Autistic spectrum disorder children and adolescents' oral health characteristics - scoping review.

This study aimed to conduct a scoping review to know children and adolescents' main oral health concerns with Autism Spectrum Disorder (ASD) and thus identify any oral characteristic that stands out, aiming at preventive and interceptive clinical conduct. A search was performed in the three electronic databases and the gray literature; in September 2021. A total of 562 studies were identified, and after applying the eligibility criteria, 73 articles were included in the synthesis of this scoping review. The mean decayed, lost, and restored teeth index (DMFT/dfmt) ranged from 0 to 12.37; the mean DMFT index (permanent dentition) from 0.06 to 6.2; and the average dmft index (deciduous dentition) ranged from 0.29 to 9.91. The mean simplified oral hygiene index (OHIS) ranged from 0 to 3.4; gingival index (GI) from 0.29 to 2; and plaque index (PI) from 0.005 to 3.15. Plaque prevalence was 25.9% to 90%; dental calculus from 4.7% to 59.41%; gingivitis from 36.7% to 100%. Bruxism was 10.3% to 73%, and dental trauma was 4.7% to 100%. This disparity in the results shows the heterogeneity of this population, with different degrees of socio-behavioral impairment, which can directly influence oral hygiene and the consequent accumulation of biofilm.

Neurological Manifestations Associated With SARS-CoV-2 in Children: A Case Series.

Neurological manifestations of COVID-19 may affect both central and peripheral nervous systems. Unlike in adults, in whom majority of severe cases derive from respiratory complications, neurological involvement is one of the main causes of severe COVID-19 in children. This study aimed to detect viral respiratory pathogens, mainly SARS-CoV-2, in nasopharynx and cerebrospinal fluid samples utilizing qRT-PCR (TaqMan) in a pediatric population in Brazil. We evaluated four children with neurological symptoms and laboratory-confirmed SARS-CoV-2 infection: three presenting with meningoencephalitis and one presenting with Guillain-Barré syndrome. All four patients had mild respiratory symptoms. SARS-CoV-2 RNA was identified in two cerebrospinal fluid samples. SARS-CoV-2 involvement should be considered for differential diagnosis in pediatric cases presenting neurological alterations even if symptoms such as headache, anosmia, or dizziness are absent.

Phonological remediation in schoolchildren with ADHD and dyslexia. / Remediação fonológica em escolares com TDAH e dislexia.

PURPOSE: To compare the performance in phonological processing skills, reading speed and reading comprehension before and after phonological remediation in a restricted group of schoolchildren with Attention Deficit Hyperactivity Disorder (ADHD) and with dyslexia. METHODS: Thirty-two schoolchildren from the 2nd to 8th year of Elementary School of both genders, with diagnosis of ADHD and Dyslexia according to the DSM-5, participated in this study. All patients underwent Phonological Remediation Program consisted of 18 weekly sessions. RESULTS: The results, expressed in z scores, showed a statistically significant difference between before and after remediation assessments in phonological processing skills, such as syllabic and phonemic awareness, working memory and lexical access. Rhyming task was analyzed separately because it represents another level of segmentation and, for this result, there was no significance. Besides these results, there was a statistically significant difference in reading speed and reading comprehension. CONCLUSION: The phonological remediation program contributes to the development of phonological processing, reading speed and reading comprehension in this population.

OBJETIVO: Comparar o desempenho da avaliação do processamento fonológico, velocidade de leitura e compreensão de texto antes e depois da aplicação de um programa de remediação fonológica em um grupo restrito de escolares com Transtorno do Déficit de Atenção e Hiperatividade (TDAH) e dislexia. MÉTODOS: Participaram deste estudo 32 escolares do 2º ao 8º ano do Ensino Fundamental, de ambos os sexos, com diagnóstico de TDAH e dislexia de acordo com o DSM-5, atendidos no Ambulatório de Neurologia Infantil do IPPMG/UFRJ. Todos os pacientes foram submetidos ao programa de remediação fonológica, que consistiu em 18 sessões semanais. RESULTADOS: Os resultados, expressos em escore z, indicaram diferença estatisticamente significativa entre as avaliações pré e pós-remediação nas habilidades do processamento fonológico, como em consciência silábica e fonêmica, memória de trabalho e acesso lexical. A tarefa de rima foi analisada separadamente, pois é considerada uma tarefa com nível de segmentação distinto de outros níveis silábicos e, para este resultado não houve significância. Além desses, houve diferença estatisticamente significativa também nos testes que medem velocidade de leitura e compreensão de texto. CONCLUSÃO: O programa de remediação fonológica contribui para o desenvolvimento do processamento fonológico, leitura e compreensão textual nesta população.

