Peri-ictal EEG in infants with PRRT2-related self-limited infantile epilepsy.

OBJECTIVE: Pathogenic PRRT2 variants cause self-limited (familial) infantile epilepsy (SeLIE), which is responsive to sodium channel blocking antiseizure medications. The interictal EEG is typically normal. We describe a cohort of infants with PRRT2-related SeLIE with striking peri-ictal EEG abnormalities. METHODS: We included all infants diagnosed with PRRT2-related SeLIE during July 2020 to November 2021 at the Royal Children's Hospital, Melbourne. Clinical features and results of aetiologic investigations were collected from electronic medical records. All EEGs were reviewed independently by two epileptologists. RESULTS: Ten infants presented with focal seizures at a median age of 5 months (range: 3-6 months). Eight had a family history of epilepsy, paroxysmal kinesigenic dyskinesia (PKD) or hemiplegic migraine. Seven of the eight infants with an EEG performed within 24 h of the most recent seizure had epileptiform discharges. Their EEGs showed focal sharp waves, spikes, polyspikes or fast activity independently over the left and right temporo-occipital regions. Conversely, the two infants with last known seizure greater than 24 h prior to their EEG had no epileptiform discharges. Oxcarbazepine was commenced in two infants and was effective. Eight infants were initially treated with levetiracetam, and all were subsequently switched to oxcarbazepine due to ongoing seizures or side effects. SIGNIFICANCE: Posterior polymorphic focal epileptiform discharges on a peri-ictal EEG recording are a feature of PRRT2-related SeLIE. This finding, particularly in the presence of a family history of infantile epilepsy, PKD or hemiplegic migraine, suggests a diagnosis of PRRT2-related SeLIE and has important treatment implications.

The Relationship of Special Education Teacher Performance on Observation Instruments With Student Outcomes.

In this study, we examined the relationship of special education teachers' performance on the Recognizing Effective Special Education Teachers (RESET) Explicit Instruction observation protocol with student growth on academic measures. Special education teachers provided video-recorded observations of three instructional lessons along with data from standardized, curriculum-based academic measures at the beginning, middle, and end of the school year for the students in the instructional group. Teachers' lessons were evaluated by external, trained raters. Data were analyzed using many-faceted Rasch measurement (MFRM), correlation, and multiple regression. Teacher performance on the overall protocol did not account for statistically significant variance in student growth beyond that of students' beginning of the year academic performance. Teacher performance on an abbreviated protocol comprised of items that had average or higher item difficulties on the MFRM analysis accounted for an additional 4.5% of variance beyond that of beginning of the year student performance. Implications for further research are discussed.