The hyperactive child and the body. A clinical study on the origin of hyperactivity in children.

A group of 22 hyperactive children from 7 to 12 years of age was selected among 38 out-patients registered at Hospital do Servidor Público de São Paulo (Civil Servant Hospital of the State of São Paulo). Their psychiatric evaluation was negative, the neurological examination showed "psychomotor syndrome", and psychological evaluation revealed disorders related with Ego maturation in all cases. Although all children were referred to psychotherapy, only thirteen underwent individual sessions once a week for an uninterrupted period of up to one year. Neither diets nor medicines were prescribed. After six months and one year of treatment, the children were reevaluated. They showed improved school performance, reduced hyperactivity, and better internal psychic organization. These results are considered as undeniable evidence of the psychodynamic origin of hyperactivity syndrome in children, when no definite neurologic or psychiatric diseases are demonstrated.

[Lateral dominance in 182 children. 1. The antimeres, the praxis, the structure-performance relation]. / A dominância lateral em 182 crianças. 1. Os antímeros, as praxias, a relação estrutura-desempenho.

182 normal children from 6 to 14 years old presenting learning difficulties were neurologically examined. A 149 items questionnaire covering the intrauterine, peri and post partum life were answered by parents and afterwards detailed in interview consultation. Special procedures on motor skill were added to the usual neurological examination, to text motor performance differences between antimeros. Dextrallity appeared in 156 cases (85.71%), sinistrallity in 8 (4.39%) and in 18 cases (9.89%) the lateral dominance could not be determined. The concept of ambidextrallity was rejected for the bilateral equivalence in motor competence was not found in the subjects. The results lead to interpret the lateral dominance as a proportional distribution of motor performances in the right and left halves of the body in a process of constant improvement of motor skills which takes place in and belongs to the development of interdependence between the individuals and their environment. It is by way of such interrelationships that the significant motor activity (praxias) is acquired. Lateral dominance is considered a dynamic mechanism resulting from this interactive process which aim is directed together with other mechanisms to provide and improve the human being survival.

[Lateral dominance in 182 children. 2. The conscious motor act]. / A dominância lateral em 182 crianças. 2. O ato motor consciente.

The mechanisms and topology of the consciousness phenomenon are briefly presented. The present results and data from literature are used to point out that to localize in one certain part of the cerebrum the conscious process seems untenable. These results derive from the neurological examination on 182 normal children from 6 to 14 years old. The children's motor behaviour during the tests on 'praxia without object' shows the conscious process and attention to be attached to the motor action in the whole extension of its development. Therefore, the consciousness is considered such a process that is present at each moment and locus of the motor action. As pointed out by the present results, it seems that presence or absence of consciouness is regulated by intrapsychic mechanisms.

[Surface electromyography in the diagnosis of lateral dominance in children: psychomotor features]. / Eletromiografia de superfície no diagnóstico da dominância lateral em crianças: aspectos psicomotores.

Surface electromyography was used to verify the lateral dominance in 100 six to fourteen years old normal children. Electromyographic records were obtained during verbal stimulation. Dexterity was found in 90, sinistrallity in 3 and indefinite dominance in 7 patients. Comparing with results from clinical examination, the electromyography seems more accurate and easy to perform. The responses obtained after verbal stimulations were attributed to a psychomotor phenomenon. Mechanisms involved in the production of muscle contractions after verbal stimulation, were not proved. Pharmacologic action of cathecolamines on the central motor neural subsystems is advanced.

[Surface electromyography during experimental stress as a tool in the diagnosis of tension headache: results in 100 cases]. / Eletromiograma de superfície durante stress experimental como subsídio no diagnóstico da cefaléia tensional: resultados em 100 casos.

We report the use of surface scalp and neck electromyography during experimental stress state in a series of 100 out-patients suffering from chronic tension headache. Results revealed a 24% to 32% of diagnostic errors in the diagnostic obtained by routine anamnestic procedures and following the criteria recommended by the Headache Classification Committee of the International Headache Society (1988). The electromyography with stress is proposed as a new diagnostic criterion for tension headache.

[Possible stages in the pathogenesis of tension headache and indications for treatment]. / Possiveis etapas na patogênese da cefaléia tensional e indicações de tratamento.

Five steps in the pathogenic process involved in the tension headache pathogenesis are suggested from a 100 patients clinical study. Therapeutic efficacy in the treatment of the tension headache is considered to be linked to the relation between the therapeutic agent and the stage in which it has focused its effect, in the pathogenic process.

Malignant melanoma of the cerebello-pontine angle region.

A case of malignant melanoma in the cerebello-pontine angle region is presented in a 72 year old female patient, who had neurological examination and CT scan suggestive of acoustic neuroma. The surgical finding and the histological examination provided the diagnosis. As a primary focus was not found on clinical examination and although autopsy was not carried out, there is a possibility of the diagnosis being a primary malignant melanoma in CNS. This specific location for this kind of tumor was found to be rare when literature is looked up.

[Spinal epidural abscesses: report of 5 cases]. / Abscessos epidurais raqueanos: registro de cinco casos.

Five cases of acute spinal epidural abscess, all in male, two of them in children (6 and 7 years old) and the others in patients older than fifty years are reported. In four cases the pathology was related to skin infection and the staphylococcus was the main agent. All the patients had a severe infectious clinical picture, pain on the spine, radicular or spinal cord involvement or both. There was a delay in diagnosis showing that this pathology is still rather unknown. The cases were treated surgically. Two patients died, two had a complete recovery and the last one recovered with neurological deficit. The patients who died had impairment of the cervical cord and were operated on in very bad general and neurological conditions. Revision of literature was performed and the authors discussed the various aspects of this disease.

Abscessos epidurais raqueanos: registro de cinco casos. / Spinal epidural abscesses: report of 5 cases

Sao registrados 5 casos de abscesso epidural raqueano de evolucao aguda. Dos 5 pacientes, todos do sexo masculino, dois eram criancas de 6 e 7 anos e os demais, adultos com mais de 50 anos. Em 4 casos a fonte de infeccao estava na pele e em um nao foi detectado o foco. O agente infeccioso foi o estafilococo em quatro casos. Em todos os pacientes ficou evidenciado um grave estado toxico-infeccioso queda do estado geral e comprometimento do sistema nervoso manifestado por sindrome radicular ou sindrome de compressao medular dependendo do nivel da coluna acometida. Todos os casos foram tratados cirurgicamente e a demora do estabelecimento do diagnostico parece ter influido decisivamente na evolucao dos casos. Dos 5 pacientes, dois vieram a falecer, dois tiveram recuperacao completa, e um recuperacao parcial, com sequela neurologica. Os casos que evoluiram para obito, apresentavam comprometimento a nivel da coluna cervical e grave quadro septicemico e broncopneumonico. Os autores fazem uma revisao da literatura discutindo os varios aspectos desta entidade nosologica, ressaltando a necessidade do estabelecimento de um diagnostico precoce e imediata intervencao cirurgica, associada a antibioticoterapia

Estudos electromiográficos em 116 pacientes de lepra

Analisando os resultados obtidos através o EMG em 116 pacientes de lepra, os autores não evidenciaram distinções electromiográficas entre os diversos grupos e tipos de lepra. Concluem ser o EMG capaz de detectar os diferentes estágios evolutivos da neuropatia leprótica e que esta compromete gradual e progressivamente os diferentes contingentes de fibras que constituem o nervo misto.