RESUMEN
INTRODUCTION: Cerebral hemorrhages in full-term newborn babies are an important factor in neonatal morbidity and mortality and very frequent in premature babies. In full-term newborn the frequency is reduced to 1-2% and the aetiopathogenesis is basically related to birth trauma. OBJECTIVE: To identify the clinical forms of cerebral hemorrhages in full-term newborn before taking prophyllactic and/or therapeutic measures if possible. DEVELOPMENT: Based on the integrated physio-pathological model of Wigglesworth and Pape, two anatomo-pathological patterns were established according to gestational age. Topographic classification was done in full-term newborn according to site (subarachoid, subdural, intraventricular, cerebellar and intraparenchymatous). We studied the pathogenesis, clinical features and diagnosis of each of these sites and emphasize the importance of neuroimaging. CONCLUSIONS: The diagnostic approach proposed permits an aetiopathogenic and therapeutic view which currently permits improved prognosis and even cure in many cases.
Asunto(s)
Hemorragia Cerebral/diagnóstico , Hemorragia Cerebral/clasificación , Hemorragia Cerebral/patología , Humanos , Recién Nacido , Imagen por Resonancia MagnéticaRESUMEN
OBJECTIVE: To determine whether visual evoked potentials (VEP) change, and to what degree, in different types of headache (migraine with or without aura, or tension headache). PATIENTS AND METHODS: We made a transversal study of 78 children (aged 3-14 years) studied between March 1997 and August 1998, classified into three groups according to HIS diagnostic criteria of 1988 and HIS-R 1997. A VEP of geometric pattern was done using the recording technique recommended by the International Society in their standards for VEP and the reference values were used for an amplitude of less than 5 microV and a latency of P100 +/- 15 ms. The qualitative variable was frequency, and the quantitative variables were the mean and the standard deviation. We studied the association between qualitative variables using the chi-squared test and the differences in means between the groups with ANOVA. All differences were considered to be statistically significant when p < 0.05. RESULTS: Girls made up 55%, with an average age of 8.84 years and a standard deviation of 3 years. There were no statistically significant differences in the mean of the VEP findings between the different types of headache with regard to amplitude (p = 0.975) and latency (p = 0.941). Neither were there any significant differences in the response to VEP in the different types of headache as far as sex and age were concerned, with p = 0.268 and p = 0.147 respectively. CONCLUSION: Our results show no statistically significant differences and do not support the idea of using VEP as a neurophysiological method for studying headaches and differentiating the various types.
Asunto(s)
Potenciales Evocados Visuales/fisiología , Trastornos Migrañosos/diagnóstico , Cefalea de Tipo Tensional/diagnóstico , Adolescente , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
A boy with severe symptoms of biotinidase deficiency diagnosed at the age of 12 years showed a remarkable improvement of his neurological picture and normalization of brain magnetic resonance imaging abnormalities when prescribed oral biotin.
Asunto(s)
Amidohidrolasas/deficiencia , Biotina/administración & dosificación , Deficiencia Múltiple de Carboxilasa/genética , Enfermedades Neuromusculares/genética , Biotinidasa , Encéfalo/patología , Niño , Humanos , Imagen por Resonancia Magnética , Masculino , Deficiencia Múltiple de Carboxilasa/diagnóstico , Deficiencia Múltiple de Carboxilasa/tratamiento farmacológico , Enfermedades Neuromusculares/diagnóstico , Enfermedades Neuromusculares/tratamiento farmacológico , Médula Espinal/patología , Resultado del TratamientoRESUMEN
During 18 months 100 children were submitted to a longitudinal study, in order to compare the efficacy of treatment with administration of intermittent rectal diazepam versus oral BID phenobarbital therapy, for prevention of febrile seizures. The group was divide in a randomized trial. Rectal diazepam was administered at dose os 0.5 mg/kg dose and the dose was repeated every eight hours during the period of fever. Diazepam was found to be as effective as oral phenobarbital in the prevention of new febrile seizures.