RESUMEN
PURPOSE: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an immune-mediated disease of the central nervous system (CNS). The aim of this study was to describe the variability of clinical presentation in anti-NMDAR encephalitis, treatment and outcomes in a case series of children and adolescents. METHODS: Retrospectively analyse patients diagnosed with anti-NMDAR encephalitis, from 2010 to 2018. RESULTS: The study population consisted of nine children with anti-NMDAR encephalitis from southern Brazil, six females and three males, aged 5 months to 16 years (mean 5 years). The time of follow-up varied between 1 and 7 years, with a mean of 3 years. The most frequent first manifestation consisted of seizures. All patients described had psychiatric symptoms and a wide spectrum of neurologic findings. Five patients had unilateral symptoms. Magnetic resonance imaging and electroencephalogram were normal in most patients. Cerebrospinal fluid pleocytosis occurred in five patients. All patients were administered immunoglobulin and/or steroids. Seven patients (78%) required cyclophosphamide and/or rituximab. Almost half of the patients fully recovered from all symptoms. CONCLUSIONS: A wide variety of symptoms were observed in this study and, although unilateral symptoms are rarely reported in the literature, a high frequency was observed among Brazilian children. Alternatives to first-line therapy should be considered in patients with clinical suspicion, even if they have not had a good response with first-line therapy.
Asunto(s)
Encefalitis Antirreceptor N-Metil-D-Aspartato/diagnóstico , Encefalitis Antirreceptor N-Metil-D-Aspartato/terapia , Adolescente , Brasil , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
ABSTRACT Objective Evaluate the prevalence of internet addiction (IA) among adolescents, as well as characterize behaviors that are considered to be a risk in this population regarding the use and addiction of the Internet. Methods In this cross-sectional study conducted in one public and one private school 91 adolescents, aged 12 to 16 years old, responded the Internet Addiction Test - Brazilian version (IAT) and Child Behavior Checklist (CBCL). Results The prevalence of internet addiction found was 21%, with no difference between private and public schools. On the group dependent on the Internet, there was a statistically significant correlation with Anxiety/Depression, Withdrawn/Depression, Rule Breaking Behavior and Aggressive Behavior, as well as the syndrome scales Social Problems, Thought Problems and Attention Problems. Conclusion Our study provides evidence of a relationship between internet addiction and behavioral problems among adolescents. As this is a cross-sectional study, we consider that future research is necessary to corroborate our results.
RESUMO Objetivo Avaliar a prevalência da dependência de internet entre adolescentes, assim como caracterizar comportamentos de risco nessa população em relação ao uso e à dependência de internet. Métodos Estudo transversal analítico realizado em dois colégios, um público e um particular, com 91 adolescentes de idade entre 12 e 16 anos, que responderam aos questionários Internet Addiction Test - versão brasileira (IAT) e Child Behavior Checklist (CBCL). Resultados Entre a população estudada, a prevalência de dependência de internet encontrada foi de 21%, não havendo diferença entre as escolas pública e particular. No grupo dependente de internet, houve relação estatisticamente significativa com os sintomas Ansiedade/Depressão, Isolamento/Depressão e Comportamento Agressivo e de Quebrar Regras. As escalas Problemas Sociais, Problemas de Pensamento e Problemas de Atenção também se correlacionam à dependência de internet. Conclusão O presente estudo demonstra evidência de correlação entre a dependência de internet e sintomas comportamentais entre adolescentes. Por se tratar de um estudo transversal, contudo, esses dados devem ser vistos com cautela e pesquisas futuras são necessárias para corroborar nossos resultados.