Evaluation of the static equilibrium in a sample of hearing impaired children

A random sample was organized with 42 children with congenital sensorineural auditory deficit (severe and bilateral) from special education schools in Campinas. Chronological ages ranged from 4 to 7 years of age. This sample was compared with two control groups of 42 children of the same chronological age but attending normal classes. All were submitted to 9 tests of the set of static equilibrium of the Evolutive Neurologic Examination. It was observed that in the position of equilibrium with opened eyes (test 8) there were no differences between the groups. In the Romberg position, the hearing impaired children of 4, 5 and 6 years of age showed a significant decrease in the ability to do the test (test 9); those of 7 years of age had equal ability whether of the control or the deficient groups. Hearing impaired children were less able to do other static equilibrium tests (heel-toe or one foot or tip-toe standing tests, with opened or closed eyes: tests 10, 12, 16, 20, 24, 25 and 26). The use of detailed neurological semiology allowed us to support the alteration of the static equilibrium in this group of hearing impaired children.Foi constituída amostra aleatória de 42 crianças deficientes auditivas neurossen-soriais congênitas, profundas e bilaterais, com idade cronológica variando entre 4 e 7 anos, que frequentavam classes de habilitação da cidade de Campinas. As crianças propostas foram comparadas) às de dois grupos controles de 42 crianças, da mesma faixa etária, que apresentavam bom rendimento escolar em classe comum. Todas foram submetidas a 9 provas do setor de equilíbrio estático do Exame Neurológico Evolutivo. Verificou-se que, na posição de equilíbrio com olhos abertos, não houve diferença entre os grupos. Na posição de Romberg, foi significativamente menor o número de deficientes auditivos que a realizaram aos 4, 5 e 6 anos; aos 7 anos foi executada por igual número de controles e deficientes auditivos. As demais provas foram realizadas por número significativamente menor de deficientes auditivos nas seguintes posturas: artelho-calcâneo com olhos abertos ou fechados (provas 24 e 25), permanecer num pé só (provas 12 e 16) ou nas pontas dos pés (provas 10 e 16). O uso de semiologia neurológica detalhada permitiu documentar as alterações do equilíbrio estático nesse grupo de crianças deficientes auditivas.34635

Neurologic semiology in a sample of hearing impaired children

A random sample of 42 sensorioneural hearing impaired children (severe and bilateral) was studied, from special classes in Campinas, with chronological ages varying between 4 and 7 years old. The children of this sample were compared with two control groups of 42 children of the same chronological age, from regular classes of private and public schools. All of them were submitted to the traditional neurological examination. Hearing impaired children showed differences as to head circumference and muscle tonus. In the other examined items we found motor hyperactivity, cerebellar and ocular syndromes although there were no significant differences between the groups.Foi constituída uma amostra aleatória de 42 crianças deficientes auditivas neuros-sensoriaís congênitas, profundas e bilaterais, com idade cronológica variando entre 4 e 7 anos, que frequentavam classes de habilitação da cidade de Campinas. As crianças propostas foram comparadas com dois grupos controles de 42 crianças, da mesma faixa etária, de classe comum. Todas foram submetidas ao exame neurológico tradicional. Verificou-se que os aspectos que demonstraram diferenças foram o perímetro craniano e o tono muscular. Nos demais itens avaliados, mostrou-se hiperatividade motora, síndrome cerebelar e síndrome ocular, porém não houve diferença significativa entre os dois grupos.34134

Complementary neuropsychological assessment with computer in congenital hemiparesis

We present the neuropsychological assessment with computer aid of six cerebral palsy children. Three children had right hemiparesis and three, left hemiparesis. The tomographic examination showed parietal cavities (porencephalic cyst in 4 children, ischemic injury in 1 case and subarachnoid cyst in 1 case). We have proposed to assess the visuo-spatial function since we suspected the children could have disturbance of this function. We did not detect this disturbance. On the other hand, the children had astereognosia and the right hemiparetic children preferred to execute signs on the right part of the computer visor. We discuss and propose explanations for both findings.Apresentamos o estudo neuropsicológico de seis crianças portadoras de paralisia cerebral forma hemiplégica, com a ajuda de computador (três crianças com hemiparesia direita e três com hemiparesia esquerda). Os exames tomograficos revelaram cavidades parietais (cisto porencefálico em 4 casos, infarto isquêmico em 1 e cisto subaracnóideo em 1). O objetivo do estudo foi verificar se havia distúrbio na organização espacial, pois os pacientes apresentavam lesão estrutural em áreas parietais e não fora detectado esse distúrbio previamente. Encontramos astereognosia e preferência para o uso da hemi-tela direita do computador nas crianças com hemiparesia direita. Discutimos e propomos explicações para estes achados. Ressaltamos ainda o papel da linguagem computacional Logo, como instrumento adequado para investigação neuropsicológica.50250

