Annals of the Child Neurology Society最新文献

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The parieto-occipital groove is a fissure, not a sulcus: Relevance to prenatal ultrasonographic imaging 顶枕沟是一个裂隙,而不是沟:与产前超声成像的关系
Annals of the Child Neurology Society Pub Date : 2023-10-26 DOI: 10.1002/cns3.20044
Harvey B. Sarnat, Ian Suchet
{"title":"The parieto-occipital groove is a fissure, not a sulcus: Relevance to prenatal ultrasonographic imaging","authors":"Harvey B. Sarnat,&nbsp;Ian Suchet","doi":"10.1002/cns3.20044","DOIUrl":"10.1002/cns3.20044","url":null,"abstract":"<p>Both fissures and sulci are permanent indentations, grooves, or foldings of the cerebral cortex. They are distinguished in large part by timing: fissures form in the first half of gestation and sulci in the second half. A notable exception is the <i>sulcus limitans</i>, a shallow longitudinal groove in the horizontal axis of the embryonic neural tube that extends throughout the spinal cord and brainstem to the mesencephalon and rostrally into the wall of the third ventricle. It is most evident in the lateral wall of the fetal spinal central canal, cerebral aqueduct, and third ventricle and demarcates alar and basal plates of primordial gray matter to denote the separation of dorsal and ventral horns in the spinal cord and sensory and motor cranial nuclei in the brainstem. Other small embryonic grooves, such as the one that demarcates the lateral from the medial ganglionic eminences, also were called <i>sulci</i>, having been named from antiquity to the late 19th century. All sulci in the embryonic brain are transitory, unlike the permanent sulci of the cerebral cortex or interfolial sulci of the cerebellar cortex.</p><p>The earliest true fissure to form is the <i>interhemispheric fissure</i>, secondary to cleavage of the prosencephalon at four to five weeks' gestational age (GA); the last fissure to form is the <i>lateral cerebral (sylvian) fissure</i> because of bending of the <i>telencephalic flexure</i>, the primitive telencephalic hemisphere in which the caudal end of the early telencephalon becomes not the occipital pole but rather the rostral pole of the temporal lobe.<span><sup>1</sup></span> Examples of intermediately timed fissures are the hippocampal and calcarine. Another distinction is that fissures result mainly from external mechanical or physical forces, whereas sulci principally form because of intrinsic growth.<span><sup>1</sup></span> Convolutions are needed so that the cerebrum at term and the fetal head at birth are not so large as to pose an intrapartum traumatic risk to both fetus and mother, which also would be conducive to survival of the species. Small mammals, such as rodents and lagomorphs, have smooth nonconvoluted brains even at maturity because the number of cortical neurons is not enough to require folding; an interhemispheric fissure forms in mice, rats, squirrels, and rabbits, but a lateral cerebral fissure does not develop.<span><sup>2</sup></span> In humans and other large mammals, the sequence of gyral and sulcal formation follows a time-linked predictable program leading to precise gyral identification at each gestational age of the late second and third trimesters and in the mature brain.<span><sup>3</sup></span> Cortical sulcation not only enables a larger surface area without a concomitant increase in cerebral volume but also provides for intracerebral connectivity conducive to more complex synaptic circuitry.<span><sup>4</sup></span></p><p>The development of fissures and sulci often is altered in many m","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 4","pages":"269-272"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134908974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atonic-BECTS: An unusual presentation of self-limited epilepsy in childhood 失张力性癫痫:儿童自限性癫痫的不寻常表现
Annals of the Child Neurology Society Pub Date : 2023-10-26 DOI: 10.1002/cns3.20043
Varun Sampat, Avantika Singh, Hema Patel
{"title":"Atonic-BECTS: An unusual presentation of self-limited epilepsy in childhood","authors":"Varun Sampat,&nbsp;Avantika Singh,&nbsp;Hema Patel","doi":"10.1002/cns3.20043","DOIUrl":"10.1002/cns3.20043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We describe an unusual patient with self-limited epilepsy in childhood to aid in the accurate diagnosis and timely treatment of an atonic variant of self-limited focal epilepsy of childhood with centrotemporal spikes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the medical records documenting the clinical presentation, diagnostic evaluation, and treatment. We also reviewed the relevant video electroencephalograms (EEGs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient