Seminars in Pediatric Neurology最新文献

The impact of undernutrition and overnutrition on early brain development 营养不良和营养过剩对早期大脑发育的影响

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101212

Ana Cabal-Herrera , Barnabas Kigen , Esperancia Kapanga , Alex Samia , Helen Nabwera , Pauline Samia

{"title":"The impact of undernutrition and overnutrition on early brain development","authors":"Ana Cabal-Herrera , Barnabas Kigen , Esperancia Kapanga , Alex Samia , Helen Nabwera , Pauline Samia","doi":"10.1016/j.spen.2025.101212","DOIUrl":"10.1016/j.spen.2025.101212","url":null,"abstract":"<div><div><span>In this review, we explore the effects of malnutrition on childhood neurodevelopment<span><span>. Early brain development is highly sensitive to nutritional status. Both undernutrition and overnutrition can disrupt critical neurodevelopmental processes, affecting cognition, emotional regulation, and long-term mental health. Nutrient deficiencies, such as iron, iodine, </span>folate<span>, and vitamin B12, have been linked to impaired brain growth and function. Similarly, excessive </span></span></span>caloric intake<span> can also negatively impact brain development as it may contribute to neuroinflammation<span><span><span> and altered neurocircuitry. The effects are most pronounced during prenatal life and early childhood, with lasting consequences on academic performance, behavior<span>, and productivity. In addition to health-related outcomes, undernutrition and overnutrition can also have significant social and financial repercussions for individuals and their communities. This review synthesizes current insights on the relationship between nutrition and brain development, explores specific nutrient effects, and highlights the role of </span></span>public health interventions. Addressing both undernutrition and overnutrition through early and targeted action is essential for optimizing </span>neurodevelopment<span> and reducing the long-term societal burden of cognitive and mental health disorders. Continuous monitoring of both existing and emerging nutritional deficiencies is necessary, particularly in marginalized communities and low- and middle-income regions, where the risk of undernutrition remains high.</span></span></span></div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101212"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic testing for infantile-onset epilepsies in resource-limited settings 在资源有限的环境中进行幼儿癫痫的基因检测

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101204

Priyanka Srivastava , Sandeep Negi , Melissa Baltuano , Carolina Reynoso , Ahmad Rithauddin Bin Mohamed , Jitendra Kumar Sahu

{"title":"Genetic testing for infantile-onset epilepsies in resource-limited settings","authors":"Priyanka Srivastava , Sandeep Negi , Melissa Baltuano , Carolina Reynoso , Ahmad Rithauddin Bin Mohamed , Jitendra Kumar Sahu","doi":"10.1016/j.spen.2025.101204","DOIUrl":"10.1016/j.spen.2025.101204","url":null,"abstract":"<div><div>Infantile-onset epilepsies, a heterogenous group of epilepsies with onset up to two years of age, constitute a significant burden in developing countries and frequently result from various genetic<span><span> variations. The phenomena of genetic heterogeneity and phenotypic </span>pleiotropy<span> are observed across epilepsy syndromes of infantile-onset epilepsies. In the current era of precision-based medicine, early genetic diagnosis and targeted management can significantly influence epilepsy and developmental outcomes. Despite rapid advancement in genetic testing, access to genetic diagnostic facilities is a global challenge, especially in resource-limited settings. The major barriers to genetic diagnosis are high costs, limited access to specialized laboratories, and the need for expert interpretation. Nevertheless, strategies like targeted gene panels, collaborations with reference laboratories, and clinical phenotyping can help maximize the diagnostic yield while considering resource constraints. Investments in infrastructure, policy support, and international collaboration can bridge the gap and ensure that affected children receive timely and accurate diagnoses. This review discusses the importance, challenges, and potential strategies for integrating genetic testing in resource-limited environments, emphasizing the need for affordable and accessible solutions that can enhance patient care.</span></span></div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101204"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The challenges of establishing centers for the surgical management of epilepsy in low- and middle-income countries 在低收入和中等收入国家建立癫痫外科治疗中心的挑战

