S106 EUROPEAN JOURNAL O F PAEDIATRIC NEUROLOGY
P42 - 2808
Neuroimaging evaluation of first afebrile seizures in pediatric
age group – Qatar experience
A.M. Khair, R. Al Shami, K. Mohamed, K. Ibrahim, M. Elseid, K. Al
Yefei, A. Elsetouhy, H. Kamal. Department of Pediatrics, Hamad
Medical Corporation, Doha, Qatar
Objective: To determine the prevalence of Neuro Imaging ab-
normality in Children (1 month to 14 years) with first afebrile
seizure. To collect evidence sufficient to make a recommenda-
tion for the use of routine neuro-imaging in children with first
episode of non-febrile seizure. Methods: We have reviewed charts
of all children who have presented to the Pediatric Emergency
Centers (PECs) in Qatar with their first afebrile seizure during
2012–2013 years. Labeling and definition of seizure was up to
the international league against epilepsy (ILAE) booklet. From
those we have found that 96 of them underwent neuroimag-
ing either on urgent or non-urgent basis. Patient demographics
and neuroimaging were reviewed in details thereafter. Results:
In our study neuroimaging abnormalities were found in (33%) of
children presented with their first Afberile seizure. Around ¼ of
patients (27%) were below 2 years of age, who have demonstrated
significantly higher percentage of abnormal imaging (59%). This
risk has showed decreased as children get older. In regard to
seizure semiology abnormal results were detected in a higher
rates in focal seizures compared to generalized ones (35% Vs
31%). Also interesting higher rates of having abnormal neu-
roimaging results were noticed in those with who presented
with status epilepticus (58%) as compared to (25%) in patients
with short seizures. Conclusion: Neuro-imaging should be con-
sidered in any and child with first afebrile seizure with those
with underlying risk factors and in area having high prevalence
of NCC, tuberculosis and it is highly recommended in younger
infants and those with focal or prolonged seizures. Change in
medical management depending on neuroimaging finding may
be required in about 6–8% of all case with first afebrile seizures.
P43 - 2841
Development coordination disorder (DCD) and attention deficit
hyperactivity disorder (ADHD) as the initial presentation of
bilateral fronto-parietal polymicrogyria type 2 (BFPP2) secondary
to GPR56 mutation
A. Aeby, P. David, S. Coppens, P. Van Bogaert. Department of
Pediatric Neurology, Erasme Hospital-ULB, Brussels, Belgium
Introduction: Bilateral Fronto-Parietal Polymicrogyria type 1 (BF-
PP1; OMIM 606854) is an autosomic recessive affection usually
linked to GPR56. Clinical (mental retardation, cerebellar signs, se-
vere psychomotor delay and symptomatic generalized epilepsy)
and radiological (bilateral fronto-parietal polymicrogyria with an
anterior to posterior gradient with brainstem and cerebellar hy-
poplasia) signs are specific. Patients with BFPP without cerebellar
or brainstem abnormalities (BFPP2) have a milder phenotype and
are not linked to GPR56 mutation (Piao et al., 2005; Bahi-Buisson
et al., 2010). We report here a patient with specific learning
disorder (Development Coordination Disorder-DCD and attention
deficit hyperactivity disorder-ADHD) that presented the radiolog-
ical characteristics of BFPP2 and harbor a GPR56 mutation. Case
report: 4-year-old boy with a normal psychomotor and speech
development, presenting awkwardness, learning difficulties and
ADHD. Familial and personal history was unremarkable. Neuro-
logical examination was normal. Neuropsychological tests per-
formed at 5.5 years showed DCD (Mouvement assessment Battery
for Children-M-ABC scale −2SD and WPPSI-III: ICV=100, IRP=71,
IVT=71 with severe dysgraphia) and ADHD. EEG was normal. He
received a multidisciplinary rehabilitation and methylphenidate
with an improvement of his learning disabilities even though
he needed special school when he left kindergarten. When he
19s (2015) S1 – S152
was 7, he presented shock-like episodes with absences. Pro-
longed video-EEG showed 2Hz generalized spikes and waves,
atypical absences and tonic seizures. Brain MRI revealed BFPP2.