Neurinoma maligno infratentorial: relato de um caso

Os autores relatam a presença de neurinoma maligno do forame jugular em uma menina de 2 anos e 9 meses de idade, não associado à doença de von Recklinghausen. Foi realizada cirurgia parcial da lesão tumoral. É salientada a baixa incidência desta entidade, sobremaneira nas crianças, frente à literatura revista

Epileptic Features Of Patients With Unilateral And Bilateral Schizencephaly.

The extent of cortical maldevelopment might correlate with the severity of the clinical manifestation, such as cognitive delay or motor dysfunction. The objective of this study was to investigate the clinical features of epilepsy in patients with unilateral and bilateral schizencephaly. We studied 44 consecutive patients with schizencephaly diagnosed by magnetic resonance imaging (MRI). The epileptic features were analyzed in detail: frequency of epilepsy, median age at onset of epilepsy, semiology of seizures, characteristic features of electroencephalographic (EEG) abnormalities, epileptic syndromes, and antiepileptic drug treatment. We also verified the presence of motor disabilities. Data were analyzed according to the presence of unilateral or bilateral clefts and to the presence of open-lip versus closed-lip schizencephaly. We used the chi-square test and Fisher exact test for statistical analysis. Twenty-four patients had a unilateral cleft (group 1) and 20 patients had bilateral clefts (group 2). Ages ranged from 1 to 37 years (mean 10.6 years). Epilepsy was present in 15 (63%) patients in group 1 and in 11 (55%) patients of group 2; a history of status epilepticus occurred in 13% of group 1 and in 27% in group 2; and a history of clusters of seizures occurred in 40% of group 1 and in 45% of group 2. Eight (53%) patients in group 1 and 6 (54%) patients in group 2 were in monotherapy. Ten (67%) patients in group 1 and 7 (64%) patients in group 2 had seizures controlled with antiepileptic drugs. The frequency of EEG abnormalities was similar between groups (75% and 85%, groups 1 and 2, respectively). Statistical analysis showed no difference between the two groups in the variables mentioned above. However, motor disability was significantly more frequent and more severe in group 2. Regarding the type of schizencephaly (open lip versus closed lip), there was no difference in the frequency of patients with epilepsy, and severe motor deficit was more frequently found in bilateral and open-lip schizencephaly. The extent of the cortical maldevelopment in patients with schizencephaly does not correlate with the severity of the clinical and EEG features of epilepsy, unlike the cognitive and motor manifestations. In addition, the type of schizencephaly (open lip versus closed lip) does not correlate with the presence of epilepsy or seizure control, unlike motor deficit.21757-6

Doença cerebrovascular na infância: II. Aspectos clínicos em 42 casos Cerebrovascular disease in children: II. Clinical aspects in 42 cases

Entre 1990 e 1998 foram analisadas, do ponto de vista clínico, 42 crianças com diagnóstico de doença cerebrovascular, internadas no Hospital das Clínicas da FCM-UNICAMP. O distúrbio cerebrovascular mais frequente foi do tipo isquêmico com acometimento predominante da artéria cerebral média, sendo o quadro clínico agudo caracterizado por manifestações epilépticas e alterações motoras, principalmente em crianças de idade precoce. A avaliação do seguimento das crianças mostrou predomínio de sequelas motoras.<br>We report the findings recorded in 42 children suffering cerebrovascular disease and assisted at the Hospital das Clínicas FCM-UNICAMP, over a 8 years period (January 1990 until April 1998). The ischemic type was the most common, and involvement of the middle cerebral artery, sudden onset of clinical manifestation with seizures and motor disability were more common in early aged children. Motor sequelae predominated in the follow-up of these children