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101224

Jorge Vidaurre , Juan C Pérez-Poveda , Manuel Campos-Puebla , Pedro Weisleder

引用次数: 0

Diagnostic and treatment gaps 诊断和治疗差距

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101200

Cyprian Birmeh , Obrey H. Urio , Jo M. Wilmshurst

{"title":"Diagnostic and treatment gaps","authors":"Cyprian Birmeh , Obrey H. Urio , Jo M. Wilmshurst","doi":"10.1016/j.spen.2025.101200","DOIUrl":"10.1016/j.spen.2025.101200","url":null,"abstract":"<div><div>The epilepsy treatment gap in low- and middle-income countries especially sub-Saharan countries is substantial, driven by socioeconomic challenges, inadequate infrastructure, and limited access to diagnosis, treatment and care. The diagnostic gap further compounds this, with many patients remaining undiagnosed or misdiagnosed due to lack of skilled healthcare professionals, inadequate diagnostic facilities, and limited access to specialized care.</div><div>A comprehensive approach that uses sustainable solutions, prioritizing local ownership, capacity building and community engagement are crucial for bridging the epilepsy treatment and diagnostic gaps. This includes a collaborative effort between the neurology community and opinion leaders as well as policy makers.</div><div>Targeted solutions such as training more neurologists through locally relevant programs and training of primary and community healthcare workers for task-shifting and task-sharing interventions. Also strengthening supply chains and procurement processes to ensure constant supply of affordable antiseizure medications. It is critical to promote leveraging of technology such as use of smartphone video recordings, remote EEG and telemedicine tools. Further collection of data is needed inclusive of registries for disease burden, to enhance consistency in diagnostic categorization, follow up and understandings of supply chain efficiency. Overlying these clinical interventions implementation of public awareness campaigns and policy reforms to reduce stigma and promote inclusivity are critical for bridging the epilepsy treatment and diagnostic gaps.</div><div>Research should focus on understanding the socioeconomic and public health factors contributing to the treatment and diagnostic gaps, and evaluating the effectiveness of rolled-out interventions.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101200"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigating the burden of cerebral palsy in low- and middle-income countries: Implications and priorities for pediatric neurology 调查低收入和中等收入国家脑瘫负担：小儿神经病学的影响和重点

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101225

Harshitha Valluri , Mugdha Mohanty , Carlos Ramirez Mongil , Griselda Fuentes , Tipu Sultan , Alcy R. Torres

{"title":"Investigating the burden of cerebral palsy in low- and middle-income countries: Implications and priorities for pediatric neurology","authors":"Harshitha Valluri , Mugdha Mohanty , Carlos Ramirez Mongil , Griselda Fuentes , Tipu Sultan , Alcy R. Torres","doi":"10.1016/j.spen.2025.101225","DOIUrl":"10.1016/j.spen.2025.101225","url":null,"abstract":"<div><div>Cerebral Palsy (CP) is the most common pediatric physical disability worldwide presenting as a non-progressive motor dysfunction due to insults to the developing brain. While CP has a higher prevalence and burden in low- and middle-income countries, the most extensive research towards care and management of the patients with CP has been conducted in high-income countries. There is a disparate impact on CP from resource limited countries due to insufficient healthcare resources, barriers to healthcare access, inadequate public health awareness, and lack of accurate data.</div><div>In this article we examine the state of CP in low- and middle-income countries. We explore the multitude of environmental, socioeconomic, and infrastructural factors that contribute to the clinical profile of CP in these regions.</div><div>Finally, we high</div><div>light the primary areas of burden that need to be addressed in low- and middle-income countries: inadequate healthcare infrastructure and resources, lack of registries, social stigma with the and limited public health education, and strain on primary caregivers.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101225"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of advocacy and private foundations in improving treatment of epilepsy in resource limited regions 宣传和私人基金会在资源有限地区改善癫痫治疗方面的影响

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101199

Rebeca Figueroa Diaz , Angel Hernandez

{"title":"Impact of advocacy and private foundations in improving treatment of epilepsy in resource limited regions","authors":"Rebeca Figueroa Diaz , Angel Hernandez","doi":"10.1016/j.spen.2025.101199","DOIUrl":"10.1016/j.spen.2025.101199","url":null,"abstract":"<div><div><span>Epilepsy treatment in resource-limited countries faces numerous challenges including limited access to antiepileptic drugs (AEDs), inadequate healthcare infrastructure, and </span>social stigma<span>. Advocacy efforts and private foundations play a vital role in addressing these barriers and improving epilepsy care outcomes. Global health projects focusing on clinical care, research, education, and advocacy have emerged to address the significant epilepsy treatment gap in low- and middle-income countries (LMICs). These collaborative initiatives aim to develop sustainable solutions, such as enhancing epilepsy care in marginalized communities and implementing strategies to mitigate treatment gaps and improve access to healthcare. The use of primary healthcare<span><span> personnel to identify epilepsy cases and initiate simple treatment protocols has shown promise in addressing the shortage of specialized medical professionals in developing countries. Advocacy and private foundations focus on educating healthcare providers, increasing public awareness, improving drug availability, and developing cost-effective </span>epilepsy surgery programs. However, challenges remain, including the need for country-specific assessments and the development of comprehensive epilepsy care models that consider the heterogeneity of the disorder and its impact on patients, families, and communities.</span></span></div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101199"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of cerebral palsy in low- and middle-income countries 低收入和中等收入国家脑瘫的管理

