[Developmental stuttering and acquired stuttering: resemblances and differences]. / Tartamudez del desarrollo y tartamudez adquirida. Semejanzas y diferencias.

INTRODUCTION: In this study the authors analyse, clinically, dysphemia (DP) and acquired stuttering (AS). AIMS. The aim of this study was to evaluate whether AS is a variant of DP or whether it is an entity that shares a common element: stuttered speech. PATIENTS AND METHODS: The authors studied 13 patients with AS and 36 with DP. In addition to the clinical evaluation, electroencephalogram (EEG) and cranial computerised axial tomography (CAT) scans were performed, with a special interest in secondary symptoms/signs, laterality profiles and pathological, personal and familial history. RESULTS: There was a notable predominance in males in both groups. AS began either in infancy or from any other age; DP only started in infancy. The most frequent organic pathology, for both DP and AS, was a severe traumatic brain injury, followed by cerebral anoxia/hypoxia, cerebrovascular accident (CVA) and others. One important element in both groups was the presence of stuttering and high percentages of left-handedness in the families. In AS, all patients were right-handed. None of the patients who experienced the onset of AS in infancy improved/yielded during adolescence. CONCLUSIONS: Both DP and AS are cases of "neurogenic" stuttering because they display organic and/or functional pathologies in the two groups, which invalidates the term "developmental", since AS also occurred in infancy. DP and AS have an element in common: they both share a genetic predisposition on which the organic/functional pathology then gives rise to the clinical symptoms, although this does not account for the absence of tics in AS.

Tartamudez del desarrollo y tartamudez adquirida. Semejanzas y diferencias / Developmental stuttering and acquired stuttering: resemblances and differences

Introducción. Se analizan clínicamente la disfemia (DF) y la tartamudez adquirida (TA). Objetivo. Valorar si la TA constituye una variante de la DF, o si se trata de una entidad con un elemento en común: el habla tartamuda. Pacientes y métodos. Se estudian 13 pacientes con TA y 36 con DF. Además de la valoración clínica, a cada paciente se le practicó un electroencefalograma (EEG) y una tomografía axial computarizada (TAC) craneal, con un especial interés en la presencia de síntomas/signos secundarios, el perfil de lateralidades y los antecedentes patológicos, personales y familiares. Resultados. En ambos grupos hay un notable predominio de hombres. La TA se inició bien en la infancia o desde cualquier edad; la DF, sólo en la infancia. La patología orgánica más frecuente para la DF y la TA fue el traumatismo craneoencefálico grave, seguido de la anoxia/hipoxia cerebral, el accidente vascular cerebral (AVC) y otros. Un elemento importante, en ambos grupos, es la presencia familiar de tartamudez y elevados porcentajes de zurdera manual. En la TA todos fueron diestros. En ningún paciente con inicio de la TA en la infancia mejoró ésta o cedió en la adolescencia. Conclusiones. Tanto la DF como la TA constituyen una tartamudez ‘neurogénica’, puesto que se han demostrado patologías orgánicas y/o funcionales en ambos grupos, lo que invalida el término ‘desarrollo’, dado que la TA también se presentó en la infancia. Para la DF y para la TA existe un elemento común: una predisposición genética, sobre la cual la patología orgánica/funcional desencadena el cuadro clínico, sin proponer una explicación para la ausencia de tics en la TA

Introduction. In this study the authors analyse, clinically, dysphemia (DP) and acquired stuttering (AS). Aims. The aim of this study was to evaluate whether AS is a variant of DP or whether it is an entity that shares a common element: stuttered speech. Patients and methods. The authors studied 13 patients with AS and 36 with DP. In addition to the clinical evaluation, electroencephalogram (EEG) and cranial computerised axial tomography (CAT) scans were performed, with a special interest in secondary symptoms/signs, laterality profiles and pathological, personal and familial history. Results. There was a notable predominance in males in both groups. AS began either in infancy or from any other age; DP only started in infancy. The most frequent organic pathology, for both DP and AS, was a severe traumatic brain injury, followed by cerebral anoxia/hypoxia, cerebrovascular accident (CVA) and others. One important element in both groups was the presence of stuttering and high percentages of left-handedness in the families. In AS, all patients were right-handed. None of the patients who experienced the onset of AS in infancy improved/yielded during adolescence. Conclusions. Both DP and AS are cases of ‘neurogenic’ stuttering because they display organic and/or functional pathologies in the two groups, which invalidates the term ‘developmental’, since AS also occurred in infancy. DP and AS have an element in common: they both share a genetic predisposition on which the organic/functional pathology then gives rise to the clinical symptoms, although this does not account for the absence of tics in AS

[Relationship between neurological deficit and intelligence quotient in children and adolescents]. / Relación entre el déficit neurológico y el cociente de inteligencia en niños y adolescentes.

