[Idiopathic generalized epilepsies with absence seizures with valproic acid treatment: neuropsychological disorders]. / Epilepsia generalizada idiopatica con ausencias tipicas tratada con acido valproico: alteraciones neuropsicologicas.

AIM: To analyze the neuropsychological profile of children with absence seizures treated with valproate. SUBJECTS AND METHODS: Sample of 34 children from 7 to 12 years with absence seizures treated with valproate (median dose: 30 mg/kg/day) and 28 controls. We get the neuropsychological profile by applying the Wechsler Intelligence Scale for Children-Revised (WISC-R) and Luria-DNI Battery. RESULTS: Children with absence seizures manifest verbal IQ significantly lower (p < 0.05) than the control group but within normal. The neuropsychological profile Luria-DNI is significantly lower (p < 0.05) than the control group in all areas except in regulation verbal, kinesthetic, visual perception, comprehension and understanding simple grammar. This is a serious deterioration profile in the areas of logical memory, short-term memory, arithmetic, numerical structure, reading, writing, naming, and articulation. Children with absence seizures have a significant memory deficit. Memory profile measured with the Luria-DNI Battery and the WISC-R appears generally deteriorated when compared with the control group (p < 0.001) although there is a paradoxical preservation of shape memory. The short-term auditory and visual memory and logical memory are particularly affected. In the epileptic group, the attentional profile (estimated by the 'third factor of the WISC-R') is generally deteriorated when compared with the control group. CONCLUSIONS: We consider in children with this diagnosis and treatment, the neuropsychological profile described to strengthen deficient neuropsychological and psychoeducational areas. Above, we claim the need, in the consultations of neuropediatrics, the neuropsychlogists to ensure the systematic analysis of neuropsychological and cognitive difficulties both at the time of the diagnosis and follow-up of epilepsy.

[Neuropsychological profiles associated with the children's oral language disorders]. / Perfiles neuropsicológicos asociados a los problemas del lenguaje oral infantil.

INTRODUCTION: Oral language disorders constitute a group of syndromes with a high prevalence among the childhood population. They form a heterogeneous group that ranges from simple problems in articulating a phoneme (dyslalias) to severe disorders affecting communication, such as children's dysarthrias and aphasias. In this paper our objective is to review the neuropsychological profiles of children who manifest different oral language disorders. DEVELOPMENT: Due to the wide range of clinical pictures and causations covered by children's oral language disorders, very few systematic reviews have been conducted to obtain an overall view of the neuropsychological profiles of these children. Although the linguistic signs and symptoms of these disorders are well understood, the associated neuropsychological signs and symptoms have not been studied. In some cases, these neuropsychological signs cause greater learning problems in children than the actual language problems themselves. CONCLUSIONS: Childhood language disorders are associated with different neuropsychological problems. The most commonly associated neuropsychological deficits are problems involving memory, attention, executive functions, motor dysfunctions, temporal perception, tactile recognition, body scheme, spatial orientation and difficulties in visual discrimination. Mnemonic disorders (essentially in short-term and working auditory memory) are usually a common denominator in the different clinical pictures that make up language disorders. The mnemonic impairment associated to dyslalias deserves special attention as this disorder is sometimes similar to that seen in language problems deriving from clinical pictures with important neurological alterations.

Perfiles neuropsicológicos asociados a los problemas del lenguaje oral infantil / Neuropsychological profiles associated with the children's oral language disorders

Introducción. Los trastornos del lenguaje oral constituyen un grupo de alteraciones con alta prevalencia dentro de la población infantil. Se trata de un grupo heterogéneo que abarca desde simples problemas de articulación de un fonema (dislalias) hasta trastornos graves de comunicación, como afasias y disartrias infantiles. En este artículo se pretende revisar los perfiles neuropsicológicos de los niños que manifiestan diferentes problemas de lenguaje oral. Desarrollo. Debido a la gran variedad de cuadros y etiologías que abarcan los trastornos del lenguaje oral infantil, no existen apenas revisiones sistemáticasque estudien de manera global los perfiles neuropsicológicos de estos niños. La semiología lingüística de estos trastornos se conoce en profundidad. Sin embargo, la semiología neuropsicológica asociada no se ha revisado. En algunos casos,estos signos neuropsicológicos determinan en los niños mayores problemas de aprendizaje que los propios problemas del lenguaje. Conclusiones. Las alteraciones del lenguaje infantil se asocian a diferentes problemas neuropsicológicos. Los déficit neuropsicológicos asociados más frecuentes son los problemas de memoria, de atención, de funciones ejecutivas, de disfuncionesmotrices, de la percepción temporal, del reconocimiento táctil, del esquema corporal, de la orientación espacial y de discriminación visual. La alteración mnésica (fundamentalmente en la memoria auditiva inmediata y de trabajo) suele ser un denominador común en los diferentes cuadros que determinan problemas del lenguaje. Merece la pena observar con especialatención el deterioro mnésico asociado a las dislalias; a veces, esta afectación es similar a la que se manifiesta en problemas del lenguaje derivados de cuadros con alteraciones neurológicas importantes