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101202

Edward Kija , Tracy Tushabe Namata , Robert Sebunya

{"title":"Management of cerebral palsy in low- and middle-income countries","authors":"Edward Kija , Tracy Tushabe Namata , Robert Sebunya","doi":"10.1016/j.spen.2025.101202","DOIUrl":"10.1016/j.spen.2025.101202","url":null,"abstract":"<div><div><span>Cerebral Palsy<span><span> (CP) is the most common cause of childhood disability globally with a higher prevalence in low and middle-income countries (LMIC). Hypoxic-ischemic encephalopathy (HIE) caused by preventable perinatal insults is still the leading cause of CP in LMIC. Spastic quadriplegic CP is the most common subtype in LMIC accounting for 70-80 % of cases. Lack of awareness compounded by stigma delays initiation of intervention leading to a poorer outcome and reduced quality of. The comprehensive management of children with CP requires an interdisciplinary team of experts. Such expertise is often lacking in LMIC. When available, its distribution is largely skewed towards urban areas. Although there is a higher burden of comorbidities, screening and diagnosis of the related conditions are inadequate, leading to poor management. Surgical interventions such as intrathecal </span>baclofen<span>, selective dorsal rhizotomy for spasticity and </span></span></span>gastrostomy<span> tube insertion for children with severe gastroesophageal reflux disease<span> is often limited by costs and shortage number of trained personnel. Evidence-based local guidelines are essential for managing children with CP, guiding government investments to improve the quality of life for entire families. Concerted efforts in healthcare system reforms, policymakers, community engagement and awareness to enhance early diagnosis and appropriate referral, management through locally generated evidence-based interventions are required in LMIC to improve care among of children with CP and their families.</span></span></div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101202"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Etiology and diagnosis of cerebral palsy in resource-limited regions 资源有限地区脑瘫的病因和诊断

IF 2.1 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-10-01 DOI: 10.1016/j.spen.2025.101226

Pratibha Singhi , Arushi Gahlot Saini

{"title":"Etiology and diagnosis of cerebral palsy in resource-limited regions","authors":"Pratibha Singhi , Arushi Gahlot Saini","doi":"10.1016/j.spen.2025.101226","DOIUrl":"10.1016/j.spen.2025.101226","url":null,"abstract":"<div><div>The prevalence of cerebral palsy (CP) is greater in resource limited countries than in higher income countries for several reasons. The etiology and risk factors for cerebral palsy are multifactorial, including perinatal, vascular, infectious, and genetic factors with significant regional variations. Whereas advancements in neonatal care and early intervention have improved outcomes in high-income countries, the burden of CP remains disproportionately high in resource-limited regions due to delayed diagnosis, inadequate access to specialized healthcare, and socioeconomic constraints. Early diagnosis of CP is crucial for timely intervention, which can significantly improve motor and cognitive outcomes. In low-resource settings, limited availability of trained healthcare professionals, lack of standardized screening tools, and inadequate neonatal follow-up programs can hinder early identification. Additionally, social and cultural norms can contribute to delayed medical attention, further exacerbating disability in affected children.</div><div>This article explores the etiology and diagnostic challenges of CP in resource-limited regions, emphasizing the unique risk factors and diagnostic challenges prevalent in these settings. Potential low-cost solutions for early diagnosis and intervention, including the use of simple clinical assessment tools, mobile health technology, and community-based rehabilitation strategies are also discussed. Addressing these challenges through cost-effective, scalable and sustainable interventions can improve outcomes for children with CP, reducing the long-term economic and social burden on families and healthcare systems.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"55 ","pages":"Article 101226"},"PeriodicalIF":2.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

