Results and complications of facial reanimation following cerebellopontine angle surgery

The present study was undertaken to evaluate the results of a group of patients following treatment for cerebellopontine angle lesions who developed postoperative facial palsy and underwent facial nerve repair in order to reanimate the muscles of facial expression. A retrospective study was performed on 23 patients treated between 1988 and 1997 at the 2nd and 4th ENT chairs of University "La Sapienza" of Pome for facial palsy following cerebellopontine angle surgery. Tumors included acoustic neuromas (n = 3). Seventeen patients underwent hypoglossal-facial anastomoses [10 with end-to-end anastomoses, 4 with May's interposition "jump-nerve" grafts and 3 with partial (30%) use of the hypoglossal nerve plus a facial cross-over]. The remaining patients were operated on using a cable graft with the sural nerve (n = 2) and the great auricular nerve (n = 4). Postoperative facial function was determined by the House-Brackmann 6-scale classification The hypoglossal-facial anastomoses resulted in long-term grade III or IV findings. Cable grafts improved facial function from grade VI to grade III. None of the patients operated on with the modified VII-XII anastomosis developed swallowing disturbances. The ten patients having traditional hypoglossal-facial anastomoses showed different degrees of tongue disability and retention of residue in the oral cavity. Surgical recovery of postoperative facial palsy can be obtained with various techniques according to the availability of the proximal facial nerve stump at the brain stem. Since a traditional hypoglossal-facial anastomosis procedure can be a source of a separate disability for the patient: techniques are preferred that leave the hypoglossal nerve mostly intact and uncompromised

Eating and feeding disorders in pediatric age

Eating and feeding disorders are common in pediatric age and may be important to discover and recover the early symptoms in order to optimize the treatment and management

Motor skills in children with primary headache: A pilot case-control study

Background: Headache is the most common painful manifestation in the developmental age, often accompanied by severe disability such as scholastic absenteeism, low quality of academic performance and compromised emotional functioning. The aim of the study is to evaluate praxic abilities in a population of children without aural migraine. Materials and methods: The test population consists of 10 subjects without migraine without aura (MwA), (8 Males) (mean age 8.40, SD ± 1.17) and 11 healthy children (7 Males) (mean age 8.27; SD ± 1.10; p = 0.800). All subjects underwent evaluation of motor coordination skills through the Battery for Children Movement Assessment (M-ABC). Results: The two groups (10 MwA vs 11 Controls) were similar for age (8.40 ± 1.17 vs 8.27 ± 1.10; p = 0.800), sex (p = 0.730), and BMI (p = 0.204). The migraine subjects show an average worse performance than the Movement ABC; specifically, migraineurs show significantly higher total score values (31.00 ± 23.65 vs 4.72 ± 2.61; p = 0.001), manual dexterity (12.10 ± 11.20 vs 2.04 ± 2.65; p = 0.009) and balance (14.85 ± 10.08 vs. 1.04 ± 1.05; p <0.001). The mean percentile of migraine performance is significantly reduced compared to controls (9.00 ± 3.82 vs 51.00 ± 24.34, p <0.001) (Table 1). Conclusion: Migraine can alter many cognitive and executive functions such as motor skills in developmental age

Borderline intellectual functioning and parental stress: An italian case-control study

Introduction: Borderline intellectual functioning (BIF) children comprises a group of subjects whit intelligence quotient (IQ) ranging 71-85, with a prevalence about 13.6%. Several studies pinpointed the role of parenting on BIF management. Aim of present study was evaluating with objective and validated tool the parental stress rate in mothers of an Italian sample of BIF children. Materials and methods: 26 BIF children (20 males and 6 females) aged 6-10 years (mean age 10.36\ub1 2.03), according to DSM-5 criteria, and 53 (42 males and 11 females) typical developing children (mean age 10.58 \ub1 1.97) were recruited for present study. Mothers of all enrolled children underwent an evaluation with Parental Stress Index (PSI) test. Results: The two studied groups were comparable for age (p = 0.646) and gender (p = 0.956). Table 1 shows comparison between BIF and Control groups among PSI-SF scale results (Table 1), specifically mothers of BIF children have a significantly higher levels of global parental stress (p <0.001 ), stress related to parenting (p <0.001), stress linked to difficult child (p <0.001) and stress related to parent-child interaction (p <0.001) than mothers of control children. (Table 1) Conclusion: Several reports showed the key role of BIF as risk factor for psychiatric troubles and poor long-term adjustment. Our findings emphasize the need to approach this condition also from a family point of view, stressing that care should not be limited to child rehabilitative treatment but must also involve a family centered intervention

