Sindrome de sandifer: a propósito de la enfermedad por reflujo gastroesofágico en niños / Sandifer syndrome and gastroesophageal reflux in childre

El Síndrome de Sandifer es un trastorno neuroconductual con movimientos de hiperextensión de cuello, cabeza y tronco, con rotación de cabeza, que generalmente se presentan durante o inmediatamente después de la ingesta de alimentos y cesa durante el sueño, secundario a enfermedad por reflujo gastroesofágico. Se caracteriza por esofagitis, anemia por deficiencia de hierro y son confundidos con frecuencia como crisis de origen epiléptico. Lactante masculino de 5 meses referido por movimientos de tónico-clónicos generalizados, de segundos de duración, con una frecuencia de 30 episodios al día, que no ceden con el uso de 3 anticonvulsivantes. Disfagia a alimentos pastosos. Hospitalización al mes de vida por episodio de amenazante de la vida. Estudios neurológicos normales. Paraclínica: anemia microcítica e hipocrómica. Videodeglutoscopia: Disfagia de fase oral leve, disfagia fase esofágica a estudiar (Regurgitación), reflujo faringolaringeo según escala de Belafsky y Larigomalacia grado I; pHmetría de 24 horas con impedancia, puntación de Boix-Ochoa de 26%, durante la colocación de la sonda se observo posición anómala de la cabeza e hiperextensión del dorso. Estudio contrastado de esófago, estómago y duodeno sin anormalidad anatómica. Endoscopia digestiva superior: Esofagitis no erosiva, Hernia hiatal. El Síndrome de Sandifer es una de las presentaciones atípicas de RGE en lactantes. Amerita la evaluación de un equipo multidisciplinario para establecer el diagnóstico. El manejo medico incluyó medidas antireflujo, esomeprazol y técnica de alimentación adecuada con evolución satisfactoria. La diversidad de enfermedades relacionadas con RGE exige el uso de variadas técnicas para lograr diagnósticos más asertivos

Sandifer's syndrome is a neurobehavioral disorder with hyperextension movements of neck, head and trunk, head rotation, which usually occur during or immediately after food intake and ceases during sleep, secondary to gastroesophageal reflux disease. It is characterized by esophagitis, anemia and iron deficiency are often confused as a crisis of epileptic origin. A male infant of 5 months reported by tonic-clonic movements of widespread, lasting seconds, with a frequency of 30 episodes per day, which do not yield with the use of 3 anticonvulsants. Pasty food dysphagia. Hospitalization month of life-threatening episode of life. Normal neurological studies. Paraclinical: hypochromic microcytic anemia. Videodeglutoscopia: mild oral phase dysphagia, esophageal dysphagia to study phase (regurgitation), pharyngolaryngeal reflux as Belafsky and Larigomalacia scale grade I, ph-metry of 24 hours with impedance, Boix-Ochoa score of 26% during the placement of probe was observed abnormal head position and hyperextension of the back. Contrast study of esophagus, stomach and duodenum without anatomical abnormality. Upper gastrointestinal endoscopy: nonerosive esophagitis, hiatal hernia. Sandifer Syndrome is one of the atypical presentations of GER in infants. Warrants evaluation by a multidisciplinary team to establish the diagnosis. The medical management included antireflux measures, esomeprazole and proper feeding technique with satisfactory outcome. The diversity of diseases associated with GER requires the use of various diagnostic techniques to get more assertive

Seizures in the newborn.

Seizures in the newborn period constitute a medical emergency. Subtle seizures are the commonest type of neonatal seizures, other types being clonic, tonic, and myoclonic. Myoclonic seizures carry the worst prognosis in terms of long-term neurodevelopmental outcome. Hypoxic-ischemic encephalopathy is the most common cause of neonatal seizures. Multiple etiologies often co-exist in neonates and hence it is essential to rule out conditions such as hypoglycemia, hypocalcemia, and meningitis before initiating specific therapy. A comprehensive approach for management of neonatal seizures has been described.

EEG signals processing for diagnosis petitmal [absence] and grandmal epilepsies using artificial neural network

Epileptic seizures are manifestation of epilepsy. Understanding of the mechanisms causing epileptic disorder needs careful analyses of the electroencephalograph [EEG] records. The detection of epileptic form discharges [spike wave] in the EEG is an important component in the diagnosis of epilepsy. Approximately one in every 100 persons will experience a seizure at some time in their life. Already intelligence spike detection method discucsed but purpose of this research is diagnosis of different kind of epilepsy [grandmal and Petitmal] by design of an intelligence diagnosis processing. In this descriptive study, 100 EEG signals of brain hemispheres from different person in healthy, interictal and ictal conditions were used. Fifty Hz noise and artifact signals were removed by soft ware procedure then signals separated by expert neurologist to three categories, healthy [frequency band 8-12 Hz], petitmal seizures [typical 3 Hz], grandmal seizures [clonic stage with 4 Hz frequency] and divided each of them to 6 seconds segments. Information of this signals [background alpha, spike and slow, poly spike and poly sharp] were extracted by wavelet transform and classified by soft ware procedure neural network to there groups healthy, ptitmal and grandmal epilepsy. In designed software accuracy of diagnosis ptitmal and grandmal epilepsies was obtained about 80%. This method introduced intelligent diagnosis of epilepsy [ptitmal and gradmal] and automatically detected healthy person from epileptic patients. One of the other advantages is help to neurologist for detection of sickness clearly and expendable different kinds of other epilepsy

Hypomelanosis of Ito.

A two-year-old male child presented with bizarre hypopigmented skin lesions, severe mental retardation and generalized tonic-clonic seizures. Examination showed hypopigmented patterned whorls and irregular patches over the trunk and linear streaks over the flexor aspects of upper and lower limbs. He also had generalized hypertonia and brisk tendon reflexes. Other systems were normal.

Epilepsia por sobresalto: estudio de siete casos / Startle epilepsy: seven cases report

Introducción. Se presentan siete pacientes con epilepsia por sobresalto. Casos clínicos. Las crisis epilépticas fueron precipitadas por una reacción de sobresalto, secundaria a un estímulo auditivo, táctil, o propiocentivo; el patrón predominante fue postura tónica, extensión de las extremidades superiores y flexión de la cabeza; la edad de inicio fue antes de los 13 años; 4 tuvieron historia de asfixia perinatal, 1 de hemorragia intracraneana, 1 de deshidratación, y en 1 no se estableció la causa. Se realizó registro electroencefalográfico en 6 casos, ninguno tuvo registro normal, sobresaliendo: anormalidades focales, paroxismos generalizados, paroxismos atípicos de punta onda y polipunta onda lenta. La tomografía axial computada cerebral en 5 pacientes demostró lesiones atrópicas focales, porencefalia, atrofia corticosubcortical difusa, y en un paciente el estudio fue normal. Se utilizaron diversos antiepilépticos, con resistencia al tratamiento convencional. Conclusiones. La epilepsia por sobresalto es una forma poco común de epilepsia, los hallazgos encontrados en el grupo estudiado son semejantes a los reportados por otros autores

Management of generalized tonic-clonic status epilepticus.

The steps to be taken in the management of GTC status are outlined in Table 2. Once the GTC status is brought under control, prevention of recurrent seizures must be considered. The specific etiology must be sought. Those patients who require long-term prophylactic anticonvulsant therapy include those with structural brain abnormalities, progressive neurological disorders, and patients with idiopathic epilepsy.