INTRODUCTION: The relationship between developmental and mental deficits due to genetic or acquired causes is well established. However the possible relationship between neurological signs and intellectual development has not been sufficiently studied. OBJECTIVE: We have conducted a transversal study to test the possible association between neurological signs and psychometric measures in children and young adolescents. PATIENTS AND METHODS: 123 patients were neurologically explored (ages between 54-185 months), 36 girls and 87 boys. These subjects were neurologically and psychometrically tested during a period of 3 years. Contingency tables, chi squared tests, discriminant analysis and ROC curves were used for statistical analysis. This statistic allowed to establish the contingencies between neurological signs (presence or absence) and intelligence quotient (IQ) groups (low and normal scores). RESULTS: The results showed a statistically significant relationship between IQ and the presence of 7 neurological signs (chi2=6.213; p=0.013). The discriminant analysis classified correctly 77.2% of subjects. The ROC curves indicated a high sensitivity and specificity if subjects presented more than 3 neurological signs. The frequency analysis established the more discriminant neurological signs. CONCLUSIONS: The obtained results in children with learning and behavioural disabilities suggest comorbidity between low IQ and neurological signs. This association is more marked in the group of children than in the pre- and adolescent group.

Relación entre el déficit neurológico y el cociente de inteligencia en niños y adolescentes / Relationship between neurological deficit and intelligence quotient in children and adolescents

Introducción. Aunque se conoce bien la relación existente entre déficit de desarrollo (por etiologías genética o adquirida) del sistema nervioso y discapacidad mental, la relación entre diversos signos neurológicos y el cociente intelectual (CI) se ha abordado pocas veces. Objetivo. Nuestro estudio utiliza un diseño de tipo transversal para comprobar la posible relación entre los resultados que se obtienen mediante la exploración neurológica y la psicométrica en dos grupos de edad (niños y adolescentes). Pacientes y métodos. Se realizó una exploración clínica en una muestra de 123 pacientes, de edades comprendidas entre los 54 y los 185 meses, 36 niñas y 87 niños, que forman parte de un estudio del desarrollo más amplio. Los pacientes se valoraron neurológica y psicométricamente durante un período de tres años. Para el análisis de datos se utilizaron diversas pruebas, tablas de contingencia, chi al cuadrado, análisis discriminante y curvas COR. Se analizaron las contingencias entre signos neurológicos específicos respecto a valores de CI normal y normal-bajo. Resultados. Se obtuvo una relación estadísticamente significativa entre el CI y siete signos neurológicos distintos (ji2 = 6,213; p = 0,013). El análisis discriminante indicó que el 77,2 por ciento de las clasificaciones realizadas eran adecuadas. Las curvas COR indicaron una alta sensibilidad y especificidad a partir de la presencia de tres signos neurológicos. El análisis de frecuencia precisó cuáles fueron estos signos. Conclusiones. Los resultados que se obtuvieron en niños y adolescentes con problemas de aprendizaje y conducta sugieren una comorbilidad entre un CI normal-bajo y determinados signos neurológicos, más marcada en el grupo de menor edad (AU)

Introduction. The relationship between developmental and mental deficits due to genetic or acquired causes is well established. However the possible relationship between neurological signs and intellectual development has not been sufficiently studied. Objective. We have conducted a transversal study to test the possible association between neurological signs and psychometrical measures in children and young adolescents. Patients and methods. 123 patients were neurologically explored (ages between 54-185 months), 36 girls and 87 boys. These subjects were neurologically and psychometrically tested during a period of 3 years. Contingency tables, chi squared tests, discriminant analysis and ROC curves were used for statistical analysis. This statistic allowed to establish the contingencies between neurological signs (presence or absence) and intelligence quotient (IQ) groups (low and normal scores). Results. The results showed a statistically significant relationship between IQ and the presence of 7 neurological signs (χ2 = 6,213; p = 0,013). The discriminant analysis classified correctly 77.2% of subjects. The ROC curves indicated a high sensitivity and specificity if subjects presented more than 3 neurological signs. The frequency analysis established the more discriminant neurological signs. Conclusions. The obtained results in children with learning and behavioural disabilities suggest comorbidity between low IQ and neurological signs. This association is more marked in the group of children than in the pre- and adolescent group (AU)