Background/Objectives: Epilepsy is a major public health issue in Sub-Saharan Africa, particularly among children, due to limited healthcare resources, socioeconomic inequalities, and cultural stigma that often result in underdiagnosis and undertreatment. This review examines pediatric epilepsy’s diagnosis, classification, and management in this setting, highlighting the need for culturally appropriate interventions to improve care quality and address these challenges. Methods: A review of the literature was conducted using MEDLINE, Embase, Scopus, and Web of Science databases to identify pertinent studies published between 2013 and 2024. This review included studies examining the epidemiology, seizure classification and etiologies of epilepsy among children in Sub-Saharan Africa. Results: This review revealed higher incidence and prevalence of epilepsy in Sub-Saharan Africa compared to high-income countries, primarily attributable to factors such as infectious diseases, perinatal injuries, and limited diagnostic resources. The most frequently reported types of epilepsy were generalized and focal seizures, with significant etiological contributions from structural and infectious causes, including nodding syndrome and HIV-related epilepsy. The treatment gap remains considerable, with up to 80% of children not receiving appropriate antiseizure medications. Conclusions: The diagnosis and treatment of epilepsy in pediatric populations in Sub-Saharan Africa is complicated by several factors, including cultural stigma and the lack of adequate healthcare infrastructure. There is an urgent need for culturally tailored diagnostic tools, improved access to affordable treatments, and public health initiatives aimed at reducing stigma. Addressing these gaps through enhanced research, improved healthcare access, and targeted educational campaigns is crucial for improving the quality of life for children with epilepsy.

Objective To assess the predictive accuracy of early neurophysiological and neuroimaging biomarkers, alone and in combination, for adverse neurodevelopmental disorders in term-born infants with neonatal encephalopathy (NE). Design Systematic review and meta-analysis conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Diagnostic Test Accuracy guidelines. Eligible studies included infants born at term with NE who underwent amplitude-integrated EEG (aEEG) or EEG and MRI of the brain within the first month of life. Adverse outcomes, assessed at 18–36 months of age, were defined as cerebral palsy, postneonatal epilepsy, severe hearing or visual impairment, moderate-to-severe developmental delay, or death attributable to NE. Searches were conducted in MEDLINE, CINAHL, Embase and Web of Science from database inception to 10 June 2025; risk of bias of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C) tool. Main outcome measures Sensitivity, specificity and diagnostic odds ratio (DOR) of abnormal aEEG background, EEG background, EEG seizures and MRI injury, individually and in combination, for predicting adverse outcomes, pooled using Bayesian bivariate random effects meta-analyses. Results 27 studies including 1843 infants were analysed. MRI injury was the individual predictor with higher DOR estimate (31.01, 95% CI 15.07 to 72.82), followed by abnormal EEG background (16.84, 95% CI 5.88 to 50.59), while abnormal aEEG background and EEG seizures performed less well (7.99, 95% CI 2.40 to 33.00; 4.46, 95% CI 1.86 to 11.42). Combining EEG background with MRI injury improved DOR (78.59, 95% CI 19.72 to 321.36) and specificity (93.8%, 95% CI 85.2% to 97.9%) compared with MRI alone. Conclusions MRI is a strong individual predictor of adverse outcomes in NE. Combining it with early EEG improves prognostic accuracy and may better support clinical decision-making. PROSPERO registration number CRD42024585816.

Early identification of neurodevelopmental risk in very preterm infants is critical for timely intervention. The Kidokoro MRI scoring system offers a semi-quantitative approach to evaluating brain abnormalities. This study aimed to assess the agreement of Kidokoro scores obtained in the same infants at 32- and 40-weeks postmenstrual age, and their association to cognitive, language, and motor outcomes at 24 months corrected age. A cohort of 187 very preterm infants (median 28⁺⁵weeks gestational age; 55% male) underwent structural MRI at two timepoints: Early (median 32⁺²weeks) and Term-Equivalent Age (median 40⁺⁵weeks), using 3 T scanners. Scans were scored independently using a modified version of the Kidokoro system. Bland-Altman analysis assessed agreement between Early and term equivalent age scores. Neurodevelopmental outcomes were assessed at 24 months using the Bayley-III. Multivariable linear regression models evaluated the predictive value of MRI scores, adjusting for sex, gestational age, birthweight centile, and socioeconomic status. Early MRI scores were consistently higher than term equivalent age scores (mean difference 1.9; 95%CI: 1.6-2.2), with white matter scores showing the largest discrepancy (mean difference 1.68; 95%CI: 1.46-1.90), primarily due to the "myelination delay" item. Excluding this item reduced the difference to 0.32 (95%CI: -0.01 to 0.64). Early and TEA Kidokoro global brain abnormality score (GBAS) were negatively associated with Bayley-III cognitive and motor, but not language scores. Higher GBAS were associated with lower cognitive (Early: β= -0. 67, 95%CI: -1.23 to -0.11; Partial R²=0.03; TEA: β= -0.60 95%CI: -1.15 to -0.06, Partial R²=0.03) and motor scores (Early: β= -1.04, 95%CI: -1.67 to -0.41, Partial R²=0.06; TEA: β= -1.18, 95%CI: -1.78 to -0.58, Partial R²=0.08). Reduction in GBAS from Early to TEA correlated with higher motor scores (β=1.02, 95%CI: 0.03 to 2.02, Partial R²=0.02). White matter abnormalities were linked to poorer motor outcomes at both timepoints. Kidokoro scores at early and term-equivalent timepoints are associated with neurodevelopmental outcomes at 24 months. Global abnormalities and white matter scored at either timepoints, or their longitudinal changes are significantly linked to motor outcomes. Refinement of scoring system for the early assessment may enhance clinical utility. The authors declare no conflicts of interest related to the content of this article.

