Temporal lobe epilepsy following maintenance electroconvulsive therapy-Electrical kindling in the human brain?

Maintenance electroconvulsive therapy (ECT) is sometimes prescribed for refractory psychiatric conditions. We describe five patients who received maintenance ECT and developed florid temporal epileptiform abnormalities on electroencephalography (EEG) despite no history of epilepsy and normal neuroimaging. All patients had received regular ECT for at least 8 months. Three patients had clinical events consistent with epileptic seizures, and video-EEG monitoring captured electrographic seizures in two patients. After cessation of ECT the EEGs normalized in all patients, and no further clinical seizures occurred. Maintenance ECT may predispose to epilepsy with a seizure focus in the temporal lobe.

The effects of the presence or absence of parents on interviews with children.

AIM: This paper discusses two independently conducted studies and argues that adult healthcare workers and researchers need to consider the influence that parents can have on a negotiated conversation between a child and an interviewer. BACKGROUND: Interviewing is a common qualitative research method used with children and in clinical practice, yet there has been little focus on how interviews with children are conducted. DATA SOURCES: Qualitative, semi-structured interviews from two separate studies involving children and young people aged six to 13 years interviewed at home with and without parents present. REVIEW METHODS: This is a methodology paper. DISCUSSION: The influences of parents on children's expressed views are complex. There is a need to attend to the power relationship between researchers, parents and children. Researchers need to be aware that the presence of parents may stop or help children's views being heard. For some children, the opportunity to express their views without their parents present leads to richer data being given. However, where parents act as proxies for researchers, the parents' understanding of their own children can lead to the collection of rich data. Researchers could explore in future studies the effects of how children and parents are prepared for interviews. Implications for practice/research Parents may help or limit children's contributions. Researchers need to be reflexive and report the effects of adult influences on interviews so that consumers of their research can arrive at informed judgements. In clinical practice, interviewing children separately from their parents whenever possible could provide clinicians with an additional perspective to inform a child-centred approach.