Earlier menarcheal age in Spanish girls is related with an increase in body mass index between pre-pubertal school age and adolescence.

BACKGROUND: Higher body mass index (BMI) has been associated with earlier pubertal development. OBJECTIVE: The aim of this longitudinal study was to determine menarcheal age in a Spanish cohort and to assess its association with anthropometric variables at birth, childhood and adolescence. We also analyse whether the tracking of weight between different ages could affect the timing of menarche. METHODS: The sample population included 195 randomly selected 6-8-year-old girls who participated in the baseline of the Four Provinces Study and in the follow-up of this study at 13-16 years old. Anthropometrical variables were measured and BMI and BMI z-score were calculated. Information regarding birth weight and menarche was obtained by means of self-report questionnaire. RESULTS: Correlation analysis showed a significant negative association of age at menarche with weight, BMI and BMI z-score in the baseline and follow-up groups but not with weight at birth. Fat mass at adolescence is related to a significantly earlier menarcheal age. When comparing weight categories, earliest menarcheal age is associated with an increase of BMI between 6-8-year-old and 13-16-year-old girls. CONCLUSION: In our study, high weight in girls is associated with the earliest age at menarche. This becomes a major influence when weight gain occurs between pre-pubertal school age and adolescence.

Confusión como síntoma de presentación de una pseudomigraña con pleocitosis en un paciente pediátrico / Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient

La cefalea con déficits neurológicos transitorios con pleocitosis linfocitaria en el líquido cefalorraquídeo (HaNDL) es una entidad poco frecuente y de etiología desconocida caracterizada por episodios de cefalea intensa, déficits neurológicos transitorios recurrentes durante 3 meses y pleocitosis linfocitaria. Presentamos el caso de una niña de 14 años con cefalea y vómitos de 4 días de evolución, asociando posteriormente confusión, disminución de conciencia, afasia, paresia facial periférica, ataxia y febrícula durante 24 h. El análisis del LCR mostró pleocitosis (110 leucocitos/ml) y proteinorraquia (87 mg/dl). El electroencefalograma mostraba enlentecimiento generalizado en el momento agudo y posteriormente actividad lenta focalizada izquierda. En los siguientes 2 meses presentó 7 nuevos episodios de cefalea migrañosa permaneciendo asintomática después. Es el primer caso pediátrico de HaNDL que se presenta como agitación y/o estado confusional. Esta entidad debe incluirse en el diagnóstico diferencial ante cuadros de cefalea y alteración de conciencia para evitar tratamientos prolongados o pruebas invasivas innecesarias

Transient headache and neurological deficits with cerebrospinal fluid lymphocytic pleocytosis (Handl) syndrome is a rare condition of unknown origin that is characterized by episodes of severe headache, transient neurological deficits that recur over less than 3 months, and lymphocytic pleocytosis in CSF. We report the case of a 14 year-old girl who presented with headache and vomiting that lasted 4 days, later combined with a clinical presentation of confusion, with a decrease in the level of consciousness, aphasia, peripheral facial paralysis, ataxia and fever for 24 hours. CSF analysis showed pleocytosis (110 cells/ml) and proteinorrachia (87 mg/dl). Electroencephalogram in the acute time showed generalized slowing, and later a focal slowing in the left hemisphere. She suffered 7 episodes of migraine (severe headache and vomiting) in the following two months, remaining asymptomatic thereafter. This is the first pediatric case published in the literature that presents with an agitated and/or confused state. This condition must be considered in the differential diagnosis of patients with headache and acute altered level of consciousness, in order to avoid prolonged treatments or unnecessary invasive testing

[Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient]. / Confusión como síntoma de presentación de una pseudomigraña con pleocitosis en un paciente pediátrico.

Transient headache and neurological deficits with cerebrospinal fluid lymphocytic pleocytosis (Handl) syndrome is a rare condition of unknown origin that is characterized by episodes of severe headache, transient neurological deficits that recur over less than 3 months, and lymphocytic pleocytosis in CSF. We report the case of a 14 year-old girl who presented with headache and vomiting that lasted 4 days, later combined with a clinical presentation of confusion, with a decrease in the level of consciousness, aphasia, peripheral facial paralysis, ataxia and fever for 24 hours. CSF analysis showed pleocytosis (110 cells/ml) and proteinorrachia (87 mg/dl). Electroencephalogram in the acute time showed generalized slowing, and later a focal slowing in the left hemisphere. She suffered 7 episodes of migraine (severe headache and vomiting) in the following two months, remaining asymptomatic thereafter. This is the first pediatric case published in the literature that presents with an agitated and/or confused state. This condition must be considered in the differential diagnosis of patients with headache and acute altered level of consciousness, in order to avoid prolonged treatments or unnecessary invasive testing.