Background Ocular Paroxysmal Events (OPEs) can accompany a variety of neurological disorders. Particularly in infants, OPEs often present a great diagnostic challenge for pediatric neurologists and neonatologists. Distinguishing between epileptic and non-epileptic events, or physiological and pathological paroxysmal events can be challenging at this age, since clinical history and physical examination are often limited. Continuous polygraphic video-EEG monitoring can be very helpful in these situations. Methods We provide a comprehensive review of OPEs in newborns and infants. The aim is to improve clinical recognition of OPEs and provide neonatologists and pediatricians with necessary knowledge to guide further management. We used the PubMed database. We reviewed studies focused on all ocular motor paroxysmal events that could occur in neonates and infants. Results Fifty-eight study researches were found and selected on the topic. We summarized and divided these studies into non-epileptic OPEs and epileptic OPEs. Conclusions OPEs can be challenging to diagnose, however, they are important to recognize and manage appropriately due to the variety of associated etiologies that neonatologists and pediatric neurologists need to be aware of, including central nervous system disorders. The distinction between epileptic vs. non-epileptic OPEs often cannot be done on the clinical grounds alone, and polygraphic video-EEG is required for diagnosing epileptic events. For non-epileptic events, further testing can then identify pathological ocular movements. To determine the etiology and prognosis of OPEs, a multimodal approach is required, including full history, thorough clinical exam coupled with ophthalmologic examination, polygraphic video-EEG monitoring, neuroimaging, and a careful follow up plan.

Ocular motor paroxysmal events in neonates and infants: a review of the literature / Falsaperla, Raffaele; Nicola Saporito, Marco Andrea; Pisani, Francesco; Mailo, Janette; Pavone, Piero; Ruggieri, Martino; Suppiej, Agnese; Corsello, Giovanni. - In: PEDIATRIC NEUROLOGY. - ISSN 0887-8994. - 117:(2021), pp. 4-9. [10.1016/j.pediatrneurol.2020.06.001]

Ocular motor paroxysmal events in neonates and infants: a review of the literature

Pisani, Francesco;
2021-01-01

Abstract

Background Ocular Paroxysmal Events (OPEs) can accompany a variety of neurological disorders. Particularly in infants, OPEs often present a great diagnostic challenge for pediatric neurologists and neonatologists. Distinguishing between epileptic and non-epileptic events, or physiological and pathological paroxysmal events can be challenging at this age, since clinical history and physical examination are often limited. Continuous polygraphic video-EEG monitoring can be very helpful in these situations. Methods We provide a comprehensive review of OPEs in newborns and infants. The aim is to improve clinical recognition of OPEs and provide neonatologists and pediatricians with necessary knowledge to guide further management. We used the PubMed database. We reviewed studies focused on all ocular motor paroxysmal events that could occur in neonates and infants. Results Fifty-eight study researches were found and selected on the topic. We summarized and divided these studies into non-epileptic OPEs and epileptic OPEs. Conclusions OPEs can be challenging to diagnose, however, they are important to recognize and manage appropriately due to the variety of associated etiologies that neonatologists and pediatric neurologists need to be aware of, including central nervous system disorders. The distinction between epileptic vs. non-epileptic OPEs often cannot be done on the clinical grounds alone, and polygraphic video-EEG is required for diagnosing epileptic events. For non-epileptic events, further testing can then identify pathological ocular movements. To determine the etiology and prognosis of OPEs, a multimodal approach is required, including full history, thorough clinical exam coupled with ophthalmologic examination, polygraphic video-EEG monitoring, neuroimaging, and a careful follow up plan.
2021
Ocular motor paroxysmal events in neonates and infants: a review of the literature / Falsaperla, Raffaele; Nicola Saporito, Marco Andrea; Pisani, Francesco; Mailo, Janette; Pavone, Piero; Ruggieri, Martino; Suppiej, Agnese; Corsello, Giovanni. - In: PEDIATRIC NEUROLOGY. - ISSN 0887-8994. - 117:(2021), pp. 4-9. [10.1016/j.pediatrneurol.2020.06.001]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2877241
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