Results of a National Delphi consensus on the outpatient management of pediatric psychogenic nonepileptic seizures in the United States.

Background And Objectives: The purpose of this study was to develop national consensus based on expert opinion on the optimal outpatient care model of pediatric psychogenic nonepileptic seizures (PNES).

Methods: A core working group (CWG) within the PNES special interest group of the Pediatric Epilepsy Research Consortium was established. The CWG developed a rigorous scoring rubric to select experts in pediatric PNES within the United States of America and a three-round Delphi study was conducted to assess consensus on key components of the management of pediatric PNES in the outpatient setting.

Education Research: Educating Child Neurology Residents About Psychogenic Nonepileptic Seizures: A Needs Assessment.

Background And Objectives: Psychogenic nonepileptic seizures (PNES) are difficult to differentiate from epileptic seizures (ES) even for neurologists who see these conditions frequently. This difficulty is due to overlapping semiologic findings between the 2 diagnoses. Previous studies have shown that trainees, including neurology trainees, are not accurate in differentiating PNES from ES.

Status Epilepticus.

Status epilepticus is a neurologic emergency defined as a seizure that lasts longer than 5 minutes. This is the most common neurologic emergency in children, and it is associated with significant morbidity and mortality. Initial seizure management focuses on stabilization of the patient, followed by medication to terminate the seizure.

La Crosse Virus Neuroinvasive Disease in Children: A Contemporary Analysis of Clinical/Neurobehavioral Outcomes and Predictors of Disease Severity.

Background: La Crosse virus (LACV) is the most common neuroinvasive arboviral infection in children in the United States. However, data regarding predictors of disease severity and neurologic outcome are limited. Additionally, long-term neurologic and neurobehavioral outcomes remain relatively sparse.

Creating a New Set of Milestones for the Clinical Neurophysiology Fellowship.

Introduction: The Accreditation Council for Graduate Medical Education and the American Board of Psychiatry and Neurology first developed milestones for the clinical neurophysiology (CNP) fellowship in 2015. The milestones provide a comprehensive evaluation of the fellow's development based on six domains of competency. Here, we describe the development of a new set of milestones for CNP fellowship with level 1 as the incoming level, level 4 as the goal for graduation, and level 5 as the aspirational level that may not be achieved.

Brief Report: Psychogenic Nonepileptic Events in Pediatric Patients with Autism or Intellectual Disability.

This is a retrospective case series of pediatric patients referred to the psychogenic nonepileptic events clinic (PNEE) who had comorbid diagnoses of autism spectrum disorder (ASD) or intellectual disability (ID). We describe 15 patients, nine with ASD and six with ID who had a telephone visit follow-up at 12 months. There were higher rates of male gender (40%) and comorbid epilepsy (53%) compared to the larger PNEE cohort.

Validating Coding for the Identification of Pediatric Treatment Resistant Epilepsy Patients.

The International Classification of Diseases (ICD) system includes sub codes to indicate that an individual with epilepsy is treatment resistant. These codes would be a valuable tool to identify individuals for quality improvement and population health, as well as for recruitment into clinical trials. However, the accuracy of these codes is unclear.

Long-term Risks of Recurrent Febrile Seizures.

Investigators from Denmark at Aarhus University studied the long-term risk of epilepsy, psychiatric disorders, and mortality among children with recurrent febrile seizures.

Safety and Efficacy of Supratherapeutic Doses of Clobazam.

Clobazam is a commonly used long-acting benzodiazepine approved by the US Food and Drug Administration (FDA) to treat seizures associated with Lennox Gastaut syndrome. The FDA approved maximum dosage of clobazam is 1 mg/kg/d or a total of 40 mg a day. Many providers exceed this dosage but there is limited data on the safety, tolerability, and efficacy of supratherapeutic doses.

Inadequate Regulation Contributes to Mislabeled Online Cannabidiol Products.

Researchers from the University of Pennsylvania, Veterans Affairs San Diego, RTI international, Americans for Safe Access, Palo Alto University and Johns Hopkins University analyzed the content of 84 cannabidiol (CBD) products purchased on the internet and compared the results to their advertised concentrations.

Opinion and Special Articles: Neurology education at US osteopathic medical schools.

Osteopathic medical schools have a longstanding tradition of training primary care physicians (PCP). Neurologic symptoms are common in the PCP's office and there is an undersupply of neurologists in the United States. It is therefore crucial for osteopathic medical students to have a strong foundation in clinical neurology.

Fluorinated acid amplifiers for EUV lithography.

Five new compounds were synthesized for use as acid amplifiers in EUV (13.5 nm) photoresists. Four compounds act as acid amplifiers and decompose by autocatalytic kinetics to generate fluorinated sulfonic acids, essential for the simultaneous improvement of resolution, sensitivity, and line edge roughness (LER) in EUV photoresists.

Preparation, separation, and characterization of ruthenium(II) thiocyanate linkage isomers.

The reaction of [(p-cym)Ru(bpy)Cl](+) (p-cym = eta(6)-p-cymene; bpy = 2,2'-bipyridine) with SCN(-) gives a mixture of the linkage isomers [(p-cym)Ru(bpy)(SCN)](+) and [(p-cym)Ru(bpy)(NCS)](+). The linkage isomers were efficiently separated by column chromatography on Hg(NO3)2-coated Al2O3. Both isomers were fully characterized by elemental analysis, (1)H NMR and IR spectroscopy, and X-ray crystallography.

Synthesis, characterization, and reactivity of [Ru(bpy)(CH3CN)3(NO2)]PF6, a synthon for [Ru(bpy)(L3)NO2] complexes.

We report a high yield, two-step synthesis of fac-[Ru(bpy)(CH3CN)3NO2]PF6 from the known complex [(p-cym)Ru(bpy)Cl]PF6 (p-cym = eta(6)-p-cymene). [(p-cym)Ru(bpy)NO2]PF6 is prepared by reacting [(p-cymene)Ru(bpy)Cl]PF6 with AgNO3/KNO2 or AgNO2. The 15NO2 analogue is prepared using K15NO2.

Ligand substitution, pH dependent deoxygenation, and linkage isomerization reactions of the 2,2'-bipyridinetetranitroruthenate dianion.

The reaction of the [Ru(bpy)(NO(2))(4)](2-) (bpy = 2,2'-bipyridine) ion in aqueous solutions produces two different nitrosyl complexes, depending on the pH of the solution. At acidic pH, complex cis,cis-Ru(bpy)(NO(2))(2)(ONO)(NO) was isolated. At neutral or basic pH, [Ru(bpy)(NO(2))(4)](2-) reacts to give cis,trans-Ru(bpy)(NO(2))(2)(NO)(OH).