Sweeney Tags: Clinical Letter Source Type: research

Low incidence of postdural puncture headache further reduced with atraumatic spinal needle: a retrospective cohort study
To evaluate the incidence of postdural puncture headache (PDPH) in a predominantly pediatric sample before and after a transition from conventional to atraumatic spinal needles. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 9, 2020 Category: Neurology Authors: Nicole Yanjanin Farhat, Cristan Farmer, An Dang Do, Simona Bianconi, Forbes D. Porter Tags: Research Paper Source Type: research

Kenneth Fred Swaiman (1931 to 2020)
Adapted with permission of the Child Neurology Society, St. Paul, MN, USA. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 5, 2020 Category: Neurology Authors: Stephen Ashwal, N. Paul Rosman Tags: Obituary Source Type: research

CGRP Monoclonal Antibody use for the Preventive Treatment of Refractory Headache Disorders in Adolescents.
Monoclonal antibodies (mAbs) to calcitonin gene-related peptide (CGRP) or its receptor have clinical trial evidence in adults with headache, but data are lacking in adolescents. (Source: Pediatric Neurology)
Source: Pediatric Neurology - October 4, 2020 Category: Neurology Authors: Kaitlin A. Greene, Carlyn Patterson Gentile, Christina L. Szperka, Marcy Yonker, Amy A. Gelfand, Barbara Grimes, Samantha L. Irwin Tags: Research Paper Source Type: research

Custom Pediatric Oncology NGS Panel Identifies Somatic Mosaicism in Archival Tissue and Enhances Targeted Clinical Care
Disorders in the PIK3CA-related overgrowth spectrum (PROS) due to somatic mosaicism are associated with segmental overgrowth of the body in conjunction with vascular, skeletal, and brain malformations such as hemimegalencephaly. A pathogenic variant may only be detectable in affected tissue and not in peripheral blood or saliva samples; therefore, archival tissue may be the only relevant available specimen for testing. While this is a common approach for cancer testing, it is not typically used for constitutional genetic disorders. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 30, 2020 Category: Neurology Authors: Catherine Quindipan, Jennifer A. Cotter, Jianling Ji, Wendy G. Mitchell, Diana J. Moke, Fariba Navid, Stefanie M. Thomas, Michele VanHirtum-Das, Larry Wang, Sulagna C. Saitta, Jaclyn A. Biegel, Matthew C. Hiemenz Tags: Short Communication Source Type: research

Child Neurology Applicants Place Increasing Emphasis on Quality of Life Factors
Medical education, residency training, and the structure of child neurology residency training programs are evolving. We sought to evaluate how training program selection priorities of child neurology residency applicants have changed over time. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 29, 2020 Category: Neurology Authors: Sarah M. Dixon, Michael M. Binkley, Sidney M. Gospe, R éjean M. Guerriero Tags: Research Paper Source Type: research

Hyperglycemic crisis in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS)
Diabetes mellitus (DM) is the most commonly encountered endocrinopathy in patients with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), which manifests as multisystemic organ failure. Whether the management of DM in MELAS requires special consideration is not fully clarified. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 29, 2020 Category: Neurology Authors: Taira Toki, Yuko Shimizu-Motohashi, Hirofumi Komaki, Eri Takeshita, Akihiko Ishiyama, Takashi Saito, Madoka Mori-Yoshimura, Noriko Sumitomo, Ayaka Hirasawa-Inoue, Eiji Nakagawa, Ichizo Nishino, Yu-ichi Goto, Masayuki Sasaki Tags: Short Communication Source Type: research

Withholding Childhood Immunizations: A Parent ’s Right or a Child’s Neglect?
In this issue of Pediatric Neurology, Roach,1 and Salter and Friedman Ross2 penned dueling arguments addressing an enduring question: is parental refusal of the administration of the recommended childhood immunizations a form of child neglect? The authors ’ opinions are not components of a ‘zero-sum game.’ Both essays support a proven notion - childhood immunizations prevent morbidity and mortality.3 On the one hand, Roach’s opinion, tethered to a personal experience, is that by denying a child a means to avoid contracting a series of prevent able illnesses, parental responsibility has been abdicate...
Source: Pediatric Neurology - September 26, 2020 Category: Neurology Authors: Pedro Weisleder, Sidney M. Gospe Tags: Editorial Source Type: research

Combined genome sequencing and RNA analysis reveals and characterizes a deep intronic variant in IGHMBP2 in a patient with SMARD1
Pathogenic variants in the IGHMBP2 gene cause recessive spinal motor neuropathies of variable phenotype, including a predominantly distal motor impairment of Charcot-Marie Tooth type 2S and the more severe condition of spinal muscular atrophy with respiratory distress (SMARD1) in which infantile respiratory failure predominates. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 26, 2020 Category: Neurology Authors: Ethan E. Bodle, Wenmiao Zhu, Frances Velez-Bartolomei, Ana Tesi-Rocha, Pengfei Liu, Jonathan A. Bernstein Tags: Editorial Source Type: research

Retrospective observational study on riboflavin prophylaxis in child and adolescent migraine
To evaluate the efficacy of riboflavin in pediatric migraineurs. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 23, 2020 Category: Neurology Authors: Rakhi Das, William Qubty Tags: Research Paper Source Type: research

Defining the Expanding Clinical Spectrum of Pediatric-Onset Stiff Person Syndrome
This study aimed to characterize the spectrum of clinical features and examination findings in pediatric-onset stiff person syndrome (SPS). (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 22, 2020 Category: Neurology Authors: Anusha K. Yeshokumar, Lisa R. Sun, Scott D. Newsome Tags: Short Communication Source Type: research

Author Response to Budhram, et al.
We would like to thank Budhram et  al. for their interest in our report, “A Stroke Mimic: Anti-MOG Antibody-Associated Disorder Presenting as Acute Hemiparesis.”1 As the authors pointed out,2 our patient resembles other cases that have been termed unilateral cortical FLAMES (FLAIR-hyperintense lesions in anti-MOG-associated enc ephalitis with seizures).3 In the initial description of unilateral cortical FLAMES, two pediatric patients were included in the literature review, one of whom did present with hemiparesis and lethargy. (Source: Pediatric Neurology)
Source: Pediatric Neurology - September 18, 2020 Category: Neurology Authors: Grace Gombolay, Michelle Tutmaher, Denise Chen, Jamika Hallman-Cooper, Philip Holt, Bryan Philbrook Tags: Correspondence Source Type: research