Social anxiety score is high in adolescents with chronic migraine.

BACKGROUND: Social anxiety disorder, also known as social phobia, is a marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. It usually begins in mid-adolescence and has a chronic course and interferes in academic, social, family and personal functioning. Recent studies have shown that social anxiety disorder is more prevalent in adults with migraine. Little evidence on this subject is available for the adolescent population. METHODS: This study was performed between August 2009 and August 2010; all patients were recruited in schools, pediatric or neuropediatric facilities, and were submitted to a detailed headache questionnaire, which consisted of demographic and clinical data. To evaluate social anxiety, the Social Phobia Inventory was used. RESULTS: A total of 151 subjects were evaluated: 50 had chronic migraine, 50 had episodic migraine and 51 were control subjects. In the chronic migraine group, the mean score in the Social Phobia Inventory was 18.5 ± 12.4, which was significantly higher than in the episodic migraine group (12.1 ± 8.1) and in the control group (13.8 ± 10.8; F(2131) = 4.8, P= 0.010). The mean score, however, was not significantly different between the control and episodic migraine groups. CONCLUSIONS: Chronic migraine is strongly associated with high social anxiety score, regardless of demographic data and pain intensity. The total burden of migraine may be increased with social anxiety disorder comorbidity.

Depressão, ansiedade e sonolência diurna em cuidadores primários de crianças com paralisia cerebral / Depression, anxiety and daytime sleepiness of primary caregivers of children with cerebral palsy

OBJETIVO:Avaliar os níveis de depressão, ansiedade e sonolência diurna excessiva em cuidadores primários de crianças com paralisia cerebral, relacionando-os às condições socioeconômicas do cuidador e às características neurológicas da criança e comparando-os a cuidadores de crianças saudáveis. MÉTODOS:45 cuidadores de crianças com paralisia cerebral e 50 cuidadores de crianças saudáveis foram aleatoriamente incluídos no estudo e responderam a um questionário semiestruturado. Avaliaram-se os níveis de depressão, ansiedade e sonolência diurna excessiva por meio das escalas de Beck, ansiedade estado-traço e Epworth, respectivamente. RESULTADOS:A maioria dos entrevistados eram mães com baixo nível socioeconômico. Os que se autoavaliaram como ansiosos e depressivos apresentaram resultados comprobatórios de ansiedade e depressão com as escalas de ansiedade estado-traço e Beck para os cuidadores de crianças com paralisia cerebral. Os níveis de sonolência diurna excessiva estiveram relacionados a elevados níveis de depressão. O comprometimento neurológico das crianças não influenciou os resultados sobre os cuidadores. CONCLUSÕES:Depressão, ansiedade e problemas relacionados ao sono foram comuns em cuidadores de crianças com paralisia cerebral. O nível de funcionalidade neurológica da criança não influenciou os resultados.

OBJECTIVE:To evaluate depression, anxiety and excessive daytime sleepiness (EDS) levels in primary caregivers of children with cerebral palsy (CCP) and to trace the relationships with their socioeconomic conditions and child neurological characteristics, as compared with caregivers of typical children (CTC). METHODS:45 CCP and 50 CTC were randomly chosen and answered a semi-structured questionnaire. We evaluated EDS on the Epworth scale. Beck depression inventory (BDI) and the state-trait anxiety inventory (STAI) identified depressive and anxious symptoms, respectively. RESULTS:The majority of subjects were mothers with low socioeconomic level. Self-perception of anxiety and depressive symptoms of CCP were confirmed through BDI and STAI. EDS was statistically related to high levels of depression. Children's disabilities did not influence the results. CONCLUSIONS:Depression, anxiety symptoms and sleep disruption were common in CCP. Child functional level did not influence the results.

Hemifacial spasm as a manifestation of pilocytic astrocytoma in a pediatric patient.

Hemifacial spasm is a disorder of the seventh cranial nerve, which is characterized by irregular, involuntary and recurrent tonic and clonic contractions of the ipsilateral facial expression muscles. This disorder affects mainly adults, and there are few cases reported in childhood. The main etiologies are vascular problems, although tumors are an important cause of hemifacial spasm via a direct or an indirect mass effect. We report a 6-year-old girl who presented with right hemifacial spasm. Magnetic resonance imaging showed a lesion in the cerebellopontine angle, extending from the midbrain to the pons with a slight mass effect on the fourth ventricle. The histological examination revealed a pilocytic astrocytoma.

Dysphonia severity degree and phonation onset latency in laryngeal adductor dystonia.