AIDS virus 艾滋病病毒

IF 2.4 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101205

Charles K. Hammond , Perpetual Kanzie , Charles Martyn-Dickens , Edward Ebo Ocran

{"title":"AIDS virus","authors":"Charles K. Hammond , Perpetual Kanzie , Charles Martyn-Dickens , Edward Ebo Ocran","doi":"10.1016/j.spen.2025.101205","DOIUrl":"10.1016/j.spen.2025.101205","url":null,"abstract":"<div><div>HIV affects both the central and peripheral nervous systems, resulting in a wide range of neurological complications due to direct viral effects, chronic inflammation, opportunistic infections, and adverse effects of antiretroviral therapy (ART), collectively referred to as neuroAIDS. In children, the underdeveloped blood-brain barrier heightens the vulnerability of the brain to neuroAIDS, impacting cognitive and motor development. Even HIV-exposed, uninfected children exhibit neurodevelopmental delays.</div><div>Chronic infection leads to a sustained viral presence in the cerebrospinal fluid, resulting in neuroinflammation. HIV encephalopathy (HIVE) remains a major concern, causing developmental regression, cognitive impairment, and motor dysfunction. Although the prevalence of HIVE has declined with the advent of combination antiretroviral therapy, rates remain high in low-resource settings.</div><div>Opportunistic infections such as tuberculous meningitis, viral encephalitis, and fungal infections are prevalent among children with HIV-AIDS. Children with HIV are also at risk for cerebrovascular diseases, neurocognitive impairments, and neuropsychiatric conditions such as mood disorders and high-risk behaviors. Epilepsy and peripheral neuropathy are more common in children with HIV, with ART regimens sometimes contributing to neuropathy.</div><div>Early ART initiation remains crucial in improving neurodevelopmental outcomes. Careful drug selection and adequate treatment of opportunistic infections before ART initiation are important to prevent drug-drug interactions and immune reconstitution inflammatory syndrome, respectively. While treatment progress has improved neurological outcomes, disparities in access to healthcare continue to impact children in resource-limited settings.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"54 ","pages":"Article 101205"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Congenital toxoplasmosis 先天性弓形体病

IF 2.4 4区医学

Seminars in Pediatric Neurology Pub Date : 2025-07-01 DOI: 10.1016/j.spen.2025.101203

Alfredo Cerisola , María Francia , Juan Pablo Gesuele

{"title":"Congenital toxoplasmosis","authors":"Alfredo Cerisola , María Francia , Juan Pablo Gesuele","doi":"10.1016/j.spen.2025.101203","DOIUrl":"10.1016/j.spen.2025.101203","url":null,"abstract":"<div><div><em>Toxoplasma gondii</em>, one of the most prevalent zoonotic parasites globally, may be transmitted to the fetus if a primary infection occurs during pregnancy. The earlier the gestational period, the lower the probability of transmission, but if it occurs, the higher the probability of pregnancy loss or severe fetal neurological or ocular damage. Primary prevention measures to pregnant women include avoiding eating or handling raw or undercooked meat, washing hands thoroughly after gardening, avoid handling contaminated soil or water or come in contact with cat feces. The infected fetus may exhibit a broad spectrum of clinical manifestations, ranging from death in utero, stillbirths, symptomatic neonatal forms with systemic involvement and/or severe and irreversible ocular or neurological damage, to asymptomatic forms. Neurological manifestations include macro- or microcephaly, hydrocephalus, intracranial calcifications, abnormal muscle tone, cerebral palsy, global developmental delay, sensorineural hearing loss, and epilepsy. The whole clinical picture of each patient with congenital toxoplasmosis depends on a variable combination of different factors including: (a) gestational age at which the maternal infection has occurred and transmitted to the fetus, (b) disease detection: were pregnant women systematically screened during pregnancy, and if so, the frequency of serological tests, (c) if infected pregnant women and neonates were treated and timing and doses of the anti-<em>T. gondii</em> drugs used, (d) differences in the parasite load and in virulence of the genotype of the implicated <em>T gondii</em> strains, (e) individual maternal immune response, and f) presence of specific clinical features such as ventriculomegaly, multiple calcifications and retinochoroiditis.</div></div>","PeriodicalId":49284,"journal":{"name":"Seminars in Pediatric Neurology","volume":"54 ","pages":"Article 101203"},"PeriodicalIF":2.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0