Actividad epileptiforme en trastornos psiquiátricos infantiles / Epileptiform activity in psychiatric disorders in children

Con frecuencia se observan anormalidades en la actividad eléctrica cerebral en pacientes con disfuncióncerebral. Pacientes y métodos. Analizamos de manera retrospectiva los resultados de los estudios electroencefalográficos realizados de agosto a diciembre de 2006, de niños con diagnóstico clínico de trastorno psiquiátrico, sin tener en cuentaa aquéllos con epilepsia. Resultados. Se revisaron 1.000 estudios de electroencefalogramas (EEG); la edad de los pacientes fue de 0 a 18 años, con un promedio de 9,7 años, y la relación por sexo fue de 67,9% varones y 32,1% mujeres. Los cuatro trastornos psiquiátricos más frecuentes fueron: trastorno por déficit de atención/hiperactividad, 422; trastorno depresivo,103; retraso mental, 99, y trastorno conductual, 96. Los EEG se dividieron en trazos normales (37,8%) y anormales (61,9%). La anormalidad más frecuente fue inmadurez bioeléctrica (56,4% de los casos). Al analizar actividades epileptiformes, encontramos26 estudios (2,6%) y datos de irritabilidad corticosubcortical en el 6,7%. El total de niños con grafoelementos epileptiformes fue 71. El grafoelemento más común fue la onda aguda (97,2%) y la localización en el lóbulo temporal (42,3%). Conclusiones. Un alto porcentaje de pacientes con trastornos psiquiátricos cursan anormalidades en su actividad eléctricacerebral, e incluso actividad epileptiforme. En la bibliografía se han comunicado anormalidades eléctricas en la población general de niños sanos, pero las cifras que encontramos son mayores para pacientes con trastorno psiquiátrico. Las neuronas funcionan mal y nos da diversidad de patologías. Es cuestionable la repercusión de la actividad eléctrica cerebral anormal, sobre los datos clínicos de los pacientes, y consideramos que se trata de un epifenómeno

Abnormalities are often observed in the electrical activity of the brain in patients with brain dysfunction.Patients and methods. We conducted a retrospective analysis of the results of electroencephalogram studies carried out between August and December 2006 on children who had been clinically diagnosed with a psychiatric disorder, without taking into account those with epilepsy. Results. A total of 1000 electroencephalogram (EEG) studies were reviewed; the age of thepatients ranged from 0 to 18 years, with an average of 9.7 years, and the ratio between sexes was 67.9% males and 32.1% females. The four most frequently observed psychiatric disorders were: attention deficit hyperactivity disorder, 422; depressive disorder, 103; mental retardation, 99; and behavioural disorder, 96. The EEG findings were divided into normal(37.8%) and abnormal patterns (61.9%). The most frequent abnormality was bioelectric immaturity (56.4% of cases). On analysing epileptiform activities, we found 26 studies (2.6%) and evidence of cortico-subcortical irritability in 6.7%. The total number of children with epileptiform patterns was 71. The most common pattern was the sharp wave (97.2%) and the mostfrequent location was the temporal lobe (42.3%). Conclusions. A high percentage of patients with psychiatric disorders also have abnormalities in the electrical activity of their brains, and even epileptiform activity. Electrical abnormalities in the general population of healthy children have been reported in the literature, but the figures that we found are higher for patients with psychiatric disorders. Functioning of the neurons is incorrect and this results in a range of different pathologies.The repercussion of abnormal electrical activity of the brain on the clinical data of the patients is open to discussion, and we consider it to be an epiphenomenon

[Epileptiform activity in psychiatric disorders in children]. / Actividad epileptiforme en trastornos psiquiátricos infantiles.

INTRODUCTION: Abnormalities are often observed in the electrical activity of the brain in patients with brain dysfunction. PATIENTS AND METHODS: We conducted a retrospective analysis of the results of electroencephalogram studies carried out between August and December 2006 on children who had been clinically diagnosed with a psychiatric disorder, without taking into account those with epilepsy. RESULTS: A total of 1000 electroencephalogram (EEG) studies were reviewed; the age of the patients ranged from 0 to 18 years, with an average of 9.7 years, and the ratio between sexes was 67.9% males and 32.1% females. The four most frequently observed psychiatric disorders were: attention deficit hyperactivity disorder, 422; depressive disorder, 103; mental retardation, 99; and behavioural disorder, 96. The EEG findings were divided into normal (37.8%) and abnormal patterns (61.9%). The most frequent abnormality was bioelectric immaturity (56.4% of cases). On analysing epileptiform activities, we found 26 studies (2.6%) and evidence of cortico-subcortical irritability in 6.7%. The total number of children with epileptiform patterns was 71. The most common pattern was the sharp wave (97.2%) and the most frequent location was the temporal lobe (42.3%). CONCLUSIONS: A high percentage of patients with psychiatric disorders also have abnormalities in the electrical activity of their brains, and even epileptiform activity. Electrical abnormalities in the general population of healthy children have been reported in the literature, but the figures that we found are higher for patients with psychiatric disorders. Functioning of the neurons is incorrect and this results in a range of different pathologies. The repercussion of abnormal electrical activity of the brain on the clinical data of the patients is open to discussion, and we consider it to be an epiphenomenon.

The wafer test: a semi-quantitative test to screen for xerostomia.

OBJECTIVE: To develop a screening test for xerostomia. METHODS: A cross-sectional study was conducted among 152 healthy subjects aged <20-60 yr, 30 patients with primary Sjögren's syndrome and 60 patients with other connective tissue diseases, sampled randomly. A validated screening questionnaire for sicca syndrome and the Schirmer-1 and wafer tests were carried out in all subjects. In addition, non-stimulated whole salivary flow was measured in a random sample of 113 participants. The main outcome was the time of dissolution of the wafer. RESULTS: Time of dissolution of the wafer was 2.8+/-2.1 min in the healthy group, 3.3+/-1.5 min in the connective tissue diseases group, and 9.2+/-3.9 min in the primary Sjögren's syndrome group (P<0.001). The correlation coefficient between the wafer test and non-stimulated whole salivary flow was -0.60 [95% confidence interval (CI) -0.47, -0.71]. A cut-off value of 4 min ('wafer 4') showed sensitivity of 92.9%, specificity of 71.7%, a positive predictive value of 31.7%, a negative predictive value of 98.6%, accuracy of 74.3%, an ROC (receiver operating curve) value of 82.3 and a likelihood ratio of 3.3 (95% CI 2.3, 4.6) for xerostomia. The proportion of patients with wafer 4 was 8% in the healthy group, 23% in the connective tissue diseases group and 93% in the primary Sjögren's syndrome group (P<0.001). Wafer 4 was a significant predictor of xerostomia after controlling for age, gender, temperature and relative humidity. CONCLUSION: The wafer test is valid and reliable for identifying subjects with xerostomia.