Although the latency between the initiation of thyroarytenoid electrical activity and the onset of phonation generally is increased in patients with adductor laryngeal dystonia, there is disagreement about whether there is overlap of latency values in these patients and normal subjects. The goal of this article was to compare the severity of dysphonia with the latency between electrophysiological activation of the thyroarytenoid muscle (TA) and the onset of phonation in patients with adductor laryngeal dystonia and compare the values with normal controls. Twenty-one patients with adductor dystonia and 15 control patients underwent laryngeal electromyographic (EMG) examination of the left TA. We measured the latency from initiation spike of the electric activity of the TA muscle to the onset of phonation. Three speech-pathologists/voice specialists arrived at a consensus to rate the perceptual evaluation of voice quality for the study group. The average latency measured for patients with mild dysphonia was 332 milliseconds, for moderate dysphonia was 426 milliseconds, and for the severe dysphonia was 792 milliseconds. We used the Spearman's correlation test to compare the latency time values and the dysphonia's degree of severity (P<0.05). Latency was significantly and directly related to the degree of severity of dysphonia.

Escala do desenvolvimento do comportamento da crianca de 1 a 12 meses

Este estudo teve como objetivo investigar o processo de desenvolvimento do comportamento da crianca normal no primeiro ano de vida e propor uma escala para avaliacao deste desenvolvimento. A amostra consistiu de 242 criancas saudaveis, de 1 a 12 meses incompletos, distribuidas conforme a idade, mes a mes, em um total de 121 criancas de cada sexo. Para a selecao da amostra foram analisados os seguintes fatores: idade, sexo, condicoes socio-economico-culturais dos pais, naturalidade da crianca, antecedentes familiares, condicoes pre, peri e pos natais, evolucao clinica, peso e altura. As criancas foram submetidas a uma avaliacao individual do seu comportamento, realizada atraves da Escala de Desenvolvimento do Comportamento da Crianca, tendo sido avaliados 64 comportamentos, classificados, quanto: aos eixos somaticos, a estimulacao e a funcao comunicativa. Os comportamentos tambem foram estudados quanto a probabilidade de ocorrencia, em cada idade, considerando-se: o aparecimento, a normalizacao e a estabilizacao. Os resultados apontaram a existencia de uma sequencia no desenvolvimento do comportamento da crianca no sentido: axial para apendicular, espontaneo para estimulado e nao comunicativo para comunicativo. Permitiram constatar no desenvolvimento do comportamento na faixa etaria estudada, diferencas estatisticamente significantes entre os sexos, indicando um ritmo mais rapido no sexo masculino que no feminino. Por considerar tais diferencas, a Escala de Desenvolvimento do Comportamento da Crianca, de 1 a 12 meses incompletos, proposta no presente estudo, foi apresentada, separadamente, para cada sexo.

Coréia de Sydenham - avaliaçäo fonoarticulatória / Sydenham Coreia-speech evaluation

O presente estudo teve como objetivo realizar uma avaliaçäo fonoarticulatória em sujeitos com quadro coréico, diagnosticado por médico especialista como coréia de Sydenham. A populaçäo avaliada constituiu-se de 15 sujeitos entre 7 e 15 anos de idade, sendo 5 do sexo masculino e 10 do sexo feminino. A avaliaçäo consistiu de análise perceptivadas funçöes respiratória, fonatória, ressonantal e articulatória e de análises objetivas das medidas fonatórias e respiratórias - tempo máximo fonatório, relaçäo s/z, capacidade vital e cociente fônico. A avaliaçäo fonoarticulatória perceptiva indicou prevalência do tipo respiratório superior, incoordenaçäo pneumofonoarticulatório, qualidade vocal soprosa e áspera, modulaçäo excessiva de frequência e intensidade, ensudercimento dos fonemas sonoros, hipernasalidade e articulaçäo imprecisa...

Juvenile systemic lupus erythematosus

With the purpose of analyzing the neurological involvement due to systemic lupus erythematosus (SLE), we evaluated 17 female patients who were seen regularly at the hospital and had been diagnosed as having SLE according to classification criteria proposed by the American College of Rheumatology revised in 1982, before the age of 16. Neurological involvement was detected in 12 patients(71 percent): headache (35 percent), extrapyramidal syndrome (35 percent), epileptic syndrome (24 percent) pyramidal syndrome (24 percent), peripheral neuropathy (12 percent) and optic neuritis (6 percent). The findings of CT scan (58 percent) and cerebrospinal fluid (50 percent) were most closely correlated to clinical neurological involvement.