Predição da etiologia baseada no tipo clínico das convulsoes no período neonatal / Prediction of etiology based on the clinical type of convulsion in the neonatal period

OBJECTIVE: To determine whether the seizure clinical type is predictive of etiology. METHODS: This is a prospective study from 9 neonatal and pediatric intensive care units. Neonatal seizures were defined clinically as described by Volpe. The seizures etiology was defined by positive clinical date, cranial sonogram and laboratory investigation routinely obtained in all neonates with seizures. Correlation between seizures type and etiologies was determined by Odds ration (OR). RESULTS: During one year 89 neonates develop neonatal seizures and the etiologies were determined. The mains seizures types were: subtle (n = 59; 66.3%), tonic (n = 27; 30.4%), clonic (n = 20; 22.4%), myoclonic (n = 4; 4.5%). The most frequent etiologies determined were: asphyxia (n = 60; 67.4%), hypocalcemia (n = 19; 21.3%), hypoglicemia (n = 14; 15.7%), peri-intraventricular hemorrhage (n = 13; 14%). The OR estimate that clonic seizures (OR 5.65 - 1.34 < OR < 23.61%) is predictive to peri-intraventricular hemorrhage. CONCLUSION: The OR estimate high risk to periventricular hemorrhage when the seizure is the clonic type. When the seizure is subtle type the risk is low to this etiology.

Avaliação neuropsicológica de crianças com hemiparesia congênita e adquirida--resultados preliminares / Neuropsicologic evaluation of children with congenital and acquired hemyparesis--early results

PURPOSE: To present the preliminary results of neuropsychological assessment for children with congenital and acquired hemiparesis with or not seizures. METHODS: Nine children at a age of 5 and 14 years old, were studied individually by one battery of test to neuropsychological assessment of cognitive function, language, gnosia, praxia visuo-motor and memory processing and emotional aspect. RESULTS: Children with hemiparesis demonstrated minimal or severe cognitive dysfuctions, impaired language abilities, poor visuo-motor and memory processing and alteration in emotional aspect. Acquired hemiparesis with seizures in childhood had a severe cognitive deficits, but congenital hemiparesis with or not seizures the neuropsychological assessment demonstrate minimal or moderate cortical deficits. CONCLUSIONS: Theses preliminary results demonstrated that congenital or acquired hemiparesis associated or not with seizures present cortical dysfuctions. The worst results was observed in acquired hemiparesis with epileptic seizures.

Avaliação de riscos ao desenvolvimento neuropsicomotor em crianças: triagem utilizando-se o Teste de Denver II e identificação de fatores maternos de risco / Assessment of risk to neuro-psychomotor development: screening using the Test Denver II and identification of maternal risks

PURPOSE: To identify a positive screening test for developmental delay in children by the Denver Test II and their risk factors. METHODS: A sample of 398 children was studied at 0 the 12 months of age regarding their neurodevelopment. The Denver II Test was used. The children who failed in two or more items of the test were suspected of having neurodevelopment delay. A set of independent variables was: socioeconomic, reproductive and environmental, birth conditions children's care. Analyses were performed using chi-square test and multivariate techinique logistic regression. RESULTS: At of 0 - 12 months of age, 45,73% (182) of the total of 398 children failed in the screening test. After adjusting for possible confounding variables, failure was associated with family lower income children, gestacional age less than 38 weeks, socioeconomic status family, schooling of the mother, mother's age, use of drug. CONCLUSIONS: This study demonstrates: 1--The Denver Test permited screening the delays development; 2--Maternal risk factors may interfere in the child's neurodevelopmental.