Animals-assisted therapy: A brief review

In rehabilitative setting, the presence of animals can be considered as an important stimulus for verbal and social communication, and for mood regulation. Interaction with an animal is beneficial for children's development and numerous psychological tests have revealed that growing up with pets has a beneficial effect on children's self-esteem and self-confidence, can improve empathy, a sense of responsibility and cognitive development, as well as social status within the peer group

Neuropsychomotricity in water: A new rehabilitative tool for neruodevelop-mental disorders

Neuropsychomotricity in water is a rehabilitative practice that avails itself just of the liquid element, as a mediator of relationships: in water yes they upset all dynamics, be they relational, of equilibrium, of movement and perception, due to the fact that proprioceptive sensations, created by bodily contact with water, they are different than those generated by contact with air

Visuospatial skills in children affected by primary nocturnal enuresis: Rehabilitative proposals

The sphincterial control problems in childhood are very common, with relevant comorbidities (i.e.: difficulty in academic performance, sleep disturbances, minor neurological signs) involved in the complex process of maturation and learning, such as to cause a great deal of discomfort and related disorders in affected subjects. Enuresis is characterized by the involuntary urination in the absence of a physical disorder, socially unacceptable in places and at one stage of life where such control is acquired by the majority of subjects (about 5 years). The present study aims to evaluate the visuospatial skills in children affected by primary monosymptomatic nocturnal enuresis (PMNE). 31 PMNE children (16 males and 15 females) (mean age 10.87, SD ± 1.68) and 61 healthy children (32 males, 29 females) (mean age 11.03, SD ± 1.85, p = 0687) were evaluated for visuomotor skills with the Visual-Motor Integration Scale (VMI). PMNE subjects show a worse performance on average to VMI, especially in the total visual-motor integration test. This finding emphasizes the importance of a framework for global and more complex than is commonly implemented, across the border but framing the subject of enuretic symptoms in a more global perspective

Psychopathological and psychodynamic hypotheses for pediatric stuttering

Stuttering is a common language alteration in pediatric age consisting in repetitions and blocks, which entail a break in the rhythm and melody of the speech. According to the WHO it is a disorder of the rhythm of the word, the subject knows precisely what he would like to say, but at the same time he is not able to say it. It is a great inconvenience for those affected, also because the slowing down of speaking is not about thought or cognitive skills

Forensic considerations on violent parasomnias during lifespan

Nocturnal parasomnias are a group of sleep complex manifestation that don't alter the sleep macrostructure, but when persistent during adulthood may be assume violent aspects with relevant forensic implications about the guiltiness

Cogan's syndrome: An autoimmune inner ear disease

Abstract Objectives The objective of our study was to review our current knowledge of the aetiopathogenesis of Cogan's syndrome, including viral infection and autoimmunity, and to discuss disease pathogenesis with relevance to pharmacotherapy. Systematic review methodology Relevant publications on the aetiopathogenesis and pharmacotherapy of Cogan's syndrome from 1945 to 2012 were analysed. Results and conclusions Cogan's syndrome is a rare autoimmune vasculitis, and its pathogenesis is unknown. Infection, but primarily autoimmunity, may play contributing roles in the pathogenesis of this disease. It is characterised by ocular and audiovestibular symptoms similar to those of Meniere's syndrome. Approximately 70% of patients have systemic disease, of which vasculitis is considered the pathological mechanism. The immunologic theory is based on the release of auto-antibodies against corneal, inner ear and endothelial antigens, and of anti-nuclear cytoplasmic auto-antibodies (ANCA). Corticosteroids are the first line of treatment, and multiple immunosuppressive drugs have been tried with varying degrees of success. Tumour necrosis factor (TNF)-alpha blockers are a category of immunosuppressive agents representing a recent novel therapeutic option in Cogan's syndrome