DNA analysis revealed compound heterozygoty in GPR56, par-
ents where heterozygous for GPR56. Conclusion: This case is,
to our knowledge, the first case of BFPP2 phenotype presenting
initially as a specific learning disorder and harbouring compound
heterozigoty in GPR56.
P44 - 2863
Clinical and radiological factors associated with later occurence
of epilepsy and epileptic encephalopathy after hypoxic ischemic
insult
N.E. Hacıfazlıoğlu, G. Ekici, O. Ünver, D. Türkdoğan. Department of
Pediatric Neurology, University of Marmara, Istanbul,Turkiye
Objective: Epileptic encephalopathy is a devastating type of
epilepsy in early life causing severe cognitive and behavioral
impairments. Epilepsy and epileptic encephalopathies may be
complications of hypoxic ischemic encephalopathy during the
neonatal period. Methods: In this retrospective study 60 patients
who suffered hypoxic ischemic encephalopathy in the neonatal
period; aged 6.75±5.34 (0.30–12.09) years, 28 girls (46.7%) and 32
boys (53.3%) were invastigated to describe clinical and radio-
logical factors associated with later occurence of epilepsy and
epileptic encephalopathy were divided in 3 groups. Group 1:
Patients with epileptic encephalopathy (n: 27 (%45) Group 2: Pa-
tients with epilepsy without encephalopathy (n: 18 (%30). Group
3: Patient without epilepsy and epileptic encephalopathy (n:15
(%25). Groups were compared for prenatal, natal and postnatal
insults, neonatal seizures, cranial USG, electroencephalography
(EEG) in neonatal period and cranial Magnetic Resonance Imagi-
nation (MRI). Results: Gestational ages and birth weights of group
3 were lower then Group 1 and Group 2 (p<0.05), asphyxia grades
of Group 1 were higher then Group 3 (p<0.01). asphyxia grades of
Group 2 were higher then Group 3 (p<0.05). The rate of neona-
tal menengitis and sepsis of Group 1 and 2 were higher then
Group 3 (p<0.05). Cortical impairment in cranial MRI in Group 1
was significantly higher then Group 2 and Group 3 (p<0.05). The
rate of neonatal seizures were higher in all of the patients with
epilepsy and epileptic encephalopathy (Group 1+Group 2) were
significantly higher then Group 3 (p<0.05). Conclusion: Higher
asphyxia grades, neonatal menengitis and sepsis, cortical im-
pairment in cranial MRI, seizures in the neonatal period are high
risk factors for evaluation of epilepsy and epileptic encephalopa-
thy in children suffered from HIE in neonatal period.
P45 - 2870
Perampanel adjunctive in pharmacoresistent epilepsy in
adolescents: Efficacy and tolerability analysis
P.M. Smeyers Durá, G. Aznar Laín. Pediatric Neurology, Department
of Pediatrics, Epilepsy Unit, Hospital Universitario y Politécnico La Fe
and Hospital del Mar, Universitat Autónoma
Objective: To evaluate the efficacy, safety and tolerability of
perampanel as add-on therapy in adolescents with focal onset
seizures aged 12 years and older in a real-life setting. Methods:
We analyse retrospectively the electronic charts of 25 adoles-
cent with refractory epilepsy aged 12–19 years. We collected
data of epilepsy history, pharmacological previous treatment,
neuroimaging studies, comorbid conditions and any previous
reaction to antiepileptic drugs. Results: 12 were males and 13
females. The etiology of epilepsy was unknown in 16% of cases
and symptomatic in 84%. These include isquemic lesions, mal-
formative complex lesions, cortical dysplasia, polymicrogiria and
others. The follow up period was from 12–3 months. 80% of
patients are still on treatment. 20% (5 patients) withdraw, 4 of