RESUMO
PURPOSE: To determine whether nonreferred children with idiopathic megalencephaly show evidence of specific neurodevelopmental dysfunction compared with sibling control subjects and age-matched control subjects. DESIGN: Cross-sectional, case-control study in a large, suburban pediatric practice. Subjects included 20 children between the ages of 6 and 15 years with a head circumference at greater than the 98th percentile, 19 siblings of these children with normalsize heads, and 16 age-matched control subjects. Standardized tests of language, academic achievement, visuomotor integration, motor function, and neurodevelopmental function were administered. RESULTS: Multivariate analysis, with control for age, showed a main effect for the presence of megalencephaly (F = 3.2; p < 0.05). Follow-up univariate analyses, with control for age, showed that children with megalencephaly had poorer performance on tasks of upper limb speed, visuomotor control, running speed, bilateral coordination, visuomotor integration, naming fluency, and minor neurologic indicators. CONCLUSION: The relationship between idiopathic megalencephaly and external hydrocephalus in infants is discussed. Results show that so-called "benign" idiopathic megalencephaly in nonreferred school-age children appears to be a clinical entity associated with subtle motor problems and neurodevelopmental dysfunction.
Assuntos
Encefalopatias/complicações , Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil , Desempenho Psicomotor , Logro , Adolescente , Braço/fisiologia , Encefalopatias/genética , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/etiologia , Linguagem Infantil , Estudos Transversais , Deficiências do Desenvolvimento/etiologia , Feminino , Seguimentos , Humanos , Hidrocefalia/complicações , Desenvolvimento da Linguagem , Masculino , Destreza Motora , Análise Multivariada , Exame Neurológico , Tempo de Reação , Corrida/fisiologiaRESUMO
To develop a broad understanding of the causes and patterns of occurrence of wheezing associated respiratory infections, we analyzed data from an 11-year study of acute lower respiratory illness in a pediatric practice. Although half of the WARI occurred in children less than 2 years of age, wheezing continued to be observed in 19% of children greater than 9 years of age who had lower respiratory illness. Males experienced LRI 1.25 times more often than did females; the relative risk of males for WARI was 1.35. A nonbacterial pathogen was recovered from 21% of patients with WARI; respiratory syncytial virus, parainfluenza virus types 1 and 3, adenoviruses, and Mycoplasma pneumoniae accounted for 81% of the isolates. Patient age influenced the pattern of recovery of these agents. The most common cause of WARI in children under 5 years of age was RSV whereas Mycoplasma pneumoniae was the most frequent isolate from school age children with wheezing illness. The data expand our understanding of the causes of WARI and are useful to diagnosticians and to researchers interested in the control of lower respiratory disease.