Cognition and behavorial morbidity associated with sleep disordered breathing in children / Alteraciones cognitivas y conductuales en los trastornos respiratorios del sueño (TRS) en niños

Sleeep disorder breathing (SDB) in chilhood includes a broad spectrum of disease ranging from primary snoring to more severe forms of obstructive sleep apnea syndrome. They may be associated with alterations different than those seen in adults, e.g., children present a low percentage of daytime sleepiness. Nevertheless, they present great difficulties in their learning, and failure in memory and attention and reports of behavior of aggressiveness. We analyze in the present review the cognitive and behavioral deficits asscoaited with the RDS and the main tests that are made for its study

Los trastornos respíratorios del sueño (TRS) en la infancia incluyen un amplio espectro que comprende desde el ronquido primario hasta las formas más graves de síndrome de apnea obstructiva del sueño (SAOS). Los niños presentan sintomatología asociada distinta a los adultos, como un bajo porcentaje de sonmolencia diurna. No obstante refieren dificultades en su aprendizaje, fallas en memoria, atención y cambios en su hiperactividad y agresividad. Se analizan los déficit cognitivos y conductuales asociados a los TRSy las principales pruebas neuropsicológicas o test que se realizan para su estudio

Meningite bacteriana aguda na infância: fatores de risco para complicações agudas e sequelas / Childhood acute bacterial meningitis: risk factors for acute neurological complications and neurological sequelae

OBJETIVO: Estudo retrospectivo que visa avaliar as complicações neurológicas agudas e sequelas neurológicas das meningites bacterianas agudas na infância, a fim de determinar possíveis sinais de alerta. MÉTODOS: Foram avaliadas crianças (entre 1 mês e 14 anos) internadas entre 2003 e 2006, com meningite bacteriana aguda. RESULTADOS: Dos 44 pacientes incluídos, 17 (38,6%) apresentaram complicações neurológicas agudas, sendo crise convulsiva a mais frequente (31,8%). Os pacientes com complicações neurológicas agudas apresentaram com mais frequência: menor contagem de neutrófilos (p = 0,03), crise convulsiva na admissão (p < 0,01) e S. pneumoniae como agente etiológico (p = 0,01). Os fatores de risco para o desenvolvimento de complicações neurológicas agudas foram: S. pneumoniae [razão de chances (odds ratio, OR) = 6,4; intervalo de confiança (IC) 1,7-24,7] e contagem de neutrófilos < 60% (p < 0,01). De 35 pacientes seguidos ambulatorialmente, 14 apresentaram sequelas neurológicas (40%), sendo alteração comportamental a mais frequente. A ocorrência de crise convulsiva na internação (OR = 5,6; IC 1.2-25,9), proteinorraquia > 200 mg/dL (p < 0,01) e menor relação glicorraquia/glicemia (p < 0,01) foram identificadas como variáveis de risco para sequelas. CONCLUSÃO: Contagem de neutrófilos < 60%, crise convulsiva na admissão e S. pneumoniae como agente etiológico foram identificados como sinais de alerta para a ocorrência de complicação neurológica aguda, enquanto que proteinorraquia, menor relação glicorraquia/glicemia e crise convulsiva na internação foram observados como fatores de risco para a ocorrência de sequelas neurológicas.

OBJECTIVE: To assess acute neurological complications and neurological sequelae of childhood acute bacterial meningitis in order to determine possible warning signs. METHODS: This retrospective study evaluated children with acute bacterial meningitis (between 1 month and 14 years of age) admitted between 2003 and 2006. RESULTS: Of the 44 patients studied, 17 (38.6%) had acute neurological complications. Seizure was the most frequent (31.8%) complication. Patients with acute neurological complications showed a higher frequency of lower neutrophil count (p = 0.03), seizure at admission (p < 0.01), and S. pneumoniae as the etiologic agent (p = 0.01). Risk factors for the development of acute neurological complications were S. pneumoniae (odds ratio [OR] = 6.4, confidence interval [CI] 1.7-24.7) and neutrophil count < 60% (p < 0.01). Of the 35 patients who were followed up, 14 had neurological sequelae (40%). Behavioral change (22.9%) was the most frequent sequela. Seizures at admission (OR = 5.6, CI 1.2-25.9), cerebrospinal fluid protein concentration > 200 mg/dL (p < 0.01), and cerebrospinal fluid glucose concentration/glycemia ratio (p < 0.01) were identified as risk variables for sequelae. CONCLUSION: Neutrophil count < 60%, seizure at admission, and S. pneumoniae as the etiologic agent were identified as warning signs for acute neurological complications, while protein levels, cerebrospinal fluid glucose concentration/glycemia ratio, and seizure at admission were seen as risk factors for neurological sequelae.

Cognitive and behavioral development profile of a Saudi girl with Fragile X syndrome

This report presents an ideal case of a girl with Fragile X syndrome. There is positive family history of the same condition. The analysis revealed low average IQ with attention deficit, shyness, and social withdrawal. The report shows that girls with Fragile X might have only mild cognitive deficits that enable them to adapt and succeed in society

HIV mania as a marker for clinical deterioration in AIDS / La Manía en la Infección por el VIH como Marcador de Deterioro Clínico en el SIDA

HIV infection continues to be a significant health problem in the Caribbean region. With the availability of antiretroviral drug treatment, it is becoming increasingly important to identify clinical markers for deterioration from infection to disease. Psychiatric symptoms are well recognized as a complication of HIV infection. Three cases are presented to suggest that the occurrence of HIV related mania may herald the transition from HIV infection to AIDS. This is relevant in assessing the course of the disorder and could indicate that the psychiatric manifestation of neurotropic infection represents a distinguishing marker for the diagnosis of AIDS perhaps before other clinical signs are evident

La infección del VIH continúa siendo un importante problema de salud en la región del Caribe. Con la disponibilidad de tratamiento de droga de antiretroviral, está poniéndose en aumento importante para identificar los marcadores clínicos para el deterioración de la infección enfermar. Se reconocen bien los síntomas psiquiátricos como una complicación de infección por VIH. Sin embargo, se presentan tres casos para sugerir que específicamente la manifestación de manía relacionada con el VIH puede tener importancia clínica en anunciar la transición de la infección por VIH a SIDA. Esto tiene relevancia en cuanto a evaluar el curso del trastorno y podría indicar que la manifestación psiquiátrica de infección neurotrópica representa un marcador distintivo para el diagnóstico del SIDA, quizás antes de que cualquier otra señal clínica se haga evidente.

Trastorno conductual del sueño REM en dos casos documentados con polisomnogragía / REM sleep behavior disorder: report of two cases

We report a 69 years old male with a parkinsonian syndrome and a 50 years old female without neurological problems who showed violent behavior during REM sleep. Polysomnography showed that both had tonic or phasic muscular activity during REM sleep and a REM sleep behavior disorder was diagnosed. Clonazepam was used in both, with good clinical response. This condition is frequently unrecognized and confused with nightmares, nocturnal delirium or other parasomnias