Gender differences in quality of life and symptom expression during recovery from concussion.

Pediatric concussion is a significant health concern for parents, medical providers, and schools. This study was designed to gain insight into gender differences in perspectives of children and adolescents recovering from concussion. Specifically, the study explored whether males and females reported different symptom loads for physical symptoms and quality of life after concussion. The Pediatric Life After Concussion Evaluation Scale (PLACES) and the Post Concussion Symptom Scale (PCSS) were completed by 277 participants ages 9-21, with a mean age of 14.8 years. The sample was 47.5% female and 52.5% male. The study showed that overall, females reported more physical and somatic symptoms (Total PCSS, p = .001), worse quality of life during recovery (PLACES, p = .008), difficulty with cognition (p = .001), and elevated emotional symptoms than males (p = .02). When an interaction between gender and time since injury was considered, there were significant interactions for the PCSS, with females experiencing higher physical and cognitive symptom load during the period spanning 1-12 weeks (1-4 weeks: M = 33.18, SD = 27.03; 5-11 weeks: M = 15.0, SD = 16.76). However, for those individuals experiencing symptoms for longer than 12 weeks, males expressed a higher physical and cognitive symptom load (M = 32.36, SD = 26.59). Findings indicate that there are gender differences in the expression of symptoms and perceptions of quality of life after concussion.

The underrecognized epilepsy spectrum: the effects of levetiracetam on neuropsychological functioning in relation to subclinical spike production.

The purpose of this prospective, open-label pilot study was to determine whether treatment with levetiracetam improves neuropsychological functioning in children and adolescents who have evidence of subclinical spike production associated with attention and learning difficulties. Six participants (mean age 9.8 years) were treated with levetiracetam up to 40 mg/kg per day and evaluated using neuropsychological (Wide Range Assessment of Memory and Learning, Second Edition), academic (Wechsler Individual Achievement Test, Second Edition, Abbreviated), and electroencephalographic assessments at baseline and after 10 weeks of treatment. Statistically significant improvements on indexes of the Wide Range Assessment of Memory and Learning, Second Edition were observed in 4 participants after 10 weeks. No statistically significant differences were observed for the Wechsler Individual Achievement Test, Second Edition, Abbreviated. Concomitant spike suppression was observed. Levetiracetam was generally well tolerated. A subset of patients exists with attention and learning problems that have associated aberrant cortical electrical activity without clinical seizures and associated neuropsychological deficits that may improve after treatment with levetiracetam.