Background: Cerebral palsy is a group of nonprogressive motor disorders resulting from early brain development impairment. Its prevalence is higher in low- and middle-income countries, where health care resources are limited. Data on cerebral palsy in refugee settings remain scarce, particularly in regions marked by prolonged displacement. Methods: This cross-sectional study examined 29 children with cerebral palsy in the Sahrawi refugee camps in Tindouf, Algeria. Detailed demographic, medical history, neurological findings, and comorbidity data were collected during outpatient visits conducted as part of a humanitarian mission. Results: Perinatal distress was reported in 65.5% of cases. Motor impairments were significant, with only 44.8% able to walk and 20.7% lacking head control. Language delays (65.5%), feeding difficulties (65.5%), and epilepsy (52%) were highly prevalent. Diagnostic evaluations, such as magnetic resonance imaging (MRI) and electroencephalography (EEG), were scarce and inconsistent. Access to rehabilitation services was discontinuous, and pharmacologic treatments for spasticity and pain were unavailable. Environmental factors, such as sandy terrain, further complicated mobility. Conclusion: Cerebral palsy in the Sahrawi refugee camps reflects patterns seen in low- and middle-income countries but is exacerbated by displacement and resource scarcity. Improved access to early diagnosis, structured rehabilitation, and targeted pharmacologic therapies is urgently needed to address these unmet needs and improve outcomes for affected children.

Introduction Early identification of neurodisability and delay after preterm birth is critical for timely intervention. Term-equivalent magnetic resonance imaging (MRI) (36–44 weeks) is widely used for prognostication, earlier MRI (<36 weeks) may offer additional value. Methods To provide a comparative diagnostic test accuracy synthesis of early versus term‑equivalent MRI for motor and non‑motor neurodevelopmental outcomes, incorporating advanced imaging modalities including volumetric and diffusion measures, PubMed, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched to January 22nd, 2026. PRISMA-DTA guidelines were followed with PROSPERO registration (CRD42024528207). Studies enrolling preterm infants (<37 weeks) undergoing both early and term-equivalent MRI with neurodevelopment assessment between 12–36-months were included. Two reviewers extracted data and assessed bias risk. Meta-analysis used a Bayesian bivariate random-effects model pooling diagnostic metrics for presence of lesion, intraventricular haemorrhage, white matter injury, and cerebellar haemorrhage. Results Of 3,249 records screened, 30 studies met inclusion. Term-equivalent MRI lesion presence (diagnostic odds ratio (DOR)=14.17 vs 2.67; sensitivity 84% vs 76%; specificity 73% vs 45%) and white matter injury (DOR=5.92 vs 2.20; sensitivity 65% vs 52% and specificity 76% vs 67%) demonstrated superior predictivity than Early MRI. White matter injury at term best predicted motor outcomes (DOR=18.43). Volumetric and diffusion measures improved predictive accuracy, especially for cognitive outcomes. Heterogeneity in MRI protocols, biomarker definitions, and outcomes limited comparability and the modest study number reduced precision. Conclusion Term-equivalent MRI offers higher predictivity than Early MRI. Standardised scoring and multimodal integration are needed to optimise early risk stratification in preterm populations.

Background/Objectives: The prevalence of neurodevelopmental and psychiatric disorders in children is a growing concern in developed countries. However, data from low- and middle-income countries (LMICs) remain scarce. The objective of this study was to ascertain the prevalence of such conditions in the school-aged children residing in Sahrawi refugee camps. In particular, the objective was to develop a bespoke screening instrument for the collection of epidemiological data and the examination of the impact of these disorders on academic performance and school life. Methods: A cross-sectional observational study was conducted in 13 primary schools within Sahrawi refugee camps, with a target sample size of 3425 children aged 7–14. The Strengths and Difficulties Questionnaire (SDQ) was administered to teachers to identify any neurodevelopmental issues. Results: A total of 74 (2.2% [95% CI: 1.7–2.7%]) of the 3425 children displayed positive SDQ results for neurodevelopmental or psychiatric difficulties. The most frequently identified issues were emotional and conduct problems, which often co-occurred. Boys exhibited higher hyperactivity rates than girls. Conclusions: This study’s findings revealed significant neurodevelopmental and psychiatric challenges in Sahrawi children, with implications for their academic and social development. The results emphasize the necessity of enhancing teacher training and mental health interventions to facilitate early identification and support.