Description</h3>\u0000 \u0000 <p>This 3-year-old girl with self-limited focal epilepsy of childhood (formerly called benign rolandic epilepsy) began having recurrent falls. Multiple clinical seizures were recorded on video EEG. The video documented generalized loss of tone resulting in falls, while the ictal EEG revealed one-second paroxysms of 4 Hz spike-slow-wave discharges in the left centrotemporal region, followed by a brief generalized electrodecrement for 400 milliseconds. These findings support the diagnosis of an atypical variant of benign epilepsy with centrotemporal spikes (BECTS), known as atonic-BECTS. Valproic acid was maximized. On follow-up, the patient was seizure-free with a normal EEG and normal development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Few prior publications describe atonic-BECTS. We present a child with atonic-BECTS whose ictal video EEG confirms atonic seizures. While atonic seizures typically occur with generalized epilepsies, our report highlights that they can present as an atypical manifestation of self-limited focal epilepsy in childhood.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 4","pages":"320-323"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134909582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Congenital myasthenic syndrome type 2C in a neonate: Redefining the phenotype of CHRNB1-related myasthenic syndromes 新生儿先天性肌无力综合征 2C 型:重新定义CHRNB1相关肌无力综合征的表型
Annals of the Child Neurology Society Pub Date : 2023-10-26 DOI: 10.1002/cns3.20045
Zurisadai Gonzalez, Simon Kayyal, Neda Zadeh, Julian Thomas
{"title":"Congenital myasthenic syndrome type 2C in a neonate: Redefining the phenotype of CHRNB1-related myasthenic syndromes","authors":"Zurisadai Gonzalez,&nbsp;Simon Kayyal,&nbsp;Neda Zadeh,&nbsp;Julian Thomas","doi":"10.1002/cns3.20045","DOIUrl":"10.1002/cns3.20045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We present a neonate with generalized weakness due to autosomal recessive congenital myasthenic syndrome type 2C (CMS2C) resulting from a compound heterozygous mutation in the <i>CHRNB1</i> gene.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patient description</h3>\u0000 \u0000 <p>Our patient was determined by multiple methodologies to have a diagnosis of CMS2C (OMIM #616314). Whole-genome sequencing revealed two distinct variants in the <i>CHRNB1</i> gene (OMIM *100710): a maternally inherited 2 kb pathogenic microdeletion on chromosome 17p13.1 and a paternally inherited intronic deletion (c.1218-9_1218-7) that was reported by the laboratory as a variant of unknown significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CMS2C is a rare autosomal recessive genetic condition associated with early-onset muscle weakness. Our patient had a paternally inherited deletion in <i>CHRNB1</i> (c.1218-9_1218-7) that was initially described as a variant of unknown significance. We suggest this finding is “likely pathogenic,” as this aberration has not been commonly described. He also had a partial deletion of <i>CHRNB1</i> in the maternally inherited allele, which provides further evidence that partial gene deletions may be a more common molecular mechanism than previously known for this condition. The combination of the clinical presentation and electrophysiologic data allowed us to understand the molecular findings and ultimately diagnose CMS2C in our patient.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 4","pages":"324-326"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134909374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Muscle channelopathies: A review 肌肉通道病变:综述
Annals of the Child Neurology Society Pub Date : 2023-10-10 DOI: 10.1002/cns3.20040
Bridget R. McGowan, Abigail N. Schwaede, Lenika De Simone, Vamshi K. Rao
{"title":"Muscle channelopathies: A review","authors":"Bridget R. McGowan,&nbsp;Abigail N. Schwaede,&nbsp;Lenika De Simone,&nbsp;Vamshi K. Rao","doi":"10.1002/cns3.20040","DOIUrl":"10.1002/cns3.20040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Muscle channelopathies are a rare and heterogeneous group of disorders that can be clinically challenging and functionally disabling. These disorders can present in both adult and pediatric age groups. These disorders have been known since the turn of the 20th century, with a steady evolution in terms of understanding the pathophysiology, phenotype, diagnostic, and treatment modalities over the last three decades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present a comprehensive review of muscle channelopathies that includes nondystrophic myotonias and periodic paralyses. The disorders in this review have been classified based on the presence or absence of myotonia on either the clinical