Introduction. Oral language disorders constitute a group of syndromes with a high prevalence among the childhoodpopulation. They form a heterogeneous group that ranges from simple problems in articulating a phoneme (dyslalias) to severe disorders affecting communication, such as children’s dysarthrias and aphasias. In this paper our objective is to review the neuropsychological profiles of children who manifest different oral language disorders. Development. Due to the widerange of clinical pictures and causations covered by children's oral language disorders, very few systematic reviews have been conducted to obtain an overall view of the neuropsychological profiles of these children. Although the linguistic signs and symptoms of these disorders are well understood, the associated neuropsychological signs and symptoms have not beenstudied. In some cases, these neuropsychological signs cause greater learning problems in children than the actual language problems themselves. Conclusions. Childhood language disorders are associated with different neuropsychological problems. The most commonly associated neuropsychological deficits are problems involving memory, attention, executive functions, motor dysfunctions, temporal perception, tactile recognition, body scheme, spatial orientation and difficulties in visual discrimination. Mnemonic disorders (essentially in short-term and working auditory memory) are usually a common denominator in the different clinical pictures that make up language disorders. The mnemonic impairment associated to dyslalias deserves special attention as this disorder is sometimes similar to that seen in language problems deriving from clinical pictures with important neurological alterations

Influencia de la reacticivad cardiovascular sobre la discriminación del latido cardíaco: implicaciones en la detección precoz de síntomas / Influence of cardiovascular reactivity on heartbeat discrimination: implications for symptom precocious detection

Una respuesta metabólicamente exagerada en personas jóvenes ante situaciones de estrés es considerada como un marcador de riesgo de una futura hipertensión. Asimismo, los autores que investigan las diferencias individuales en la percepción de síntomas consideran que una mayor percepción visceral puede estar asociada con un mejor reconocimiento de síntomas en aquellas personas que padecen enfermedades crónicas con manifestaciones sutiles o vagas, como por ejemplo, la hipertensión esencial. En consecuencia, este estudio examina la relación entre reactividad cardiovascular y percepción del latido cardiaco. Una muestra de 42 sujetos participó en dos sesiones experimentales: en la primera de ellas realizaron una tarea evocadora de reactividad cardiovascular, en la segunda una tarea de discriminación del latido cardiaco mediante el método de los estí- mulos constantes. La reactividad cardiovascular fue definida como la diferencia en puntuación entre una condición de línea base y la condición de tarea. Las variables fisiológicas en las que se midió la reactividad cardiovascular fueron el periodo cardiaco (PC), la presión arterial sistólica (PAS) y la presión arterial diastólica (PAD). Si bien en el total de la muestra se encontraron diferencias significativas en todas las variables fisiológicas entre la condición de línea base y la condición de tarea, el grupo que logró discriminar el latido cardiaco no mostró una reactividad cardiovascular más elevada que el grupo que no logró discriminarlo, al menos en cuanto al periodo cardiaco y a la presión arterial se refiere (AU)

An overstated metabolic response to stressful situations in young persons is considered to be an indicator of hypertension risk. Likewise, some authors suggest that individual differences in symptom perception could be linked to visceral perception. A major visceral perception is usually associated with better symptoms recognition in those persons who experience chronic diseases with subtle or vague manifestations, as for example, the essential hypertension. This study is focused on the relation between cardiovascular reactivity and heartbeat perception. Forty two subjects performed two experimental sessions: the first one was an active coping computerized stress task; the second one, a heart beat discrimination task. Physiological variables used to measure cardiovascular reactivity, defined as difference scores between baseline and task condition, were: cardiac period, systolic and diastolic blood pressure. There were significant differences in all physiological variables between baseline and task, but the group of good heart beat discriminators did not show cardiovascular reactivity scores higher than the group that was unable of heart beat discrimination, at least as cardiac period and blood pressure are concerned (AU)

[Hypertension, cardiovascular reactivity to stress and sensibility to pain]. / Hipertensión, reactividad cardiovascular ante el estrés y sensibilidad al dolor.

OBJECTIVE: To provide a review of empirical evidence of decreased pain perception in hypertensive persons or exaggerated cardiovascular reactivity to stress. DEVELOPMENT: To following article will briefly review the existing literature on the association between hypoalgesia and high blood pressure. In particular, evidence of hypoalgesia in normotensive individuals at increased risk for hypertension (exaggerated cardiovascular reactivity to stress) will be offered in support of the notion that high cardiovascular reactivity to stress and decreased pain perception may result from a common physiological dysfunction. Cardiovascular reactivity refers to changes in cardiovascular activity associated primarily with exposure to psychological stress. Different individuals show different amounts of reactivity under the same conditions. The greater cardiovascular reactivity to behavioral stressors may play some role in the development of sustained arterial hypertension. Central opioid hyposensitivity is hypothesized as a mechanism of both hypoalgesia and exaggerated autonomic and neuroendocrine responses to stress in individuals at risk for hypertension. The paraventricular nucleus of the hypothalamus (PVN) serves the crucial function of integrating cardiovascular and painful responses. The central opioid hyposensitivity model of hypoalgesia asserts that attenuation of inhibitory opioid input to the PVN may have important consequences for pain modulation. These consequences includes: 1) greater activation of baroreceptor reflex arcs, 2) enhanced release of endogenous opioids during stress, and 3) increased stimulation of descending pain modulation pathways. CONCLUSIONS: High elevated thresholds to painful thermal stressors might serve as a behavioral marker of risk for hypertension before the onset of high blood pressure levels.