Desenvolvimento neurológico: avaliação evolutiva / Neurologic development: evolutional assessment

Esse artigo se propõe a revisar a avaliação do desenvolvimento neuropsicológico das crianças no seu período pós-natal, com o objetivo de fornecer aos profissionais de saúde envolvidos na assistência infantil subsídios teóricos para vigilância do desenvolvimento normal e da intervenção precoce, que pode minimizar as repercussões funcionais e lesionais do sistema nervoso submetido a eventos potencialmente patológicos, melhorando a qualidade de vida da criança, da família e com menor custo social na reabilitação (AU)

This article intend to review the assessment of the children's neuropsicologic development in the postnatal period, with the aim to give theoric information to heath professionals envolved in the children's care in terms of vigilance of the normal development and precocious intervention, wich can minimise the functional and lesional central nervous system repercutions, submitted to potencially pathological events, making better the child and family quality of live, with lower social costs in the rehabilitation (AU)

Auditory hypersensitivity in children and teenagers with autistic spectrum disorder

OBJETIVO: Verificar se o comportamento clínico de hipersensibilidade auditiva, relatado nas entrevistas com os pais/cuidadores e terapeutas/professores de crianças e adolescentes com transtorno do espectro autista, corresponde aos achados audiológicos. MÉTODO: O diagnóstico clínico para a hipersensibilidade auditiva foi investigado a partir do protocolo de entrevista. Após, foi utilizada a pesquisa do reflexo acústico estapédico e observadas as reações ao estímulo sonoro intenso em campo aberto. RESULTADOS: Dos 46 sujeitos, 11 (23,9%) foram diagnosticados clinicamente como hipersensíveis ao som, e somente 2 demonstraram desconforto quando expostos ao estímulo sonoro intenso em campo aberto. Não houve diferença estatisticamente significante para a pesquisa do reflexo acústico estapédico ipsilateral entre os grupos. CONCLUSÃO: As manifestações comportamentais aos sons não estão associadas à hipersensibilidade das vias auditivas, mas, sim, a dificuldades no processamento superior, envolvendo sistemas que comumente estão comprometidos nos pacientes do espectro autista, como o sistema límbico.

Neurological examination in the healthy term newborn

We carried out a cross-sectional study with a sample of 106 normal full-term newborns examined within 24 to 72 hours of birth. The following findings were evaluated: head and chest measurements, muscle strength, tone, tendon reflexes, superficial reflexes, primitive reflexes, and cranial nerves. All 106 newborns were considered neurologically normal. We found no differences in the neurological examination findings for newborns with different gestational ages. Primitive reflexes and appendicular tone in newborns examined at earlier postnatal ages tended to be less intense. We were able to determine the prevalence of certain neurological examination findings for the normal newborn and to discuss some differences between our results and those of other studies. Prevalence estimations for the different findings in our study may be valid for different populations as long as the same methodology is adopted

From the foot-mouth reflex to the hand-mouth reflex: a continuum of responses to appendicular compression

We studied the mouth opening response to appendicular compression in two groups of children. This study performed with the intention of testing the semiologic role of the act of mouth opening following stimulation of various regions, based on the hand mouth reflex of Babkin. Group I was formed by 33 normal children who underwent monthly follow up assessments since birth; and group II consisted of 50 children older than 6 months of age, known to have a neurologic deficit and a neuro-psychomotor development equivalent to that of a child in the first trimester of life. We observed that the normal mouth opening response in group I was more pronounced following compression of the hand and forearm when compared to compression of the arm (p<0.001). This response could persist for as long as the first 6 months of life. We were not able to elicit a mouth opening response following compression of the lower limb in this group. Among children from group II, we observed mouth opening responses to stimulation of all limb segments. Within the upper limb, the response was more pronounced following compression of the hand in comparison to the forearm (p<0.01), and forearm in comparison to the proximal arm (p<0.01). Stimulation of the foot was more effective in eliciting a mouth opening response when compared to equivalent stimulation of the lower leg (p<0.05). However, there was no statistical difference when responses to stimulation of the lower leg and thigh were compared. The presence of the previously unreported foot-mouth response may serve as an indicator of central nervous system compromise and could be associated with a poorer prognosis. We believe that our observations of the specific foot-mouth response patterns may serve as a marker of early neuro-psychomotor development dysfunction during childhood.