exam or on electrophysiological testing. The historical background, genetics, pathophysiology, phenotypic presentations, and treatment modalities of each disorder reveal similarities as well as specific nuances in the disease phenotypes. Neurophysiologic testing shows differences in responses on routine and exercise testing and can narrow the differential within subsets of nondystrophic myotonias and periodic paralyses. The advances in genetics further aid in specifying which of the putative channels are at fault. Management can then be guided by knowledge of the causative gene and involves either avoidance of triggers or channel-based therapeutics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Muscle channelopathies are rare, but a high index of suspicion along with a knowledge of the phenotype will help guide neurophysiological and genetic testing. A muscle channelopathy diagnosis, subsequently, can assist in avoiding triggers and directing treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 4","pages":"273-288"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
“Fifth-day fits” revisited: A literature review of benign idiopathic neonatal seizures and comparison with KCNQ2- and KCNQ3-associated benign familial epilepsy syndromes 重新审视“第五天发作”:良性特发性新生儿癫痫的文献综述及其与KCNQ2和KCNQ3相关的良性家族性癫痫综合征的比较
Annals of the Child Neurology Society Pub Date : 2023-09-12 DOI: 10.1002/cns3.20039
Varun Kannan, Aishwarya V. Pareek, Abhijit R. Das, Charles T. Gay, James J. Riviello Jr.
{"title":"“Fifth-day fits” revisited: A literature review of benign idiopathic neonatal seizures and comparison with KCNQ2- and KCNQ3-associated benign familial epilepsy syndromes","authors":"Varun Kannan,&nbsp;Aishwarya V. Pareek,&nbsp;Abhijit R. Das,&nbsp;Charles T. Gay,&nbsp;James J. Riviello Jr.","doi":"10.1002/cns3.20039","DOIUrl":"https://doi.org/10.1002/cns3.20039","url":null,"abstract":"<p>Benign idiopathic neonatal seizures (BINS), colloquially referred to as the “fifth-day fits,” is a clinical neonatal epilepsy syndrome associated with early, spontaneous resolution of seizures and favorable developmental outcome. Although this disease entity was first described over four decades ago, the etiopathogenesis remains unknown, and it is unclear if the syndrome represents a single, cohesive disorder or a common manifestation of various unrelated neonatal neurological disturbances. As such, there are no standardized approaches to diagnostic workup and management. Benign familial neonatal seizures (BFNS) is a well-characterized genetic syndrome associated with <i>KCNQ2</i> and <i>KCNQ3</i> pathogenic variants, which also manifests clinically with self-resolving seizures in the neonatal period. While it remains unclear if there is any shared pathogenesis between these two disorders, the exceedingly similar phenotypic presentations and natural history raise the question of whether consensus management approaches used in genetic BFNS can also be applied to BINS. Here, we present a topical and historical review of BINS and BFNS literature and propose specific treatment recommendations based on extrapolation of limited existing clinical data.</p>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"202-208"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50130899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distribution of hand function by age in individuals with Rett syndrome Rett综合征患者手功能的年龄分布
Annals of the Child Neurology Society Pub Date : 2023-09-12 DOI: 10.1002/cns3.20038
Jeffrey L. Neul, Tim A. Benke, Eric D. Marsh, Jane B. Lane, David N. Lieberman, Steven A. Skinner, Daniel G. Glaze, Bernhard Suter, Peter T. Heydemann, Arthur A. Beisang, Shannon M. Standridge, Robin C. C. Ryther, Richard H. Haas, Lloyd J. Edwards, Amitha Ananth, Alan K. Percy
{"title":"Distribution of hand function by age in individuals with Rett syndrome","authors":"Jeffrey L. Neul,&nbsp;Tim A. Benke,&nbsp;Eric D. Marsh,&nbsp;Jane B. Lane,&nbsp;David N. Lieberman,&nbsp;Steven A. Skinner,&nbsp;Daniel G. Glaze,&nbsp;Bernhard Suter,&nbsp;Peter T. Heydemann,&nbsp;Arthur A. Beisang,&nbsp;Shannon M. Standridge,&nbsp;Robin C. C. Ryther,&nbsp;Richard H. Haas,&nbsp;Lloyd J. Edwards,&nbsp;Amitha Ananth,&nbsp;Alan K. Percy","doi":"10.1002/cns3.20038","DOIUrl":"https://doi.org/10.1002/cns3.20038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to determine the longitudinal distribution of hand function skills in individuals with classic Rett syndrome (RTT), an X-linked dominant neurodevelopmental disorder, and correlate with <i>MECP2</i> variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a longitudinal study of 946 girls and young women with typical RTT seen between 2006 and 2021 in the US Natural History Study (NHS) featuring a structured clinical evaluation to assess the level of hand function skills. The specific focus of this study was to assess longitudinal variation of hand skills from age 2 through age 18 years in relation to specific <i>MECP2</i> variant groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following the initial regression period, hand function continues to decline across the age spectrum in individuals with RTT. Specific differences are noted with steeper declines in hand function among those with milder variants (Group A: R133C, R294X, R306C, and C-terminal truncations) compared with groups composed of individuals with more severe variants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These temporal variations in hand use represent specific considerations that could influence the design of clinical trials that test therapies aiming to ameliorate specific functional limitations in individuals with RTT. Furthermore, the distinct impact of specific <i>MECP2</i> variants on clinical severity, especially related to hand use, should be considered in such interventional trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"228-238"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50130898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A three-year-old girl with subacute encephalopathy, myoclonus, and regression 一名患有亚急性脑病、肌阵挛和退行性变的三岁女孩
Annals of the Child Neurology Society Pub Date : 2023-08-26 DOI: 10.1002/cns3.20037
Shermila Pia, Ryan Carrier, David Bearden
{"title":"A three-year-old girl with subacute encephalopathy, myoclonus, and regression","authors":"Shermila Pia,&nbsp;Ryan Carrier,&nbsp;David Bearden","doi":"10.1002/cns3.20037","DOIUrl":"10.1002/cns3.20037","url":null,"abstract":"<p>This previously healthy three-year-old girl presented with two months of developmental regression, progressive fatigue, and jerking movements in the setting of failure to thrive and macrocytic anemia. She previously spoke in full sentences but began using only one-to-two-word phrases. She would collapse after walking short distances or going up stairs. Examination revealed lethargy, irritability, myoclonic jerks of trunk and limbs, diffuse hyperreflexia with clonus, and wide-based unsteady gait. Labs showed vitamin B<sub>12</sub> &lt; 200 pg/mL (lowest reportable), methylmalonic acid 14 μmol/L (ref. 0.0–0.4 μmol/L), homocysteine 224 μmol/L (ref. 0–15 μmol/L), and mean corpuscular volume 110 (ref. 76–87 fL). Magnetic resonance imaging revealed no brain abnormalities, but spinal imaging showed extensive T2 hyperintensity of the dorsal columns (Figure 1). She was diagnosed with spinal cord degeneration secondary to vitamin B<sub>12</sub> deficiency. Parenteral B<sub>12</sub> supplementation led to rapid clinical improvement. However, without continued parenteral supplementation, she had declining B<sub>12</sub> levels and is undergoing further investigation for a malabsorptive or genetic-metabolic etiology.</p><p>Cobalamin, or vitamin B<sub>12</sub>, is important in myelin metabolism and brain development. Pediatric B<sub>12</sub> deficiency is most commonly due to nutritional insufficiency, malabsorption, or more rarely, genetic-metabolic syndromes.<span><sup>1-3</sup></span> Infants and toddlers often present with developmental regression, lethargy, hypotonia, and abnormal movements such as myoclonus or chorea.<span><sup>1, 4</sup></span> Spinal cord degeneration secondary to B<sub>12</sub> deficiency is exceedingly rare in children in developed countries.<span><sup>1, 2</sup></span> In terms of treatment, oral B<sub>12</sub> replacement is sufficient in cases of nutritional deficiency. Malabsorptive or genetic-metabolic etiologies, on the other hand, are likely to require ongoing parenteral supplementation.<span><sup>3</sup></span> Prognosis is dependent on age of onset and duration of uncorrected B<sub>12</sub> deficiency.<span><sup>1</sup></span></p><p><b>Shermila Pia</b>: Conceptualization; investigation; writing—original draft. <b>Ryan Carrier</b>: Writing—review &amp; editing. <b>David Bearden</b>: Supervision; writing—review &amp; editing.</p><p>DB is an associate editor for <i>Annals of the Child Neurology Society</i>. SP and RC declare no conflicts of interest.</p>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"254-255"},"PeriodicalIF":0.0,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45389838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Empowering differences: Disability in child neurology training 授权差异:儿童神经学培训中的残疾
Annals of the Child Neurology Society Pub Date : 2023-08-16 DOI: 10.1002/cns3.20036
Young-Min Kim, Diana M. Cejas
