P07.13 Neuroimaging and multimodal approach to dyslexia

Poster sessions P07.12 BECTS evolving to Landau Kleffner Syndrome and subsequent recovery: A longitudinal case study with fMRI, Source EEG and neuropsychology A.N. Datta1 *. 1 University Children’s Hospital 4005 Basel, Switzerland Background: Landau Kleffner Syndrome (LKS) and benign epilepsy with centro-temporal spikes (BECTS) show different severe language impairments. We aim to document the process of language reorganisation in these epileptic syndromes. Methods: Source EEGs with 64 electrodes were performed for exact focus localisation, fMRI were done to document the cerebral localization of language (using paradigma of silence sentence generation and reading) at the age of 8.3 and 9.1 years. Neuropsychological examinations were done by Wechsler Intelligence Scale for Children-III (WISC-III) at 8.3 and 8.9 years consisting of a verbal and a performance scale. Results: Our patient started with left hemispheric BECTS at the age of 7.4 years evolving at 8 years to LKS with bilateral, continuous discharges during sleep touching the frontal inferior and the whole temporal lobes with strong propagation to the homologous right hemispheric areas. Acquired (partial) aphasia with rather poor verbal and better performance index (vIQ 71, pIQ 81) resulted from WISCIII; in fMRI, language tasks clearly derived from the right hemisphere, although the boy was right-handed. Treated with Sultiam and Clobazam, continuous discharges disappeared and only rare left hemispheric abortive spikes remained. Verbal and performance IQ increased (vIQ 81, pIQ 123). In fMRI, language induced cerebral activation tended to shift back to a bilateral, but still more right hemispheric localization giving way to right hemispheric functions; left and right hemispheric functions clearly improved. Conclusion: This case confirms the hypothesis of a single spectrum disorder of BECTS and LKS inducing language impairment. Effective treatment of epileptic discharges causes speech improvement and cortical reorganisation of the neuronal language network. P07.13 Neuroimaging and multimodal approach to dyslexia S. Sandrone1 *. 1Vita-Salute San Raffaele University, Milan, Italy Background: Neuroimaging is a label encompassing several techniques − i.e. from Computed Axial Tomography and Diffusion Tensor Imaging to Positron Emission Tomography and functional Magnetic Resonance Imaging − that provide fundamental information on structural and functional organization of the brain, although showing spatial and/or temporal resolution constrains depending on the technique used. The multimodal approach, namely the combination of some of these techniques, has been recently proposed as a way to gain a comprehensive and more detailed view of a cerebral phenotype, both in physiological and pathological conditions. Aim of the study: The aim of the paper is to analyze and compare the pros and cons of the possible combinations of techniques in the study of developmental dyslexia, a learning disability that impairs a person’s ability to read and which is unexplained by sensory, cognitive, motivational or scholastic deficits, to determine the best multimodal approach to get a complete overview of the dyslexic brain. Methods: Methodological review of previous experimental studies (from 1995 to 2010). Results and Conclusions: Not only a combination of functional Magnetic Resonance Imaging (fMRI) and Electroencephalography (EEG) as previously reported, but an integrative use of fMRI-EEG and Diffusion Tensor Imaging can provide

S63 us a more detailed view of the anatomo-functional brain organization in dyslexic children: this multimodal approach and its further integration with genetic and behavioral data is necessary to design a screening battery of tests to diagnose dyslexia earlier and promote preventive intervention, shifting from basic research to diagnostic application. P07.14 The advantages of ultrasound diagnosis of spinal cord disorders in children of first life year. S. Shamansurov1 *, M. Gulamova1 , D. Mutailloeva1 . 1Tashkent Medical Institute of Postgraduate Education, Uzbekistan Background: Spinal pathology in children, the questions of its effective early diagnostics are important. Purpose: To explore the benefits of ultrasound diagnostics of spinal cord in children of the first year of life with spinal pathology. Materials and Methods: There were examined 77 children with spinal pathology, in children of the first year. To examine child there are 2 basic positions used. First: the child is in a side-lying position on the left side with his face to the mother. Second: the baby is lying prone on his stomach, on the knees of an assistant with pronated head. This position is most convenient for the study atlantooccipital connection. Results: As the result of study we can be differentiat spinal pathologies. Thus deformation of the spinous processes and the asymmetry of atlantooccipital joint accompany spinal trauma; associated cerebrospinal trauma, signs of increasing intermeningeal spaces of the brain and spinal cord, syndrome Klippel-feil, spinal disraphia (syringomyelia, spina bifida occulta, spina bifida aperta) can be differentiated from meningo- and meningomielocele, intramedullary tumors. Expansion of the central spinal canal at the lumbar spine allows us to differentiate mielocystocele from sacrococcigeal teratoma. Conclusions: Ultrasound examination of the spinal cord in children of the first year of life is more informative, affordable, accessible, noninvasive, and without the need for comfort or general anesthesia, unlike MRI, which is the main diagnostic method in adults. P07.15 The Role of Advanced Neuroimaging in Infantile Refsum Disease G. Haliloglu1 *, K.K. Oguz2 , M. Kilic3 , T. Coskun3 , A. Tokatli3 , R. Wanders4 , F.M. Sonmez5 , M. Topcu1 . 1 Hacettepe University Children’s Hospital, Department of Pediatric Neurology, Ankara, Turkey, 2 Hacettepe University Children’s Hospital, Department of Neuroradiology, Turkey, 3 Hacettepe University Children’s Hospital, Department of Pediatric Metabolism and Nutrition, Turkey, 4 Department of Pediatrics, Laboratory of Genetic Metabolic Diseases, Academic Medical Center, Amsterdam, Netherlands, 5 Karadeniz Technical University, Department of Pediatric Neurology, Turkey Background: Infantile Refsum Disease (IRD), is a rare autosomal recessive inborn error of metabolism, and is the mildest variant in a triad of peroxisome biogenesis defects. Case presentation: A 3.5 year-old girl presented with developmental delay, visual and hearing impairment. Primary complaints were developmental and language delay noticed at the age of 8 months and 18 months, respectively. She had microcephaly, severe developmental delay, generalized hypotonia, bilateral sensorineural hearing loss, retinitis pigmentosa and decreased vision, decreased deep tendon reflexes. She had autistic feautures and was unable to sit without help. Results: Bilateral and symmetrical involvement of peritrigonal white matter and centrum semiovale, thalami, the corpus callosum along with corticospinal tracts, as assessed by increased T2 signal, was highly suggestive