Neurodevelopmental dysfunction among nonreferred children with idiopathic megalencephaly.

PURPOSE: To determine whether nonreferred children with idiopathic megalencephaly show evidence of specific neurodevelopmental dysfunction compared with sibling control subjects and age-matched control subjects. DESIGN: Cross-sectional, case-control study in a large, suburban pediatric practice. Subjects included 20 children between the ages of 6 and 15 years with a head circumference at greater than the 98th percentile, 19 siblings of these children with normalsize heads, and 16 age-matched control subjects. Standardized tests of language, academic achievement, visuomotor integration, motor function, and neurodevelopmental function were administered. RESULTS: Multivariate analysis, with control for age, showed a main effect for the presence of megalencephaly (F = 3.2; p < 0.05). Follow-up univariate analyses, with control for age, showed that children with megalencephaly had poorer performance on tasks of upper limb speed, visuomotor control, running speed, bilateral coordination, visuomotor integration, naming fluency, and minor neurologic indicators. CONCLUSION: The relationship between idiopathic megalencephaly and external hydrocephalus in infants is discussed. Results show that so-called "benign" idiopathic megalencephaly in nonreferred school-age children appears to be a clinical entity associated with subtle motor problems and neurodevelopmental dysfunction.

Mexican-American folk belief in a pediatric emergency room.

The pattern, extent and patient care implications of medical folk belief in the Mexican-American population utilizing a pediatric emergency room were assessed. The parents of caretakers of 85 randomly selected patients were interviewed in the emergency room waiting area. The extent of knowledge and family history of four traditional folk diseases (magical fright, evil eye, surfeit, and fallen fontanelle) were determined, as was the utitlization of folk healers. The proportion of individuals with traditional knowledge varied with the specific folk disease and with demographic characteristics. Those born in Mexico were more likely to have knowledge of folk disease symptoms and treatment. Of 43 patients who had received treatment prior to coming to the emergency room, 13 had received an herbal folk remedy prescribed by a family member. Twenty-eight reported previous use of folk healers for pediatric illness although none had sought such care for the present illness. Of 57 informants who offered a cause for the child's present illness, two named a folk disease. Mexican-American folk belief is common in the population of Hispanic origin who utilize this pediatric emergency room. The illness for which care is sought, however, is felt to be amenable to scientific care and therfore medical folk belief is not often a clinically relevant factor in the emergency room setting.