{"title":"Empowering differences: Disability in child neurology training","authors":"Young-Min Kim,&nbsp;Diana M. Cejas","doi":"10.1002/cns3.20036","DOIUrl":"10.1002/cns3.20036","url":null,"abstract":"<p>The article by Roach<span><sup>1</sup></span> describes diversity implications in child neurology training, calling for initiatives toward consensus-building and change. In this letter, we call for an initiative to empower disabled physicians and to pursue a workforce that is neurodiverse.</p><p>Schor has underscored the value of developing a workforce that reflects those we serve.<span><sup>2</sup></span> A child neurology workforce, then, should include disabled physicians, including those who identify as neurodivergent with insight regarding neurological differences that compose the human spectrum.</p><p>In the United States, disabled persons comprise nearly a quarter of adults, but only 3.1% of practicing physicians report having a disability.<span><sup>3</sup></span> This may be an underestimate because disclosure comes with risk. Myriad obstacles prevent disabled physicians from disclosing their disability, including cultural expectations, disability stigma, and penalties that come with disclosure. This leads many to hide their disability and discourages disabled students from pursuing medical careers altogether. Likewise, neurodivergent traits are seen generally as problems in medical training despite increasing literature regarding disabled medical trainees and autistic students in higher education.<span><sup>4, 5</sup></span> While affirmative practices may accommodate marginalized racial, gender, ethnic, and socioeconomic identities, neurodivergent traits may be seen as simply disqualifying. Neurodivergent individuals may not disclose their diagnosis during training and may believe that conforming—camouflaging or “masking” their traits and ignoring their needs—is the only path forward.<span><sup>6</sup></span></p><p>When our culture and our health care and economic systems view disabled and neurodivergent persons via a lens of alterity—<i>le regard médical</i>, medicalization of behavioral traits, empirical reductionism, and valuation of persons by their economic productivity—disabled physicians meet an unmet need. Disabled physicians are not token individuals but empowered individuals who embody belonging in an equitable society. They teach us to adapt, to consider lived experience, intersectionality, and identity, which are integral to consensus-building, shared decision-making, and goal-directed care. When physicians and patients share common identities, our partnerships can be strengthened, trust engendered, and outcomes improved.</p><p>The fact may be that we have always had disabled and neurodivergent physicians among us. What we may need above all is the courage to ask ourselves whether recognizing—and empowering—our differences would better reflect the needs of our patients, making medicine good and integral to our shared humanity. If we as a professional community are pursuing equity and justice rather than token diversity and inclusion, we need to raise up disabled physicians. What must change in our system of training and ","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"256-257"},"PeriodicalIF":0.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41542451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Asking impertinent questions: The art of manuscript peer review 提出无礼的问题:手稿同行评审的艺术
Annals of the Child Neurology Society Pub Date : 2023-07-25 DOI: 10.1002/cns3.20034
E. Steve Roach
{"title":"Asking impertinent questions: The art of manuscript peer review","authors":"E. Steve Roach","doi":"10.1002/cns3.20034","DOIUrl":"10.1002/cns3.20034","url":null,"abstract":"<p>Prepublication peer review of scientific manuscripts is used by most legitimate scientific publications. Skillful peer reviews represent a valuable contribution to the field by improving the quality of scientific research communication and promoting scientific integrity.</p><p>Peer review of scientific manuscripts was introduced in 1733 by the Royal Society of Edinburgh. In 1752, a committee of the Royal Society of London began prepublication reviews for the society's <i>Philosophical Transactions</i>.<span><sup>1</sup></span> In 1893, the <i>British Medical Journal</i> began using outside referees for noneditorial articles.<span><sup>2</sup></span> However, prepublication peer review of medical and scientific manuscripts did not become standard until the mid-1900s, led by the introduction of manuscript review by <i>JAMA</i> and <i>Science</i> in the 1940s and <i>Lancet</i> in 1976.<span><sup>2</sup></span> The peer review process was likely facilitated by the advent of photocopy technology.