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Extended Glasgow Outcome Scale to Evaluate the Functional Impairment of Patients With Subcortical Band Heterotopia: A Multicentric Cross-sectional Study - 23/03/23

Doi : 10.1016/j.pediatrneurol.2023.01.012 
Irene Toldo, MD, PhD a, ⁎ , Francesco Brunello, MD a, Paola Cavasin, MD a, Margherita Nosadini, MD, PhD a, Stefano Sartori, MD a, Anna Chiara Frigo, MD b, Roberto Mai, MD c, Veronica Pelliccia, MD c, Maria Margherita Mancardi, MD d, Pasquale Striano, MD d, Marisavina Severino, MD e, Federico Zara, MD f, Romana Rizzi, MD g, Susanna Casellato, MD h, Gabriella Di Rosa, MD i, Mario Mastrangelo, MD j, Alberto Spalice, MD k, Mauro Budetta, MD l, Luca De Palma, MD m, Renzo Guerrini, MD n, Dario Pruna, MD o, Duccio Maria Cordelli, MD p, Vito Sofia, MD q, Amanda Papa, MD r, Valentina Chiesa, MD s, Francesca Ragona, MD t, Pasquale Parisi, MD u, Alfredo D'Aniello, MD v, Pierangelo Veggiotti, MD w, Filippo Dainese, MD x, Lucio Giordano, MD y, Laura Licchetta, MD z, Paolo Tinuper, MD z, Giuseppe D'Orsi, MD aa, Matteo Cassina, MD, PhD ab, Renzo Manara, MD ac
a Child Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy 
b Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy 
c 'Claudio Munari' Centre for Epilepsy Surgery, ASST GOM Niguarda, Milan, Italy 
d Child Neuropsychiatry Unit, Clinical and Surgical Neurosciences Department, IRCCS Istituto Giannina Gaslini, Genova, Italy 
e Pediatric Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy 
f Laboratory of Neurogenetics and Neuroscience, IRCCS Istituto G. Gaslini, Genova, Italy 
g Neurology Unit, Department of Neuro-Motor Diseases, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy 
h Child Neuropsychiatry Unit, University Hospital of Sassari, Sassari, Italy 
i Child Neuropsychiatry Unit, Department of Human Pathology of the Adult and Developmental Age, University Hospital "G. Martino", Messina, Italy 
j Unit of Child Neurology and Psychiatry, Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy 
k Department of Pediatrics, Child Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy 
l Pediatric and Child Neurology Unit, Cava de' Tirreni AOU S. Giovanni di Dio e Ruggiero d'Aragona Hospital, Salerno, Italy 
m Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy 
n Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy 
o Pediatric Neurology and Epileptology Unit, "Brotzu" Hospital, Cagliari, Italy 
p IRCCS Institute of Neurological Sciences of Bologna, UOC Neuropsychiatry of the Pediatric Age, Bologna, Italy 
q Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy 
r Department of Child Neurology and Psychiatry, AOU Maggiore della Carità Novara, Novara, Italy 
s Epilepsy Centre-Child Neuropsychiatry Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy 
t Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy 
u Child Neurology, Faculty of Medicine & Psychology, NESMOS Department, Sapienza University, Rome, Italy 
v IRCCS "NEUROMED", Pozzilli, Italy 
w Pediatric Neurology Unit, V. Buzzi Hospital, University of Milan, Milan, Italy 
x Epilepsy Centre, SS. Giovanni e Paolo Hospital, Venice, Italy 
y Child Neuropsychiatric Division, Spedali Civili, Brescia, Italy 
z Department of Biomedical and Neuromotor Sciences, University of Bologna, Milan, Italy 
aa Epilepsy Centre, Clinic of Nervous System Diseases, Ospedali Riuniti, University of Foggia, Foggia, Italy 
ab Clinical Genetics Unit, Department of Women's and Children's Health, University of Padova, Padova, Italy 
ac Neuroradiology, Department of Neuroscience, University of Padova, Padova, Italy 

∗Communications should be addressed to: Dr. Toldo; Child Neurology and Neurophysiology Unit; Department of Women's and Children's Health; University Hospital of Padua; via Giustiniani, 3; Padova 35128, Italy.Child Neurology and Neurophysiology UnitDepartment of Women's and Children's HealthUniversity Hospital of Paduavia Giustiniani, 3Padova35128Italy

Abstract

Background

Subcortical band heterotopia (SBH) is a rare malformation of the cortical development characterized by a heterotopic band of gray matter between cortex and ventricles. The clinical presentation typically includes intellectual disability and epilepsy.

Purpose

To evaluate if the Extended Glasgow Outcome Scale-pediatric version (EGOS-ped) is a feasible tool for evaluating the functional disability of patients with (SBH).

Method

Cross-sectional multicenter study of a cohort of 49 patients with SBH (female n = 30, 61%), recruited from 23 Italian centers.

Results

Thirty-nine of 49 (80%) cases showed high functional disability at EGOS-ped assessment. In the poor result subgroup (EGOS-ped >3) motor deficit, language impairment, and lower intelligence quotient were more frequent (P < 0.001, P = 0.02, and P = 0.01, respectively); the age at epilepsy onset was remarkably lower (P < 0.001); and the prevalence of epileptic encephalopathy (West syndrome or Lennox-Gastaut-like encephalopathy) was higher (P = 0.04). The thickness and the extension of the heterotopic band were associated with EGOS-ped score (P < 0.01 and P = 0.02). Pachygyria was found exclusively among patients with poor outcome (P < 0.01).

Conclusions

The EGOS-ped proved to be a reliable tool for stratifying the functional disability of patients with SBH. According to this score, patients could be dichotomized: group 1 (80%) is characterized by a poor overall functionality with early epilepsy onset, thick heterotopic band, and pachygyria, whereas group 2 (20%) is characterized by a good overall functionality with later epilepsy onset and thinner heterotopic band.

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Keywords : EGOS-ped, Subcortical band heterotopia, Functional disability, Children, Adults


Plan


 Disclosures: The authors have stated that they had no interests which might be perceived as posing a conflict or bias.
 Funding: No funding resources were used for the study.
 Declarations of interest: None.


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Vol 141

P. 58-64 - avril 2023 Retour au numéro
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