ABSTRACT
El síndrome afectivo-cognitivo cerebeloso se caracteriza por alteración en funciones ejecutivas, problemas de organización y memoria visuoespacial, alteración en la producción del lenguaje y trastorno de conducta. Niño de 11 años con dificultades de aprendizaje, trastorno de conducta y problemas de interacción social. En la exploración física destaca conducta inmadura, escaso contacto visual, dificultad para mantener la atención, lenguaje expresivo pobre y disabilidad motriz global con dispraxia para las variantes de la marcha, sin signos cerebelosos definidos. Valoración neuropsicológica: cociente intelectual 84 con datos compatibles con síndrome afectivo-cognitivocerebeloso. RM cerebral: proceso expansivo en vermis cerebeloso inferior, que permanece estable tras 5 años de seguimiento. El cerebelo participa como centro coordinador de funciones cognitivas y emocionales. Ante un niño con un trastorno de aprendizaje con componente conductual y afectivo asociado debe incluirse la patología cerebelosa en el diagnóstico diferencial y descartar una lesión a este nivel
Cerebellar cognitive affective syndrome is characterized by disturbances of executive function, impaired spatial cognition, linguistic difficulties, and personality change. The case of an 11 year old boy is presented, with behavior problems, learning difficulties and social interaction problems. In the physical examination he had poor visual contact, immature behavior, reduced expressive language and global motor disability with gait dyspraxia, with no defined cerebellar motor signs. In the neuropsychological evaluation he has a full scale overall intellectual quotient of 84, with signs of cerebellar cognitive affective syndrome. A tumour affecting inferior cerebellar vermis was observed in the magnetic resonance imaging, which had not significantly grown during 5 years of follow up. The cerebellum participates in controlling cognitive and affective functions. Cerebellar pathology must be considered in the differential diagnosis of children with cognitive or learning disorder with associated behavioral and emotional components
Subject(s)
Humans , Male , Child , Cerebellar Neoplasms/congenital , Cerebellar Neoplasms/diagnosis , Cerebellar Neoplasms/metabolism , Infant, Premature/metabolism , Learning Disabilities/complications , Learning Disabilities/diagnosis , Neuroanatomical Tract-Tracing Techniques/ethics , Neuroanatomical Tract-Tracing Techniques/instrumentation , Cerebellar Neoplasms/complications , Cerebellar Neoplasms/mortality , Infant, Premature/growth & development , Learning Disabilities/genetics , Learning Disabilities/prevention & control , Neuroanatomical Tract-Tracing Techniques/methods , Neuroanatomical Tract-Tracing TechniquesABSTRACT
Cerebellar cognitive affective syndrome is characterized by disturbances of executive function, impaired spatial cognition, linguistic difficulties, and personality change. The case of an 11 year old boy is presented, with behavior problems, learning difficulties and social interaction problems. In the physical examination he had poor visual contact, immature behavior, reduced expressive language and global motor disability with gait dyspraxia, with no defined cerebellar motor signs. In the neuropsychological evaluation he has a full scale overall intellectual quotient of 84, with signs of cerebellar cognitive affective syndrome. A tumour affecting inferior cerebellar vermis was observed in the magnetic resonance imaging, which had not significantly grown during 5 years of follow up. The cerebellum participates in controlling cognitive and affective functions. Cerebellar pathology must be considered in the differential diagnosis of children with cognitive or learning disorder with associated behavioral and emotional components.
Subject(s)
Cerebellar Neoplasms/complications , Cognition Disorders/etiology , Mood Disorders/etiology , Child , Humans , MaleABSTRACT
La intoxicación por vitamina D es una causa bien conocida de hipercalcemia infantily puede tener serias consecuencias (renales, cardiacas y neurológicas fundamentalmente). El empleo de suplementos nutricionales enriquecidos con vitaminas, de venta sin receta, conlleva un importante riesgo de que esto ocurra. La clínica de la hipercalcemia es inespecífica y, unida al hecho de que con frecuencia se niega la ingesta de dichos suplementos, el diagnóstico de intoxicación por vitamina D se demora y el número de pruebas complementarias realizadas es amplio. Exponemos una serie de 3 casos de hijos de inmigrantes latinoamericanos que estaban recibiendo suplementos nutricionales traídos de los países de origen de sus padres. Los 3 se presentaron en nuestro centro en un intervalo de 5 meses. Tras el antecedente de un primer caso, el diagnóstico de los 2 siguientes fue más rápido, así como la instauración del tratamiento para la hipercalcemia. Los niveles iniciales de calcio y 25-hidroxivitamina D fueron, respectivamente, para cada caso: 17,9 mg/dl y 504 ng/ml, 14,46 mg/dl y 505 ng/ml, y 14,2 mg/dl y530 ng/ml. Recibieron tratamiento con sueroterapia, furosemida y corticoides, y en uno de los casos con calcitonina subcutánea. La evolución clínica de todos ellos fue óptima, normalizándosela calcemia y la función renal (AU)
Vitamin D intoxication is a well-known cause of hypercalcemia in children and can have serious consequences (renal, cardiac and neurologic mainly). The use of the so-called over the-counter (OTC) supplements involves a high risk in this taking place. The clinical expression of hypercalcaemia is unspecific, and, together with the fact that the administration of such supplements is frequently denied, the diagnosis of vitamin D intoxication is often delayed and the number of complementary tests performed is high. We here-for expose a series of 3 cases all of which are infants born from Latin-American immigrants who were receiving supplements that came from their parents originary countries. All 3 cases were admitted in our hospital within a period of 5 months. After the first preceding case, the diagnosis of the 2 latter ones was performed promptly and so was the instauration of the treatment for hypercalcemia. The initial levels of serum calcium and of 25-hydroxy vitamin D where, respectively for each case: 17.9 mg/dl and 504 ng/ml; 14.46 mg/dl and 505 ng/ml; 14.2 mg/dl and 530 ng/ml. All 3 patients received intravenous treatment with serum, furosemide and corticoids and in one case with subcutaneous calcitonine as well. The clinical outcome was optimal for them all, with normalization of the calcium levels and of the renal function (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Vitamin D/poisoning , Hypercalcemia/chemically induced , Self Medication/adverse effects , Emigrants and Immigrants , Furosemide/therapeutic use , Adrenal Cortex Hormones/therapeutic useABSTRACT
Vitamin D intoxication is a well-known cause of hypercalcemia in children and can have serious consequences (renal, cardiac and neurologic mainly). The use of the so-called over-the-counter (OTC) supplements involves a high risk in this taking place. The clinical expression of hypercalcaemia is unspecific, and, together with the fact that the administration of such supplements is frequently denied, the diagnosis of vitamin D intoxication is often delayed and the number of complementary tests performed is high. We here-for expose a series of 3 cases all of which are infants born from Latin-American immigrants who were receiving supplements that came from their parents originary countries. All 3 cases were admitted in our hospital within a period of 5 months. After the first preceding case, the diagnosis of the 2 latter ones was performed promptly and so was the instauration of the treatment for hypercalcemia. The initial levels of serum calcium and of 25-hydroxy vitamin D where, respectively for each case: 17.9 mg/dl and 504 ng/ml; 14.46 mg/dl and 505 ng/ml; 14.2mg/dl and 530 ng/ml. All 3 patients received intravenous treatment with serum, furosemide and corticoids and in one case with subcutaneous calcitonine as well. The clinical outcome was optimal for them all, with normalization of the calcium levels and of the renal function.
