Hemiplegia congênita e adquirida na criança: interrelação entre a presença de crises epilépticas e os achados eletrencefalográficos / Congenital and acquired hemiplegia in children: epileptic crisis and eletrencephalografic signs

PURPOSE: The aim of the study is to compare the presence or absence of seizures and their relationship with the electroencephalographic findings in children with congenital and acquired hemiplegia. METHODS: 35 children with congenital and acquired hemiplegia were studied by clinical and electroencephalographic features. We analyzed the frequency and seizures severity and their relationship between the background activity and epileptogenic discharges in the electroencephalogram (EEG). RESULTS: From the 35 children, 26 (74.6%) presented congenital hemiplegia and 9 (25.6%) acquired one. Seventeen (48.5%) had right hemiplegia and 18 (51.4%) left one. It was find 25 cases (71.4%) with seizures and 10 cases without seizures. All the patients with seizures presented abnormal EEG activity that was bilateral in 44% of the cases. The patient without seizures presented abnormal background activity in 90% of cases and only 10% were bilateral. Concerning epileptogenic activity, it was find 78% of patients with seizures and 68% of patients without seizures.There was statistical significance related to abnormal background activity and uncontrolled epileptic seizures. CONCLUSION: The bilateral disorganization of the background activity in the EEG is related with uncontrolled seizures. The background activity well organized in the opposite side of lesion has a good prognosis to control seizures. The epileptogenic focal activity isn't always related with the presence of seizures.

Hemiparesia congênita: avaliaçäo neuropsicológica complementar utilizando computador / Congenital hemiparesis: complementary neuropsychological evaluation with computer

Apresentamos o estudo neuropsicológico de seis crianças portadores de paralisia cerebral forma hemiplégica, com a ajuda de computador (três crianças com hemiparesia direita e três com hemiparesia esquerda). Os exames tomográficos 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 organizaçäo espacial, pois os pacientes apresentavam lesäo estrutural em áreas parietais e näo 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 explicaçöes para estes achados. Ressaltamos ainda o papel da linguagem computacional Logo, como instumento adequado para investigaçäo neuropsicológica