Channelopathies in pediatric neurology

Oxcarbazepine use in paroxysmal kinesigenic dyskinesia: report on four patients

The paroxysmal dyskinesias are a heterogeneous group of movement disorders. They are distinguished from one another by the mechanism through which abnormal movements are induced. Paroxysmal kinesigenic dyskinesia is the most common subtype, consisting of involuntary dyskinesias induced by purposeful movements. It typically responds favorably to anticonvulsants. This retrospective review describes four unrelated children and adolescents with idiopathic paroxysmal kinesigenic dyskinesia who were treated with oxcarbazepine. Each patient achieved complete resolution of signs with low-dose oxcarbazepine monotherapy.

Advances in the pathophysiology of developmental epilepsies

Pediatric epilepsies display unique characteristics that differ significantly from epilepsy in adults. The immature brain exhibits a decreased seizure threshold and an age-specific response to seizure-induced brain injury. Many idiopathic epilepsy syndromes and symptomatic epilepsies commonly present during childhood. This review highlights recent advances in the pathophysiology of developmental epilepsies. Cortical development involves maturational regulation of multiple cellular and molecular processes, such as neurogenesis, neuronal migration, synaptogenesis, and expression of neurotransmitter receptors and ion channels. These normal developmental changes of the immature brain also contribute to the increased risk for seizures and unique responses to seizure-induced brain injury in pediatric epilepsies. Recent technological advances, especially in genetics and imaging, have yielded exciting discoveries about the pathophysiology of specific pediatric epilepsy syndromes, such as the emergence of channelopathies as the cause of many idiopathic epilepsies and identification of malformations of cortical development as a major source of symptomatic epilepsies in children.