<span><sup>3</sup></span></p><p>The overlapping goals of peer review are to provide editors with an assessment of the veracity and potential significance of the submission and to help the author improve the quality of the manuscript. However, there are sometimes benefits to a reviewer as well, such as improved manuscript preparation skills, exposure to new concepts and ideas, and opportunities for improved professional standing.</p><p>A number of studies have analyzed the effectiveness of manuscript peer review, the potential effects of reviewer bias, and the authors' satisfaction with the review process.<span><sup>4-7</sup></span> Despite the acknowledged importance of manuscript peer review, information about how to do it effectively is scant, and formal training in manuscript reviewing is usually limited. There are many different ways to complete a manuscript review, but what follows is a primer on effective manuscript peer review by an editor with years of reviewing and editing experience.</p><p>Does the manuscript pass the “smell test”? As a reviewer, you are the content expert, and editors will appreciate your placing a study into context. Are earlier publications being ignored or trivialized? Well-crafted manuscripts offer a clear explanation of their purpose, ideally in the introduction. If the reviewer struggles to grasp the manuscript's importance, so will the readers.</p><p>Rare is not the same thing as novel. Manuscripts occasionally have important implications that are not recognized by the authors. More often, the authors suggest novelty when little exists. Not all novelty is equally meaningful. I am usually unimpressed with “geographic” manuscripts (“we describe the first patient with West Nile encephalitis in all of Wyoming”), “making people aware” manuscripts (describing something that is uncommon but already well-known), “masquerading as” manuscripts, incremental data reports (adding a few more patients to last year's published summary), a","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"176-179"},"PeriodicalIF":0.0,"publicationDate":"2023-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45018501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Longitudinal imaging in Kleefstra syndrome—Brief report and literature review 克莱夫斯特拉综合征的纵向成像-简要报告和文献复习
Annals of the Child Neurology Society Pub Date : 2023-07-05 DOI: 10.1002/cns3.20032
Giovanni Castellucci, Csaba Juhasz, Aimee F. Luat
{"title":"Longitudinal imaging in Kleefstra syndrome—Brief report and literature review","authors":"Giovanni Castellucci,&nbsp;Csaba Juhasz,&nbsp;Aimee F. Luat","doi":"10.1002/cns3.20032","DOIUrl":"10.1002/cns3.20032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kleefstra syndrome (KS) is a rare genetic condition affecting the euchromatic histone methyltransferase 1 (<i>EHMT1</i>) gene, typically presenting with developmental delay, generalized hypotonia, distinctive facial dysmorphisms, and neuropsychiatric anomalies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We collected longitudinal magnetic resonance imaging (MRI) data of a child with KS and cerebrospinal fluid (CSF) dissection over 16 years and reviewed the literature focusing on articles reporting MRI findings in KS based on a PubMed search.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An 18-year-old female with KS presented with developmental delay at age 18 months and seizures at age 10 years. At age 23 months, MRI showed ventriculomegaly. Follow-up MRI nine years later showed CSF dissection from the right lateral ventricle, which progressed similarly in the contralateral side 3 years later and stabilized over time. To date, only 20 articles report MRI findings from 49 patients with KS. The brain imaging findings range from normal (about 25%) to various abnormalities, including ventriculomegaly, white matter signal abnormalities, and dysmorphic corpus callosum and brainstem structures. CSF dissection was not found in any cases with white matter or other abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CSF dissection may be a rare neuroimaging finding of KS. Its etiology is unclear, but we speculate that epigenetic mutations could indirectly affect the development and integrity of ependymal cell lining along the ventricles. Alternatively, the long-standing hydrocephalus may have caused the development of pseudodiverticula and subsequent CSF dissection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72232,"journal":{"name":"Annals of the Child Neurology Society","volume":"1 3","pages":"244-249"},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cns3.20032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48894890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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