Epilessie del lobo occipitale

Vengono presentate le diverse forme di epilessie occipitali dell'infanzia e dell'adolescenza, con le specifiche caratterizzazioni cliniche, elettroencefalografiche. Viene discussa la terapia e la prognosi delle singole forme

ANORESSIA NERVOSA E NUTRIZIONE

Nell'ambito dei disturbi del comportamento alimentare in et\ue0 evolutiva spesso \ue8 necessario ricorrere ad interventi forzati di rialimentazione tramite sondino naso-gastrico o via parenterale. Si discutono dunque i vantaggi e gli svantaggi di tali intervent

Motor representation of actions in children with autism

Background: Children with Autistic Spectrum Disorders (ASD) are frequently hampered by motor impairment, with difficulties ranging from imitation of actions to recognition of motor intentions. Such a widespread inefficiency of the motor system is likely to interfere on the ontogeny of both motor planning and understanding of the goals of actions, thus delivering its ultimate effects on the emergence of social cognition. Copyright:Methodology/Principal Findings: We investigate the organization of action representation in 15 high functioning ASD (mean age: 8.11) and in two control samples of typically developing (TD) children: the first one, from a primary school, was matched for chronological age (CA), the second one, from a kindergarten, comprised children of much younger age (CY). We used nine newly designed behavioural motor tasks, aiming at exploring three domains of motor cognition: 1) imitation of actions, 2) production of pantomimes, and 3) comprehension of pantomimes. The findings reveal that ASD children fare significantly worse than the two control samples in each of the inspected components of the motor representation of actions, be it the imitation of gestures, the self-planning of pantomimes, or the (verbal) comprehension of observed pantomimes. In the latter task, owing to its cognitive complexity, ASD children come close to the younger TD children's level of performance; yet they fare significantly worse with respect to their age-mate controls. Overall, ASD children reveal a profound damage to the mechanisms that control both production and pre-cognitive "comprehension" of the motor representation of actions.Conclusions/Significance: Our findings suggest that many of the social cognitive impairments manifested by ASD individuals are likely rooted in their incapacity to assemble and directly grasp the intrinsic goal-related organization of motor behaviour. Such impairment of motor cognition might be partly due to an early damage of the Mirror Neuron Mechanism (MNM)

Care to relieve pain-stress in preterm newborns

Background and aim of the work: A variety of non-pharmacological pain-prevention and relief techniques have been studied to evaluate the pain reduction in neonates. The aim of our study was to compare the analgesic effect of sucking a pacifier with the use of eutectic mixture of local anaesthetics (EMLA) during venipuncture in preterm newborns, using physiological and behavioural parameters as indicators of pain. Methods:We analysed the reaction to invasive procedures in 17 preterm newborns. Our patients underwent repeated vein draws without pain relief, sucking a pacifier, after the application of EMLA; we also evaluated a group of patients approached for care without pricking. For each infant we recorded the average values of the physiological parameters at rest and after pain stimuli, behavioural conditions (crying or grimaces), number and time required for blood draw. Results: The maximum heart rate values, respiratory rate, and the maximum respiratory rate values presented a statistically difference only between subjects that underwent vein draws compared to subjects without pricking (p<0.01). Moreover, the SpO2 parameter presented a significant increase in the control group compared to the others (p=0.024). Analysis of behavioural parameters shows that crying seems significantly related to the duration and number of venipunctures (p=0.000). Conclusions: It is clear that pain stress is more closely related to the duration and number of venipuncture than pain relief methods. Our results suggest that limiting the number and duration of vein draws could help to reduce pain stress in preterm newborns. © Mattioli 1885

Clinical features of benign infantile convulsions: familial and sporadic cases.

Objective: To give a contribution about the existence of non familial benign infantile convulsions during the first two years of life. Patients and Methods: We evaluated 58 patients (29 females and 29 males) with seizure onset ranging between 4 and 24 months of life, regular psychomotor development, unremarkable neuro-imaging studies and interictal electroencephalogram. We analyzed gender, age at onset, duration, manifestations and frequency of seizures, family history of febrile or infantile convulsions. Results: 17 patients had a family history of benign epilepsy, while 41 had not. Among the latter, 12 showed a family history of febrile seizures and the remaining 29 had an uncertain or fully negative familiarity with it. No clinical differences have been observed between the familial and the non familial groups. Nobody experienced seizures after the age of two and the psychomotor development remained normal in all patients, during follow-up. Conclusions: This study confirms the existence of non familial benign infantile convulsions and the benign outcome of this type of seizures either familial or non-familial. In addition to this, we also discuss the possibility to avoid anti-epileptic treatment

Clinical and pharmacological approaches of status epilepticus in children: Personal experience. Minerva Psichiatrica

Background: Status epilepticus is a neurological emergency that require a prompt treatment following steps of more aggressive therapy. We analysed efficacy of treatment protocol in paediatric SE. Methods: We present a retrospective study in 29 patients (age range: 3mm-18yy) affected by status epilepticus (SE) of whom 16 patients had a previous diagnosis of epilepsy (symptomatic or idiopathic) while, in 13 cases, SE was the first epileptic event. Protocol of treatment suggests a first treatment with intravenous Diazepam followed by a bolus of Phenytoin (PHT) in case of non-response. All patients were carefully monitored, electroencephalographic activity (EEG) and vital signs, particularly respiratory depression. When the patients were classified as refractory or suffered from respiratory insufficiency, they were transferred into ICU where anesthetic drugs ( propofol or pentothal) could be administered. Results: Seventeen children were treated in neurological unit: 7 (24%) children responded to intravenous Diazepam. 10 (35%) children required an additional bolus of Phenytoin at the variable dose of 15-20 mg/Kg/bolus. 12 patients (41%) were admitted to Intensive Unit Care (ICU): 3 for respiratory insufficiency and 9 for treatment with anaesthetics drugs. Conclusions: In our experience so as in literature there is no Gold Standard in the treatment of SE. Nearly half of patients needed ICU support thus, the best approach still remains multidisciplinary

An unusual diagnosis in a child suffering from juvenile Alexander disease: a clinical and imaging report.

Alexander disease is a rare, sporadic leukoencephalopathy characterized by white matter abnormalities with frontal predominance and clinically as a rule associated with megalencephaly, seizures, spasticity and psychomotor deterioration. We describe a boy who was diagnosed as affected by anorexia nervosa because his refusal to eat, progressive weight loss and psychological disturbances. The observation of a hyperintense lesion on T2-weighed MR images was initially explained as a pontine and extrapontine myelinolysis related to malnutrition. Following MRI and DNA analysis we diagnosed a juvenile type of Alexander disease