Remediação fonológica em escolares com TDAH e dislexia / Phonological remediation in schoolchildren with ADHD and dyslexia

RESUMO Objetivo: Comparar o desempenho da avaliação do processamento fonológico, velocidade de leitura e compreensão de texto antes e depois da aplicação de um programa de remediação fonológica em um grupo restrito de escolares com Transtorno do Déficit de Atenção e Hiperatividade (TDAH) e dislexia. Métodos: Participaram deste estudo 32 escolares do 2º ao 8º ano do Ensino Fundamental, de ambos os sexos, com diagnóstico de TDAH e dislexia de acordo com o DSM-5, atendidos no Ambulatório de Neurologia Infantil do IPPMG/UFRJ. Todos os pacientes foram submetidos ao programa de remediação fonológica, que consistiu em 18 sessões semanais. Resultados: Os resultados, expressos em escore z, indicaram diferença estatisticamente significativa entre as avaliações pré e pós-remediação nas habilidades do processamento fonológico, como em consciência silábica e fonêmica, memória de trabalho e acesso lexical. A tarefa de rima foi analisada separadamente, pois é considerada uma tarefa com nível de segmentação distinto de outros níveis silábicos e, para este resultado não houve significância. Além desses, houve diferença estatisticamente significativa também nos testes que medem velocidade de leitura e compreensão de texto. Conclusão: O programa de remediação fonológica contribui para o desenvolvimento do processamento fonológico, leitura e compreensão textual nesta população.

ABSTRACT Purpose: To compare the performance in phonological processing skills, reading speed and reading comprehension before and after phonological remediation in a restricted group of schoolchildren with Attention Deficit Hyperactivity Disorder (ADHD) and with dyslexia. Methods: Thirty-two schoolchildren from the 2nd to 8th year of Elementary School of both genders, with diagnosis of ADHD and Dyslexia according to the DSM-5, participated in this study. All patients underwent Phonological Remediation Program consisted of 18 weekly sessions. Results: The results, expressed in z scores, showed a statistically significant difference between before and after remediation assessments in phonological processing skills, such as syllabic and phonemic awareness, working memory and lexical access. Rhyming task was analyzed separately because it represents another level of segmentation and, for this result, there was no significance. Besides these results, there was a statistically significant difference in reading speed and reading comprehension. Conclusion: The phonological remediation program contributes to the development of phonological processing, reading speed and reading comprehension in this population.

Transcranial sonography in psychiatry as a potential tool in diagnosis and research.

OBJECTIVES: During the last two decades transcranial sonography (TCS) of the brain parenchyma evolved from a pure research tool to a clinical relevant neuroimaging method especially in Parkinson's disease and related movement disorders. The aim of this systematic review is to update and summarise the published TCS findings in psychiatric disorders and critically address the question whether TCS may be a valuable tool for the diagnosis or differential diagnosis of psychiatric disorders similarly to the field of movement disorders. METHODS: This paper provides detailed information about the perspectives and limitations of TCS, including guidelines for the scanning procedures, assessment of midbrain structures and discusses the potential causes of the ultrasound abnormalities in psychiatric disorders. RESULTS: Changes in the echogenicity of subcortical brain structures were detected in different disorders, such as obsessive-compulsive disorder, autism spectrum disorder, schizophrenia, panic disorder, attention-deficit/hyperactivity (ADHD), bipolar disorder and depressive disorder. Although the physical properties of brain tissue underlying the echogenic features in TCS are largely unknown, no alternative technique provides the same insight into the specific central nervous structural characteristics. CONCLUSIONS: Urgent research questions to further clarify the underlying pathophysiological and structural alterations are further outlined to bring this promising technique to the clinic.

Pilot study of brain morphometry in a sample of Brazilian children with attention deficit hyperactivity disorder: influence of clinical presentation.

PURPOSE: Currently, the diagnosis of attention deficit hyperactivity disorder (ADHD) rests on clinical criteria. Nonetheless, neuroimaging studies have demonstrated that children with ADHD have different cortical thickness and volume measures to typically developing children (TDC). In general, studies do not evaluate the influence of clinical presentation in the brain morphometry of ADHD children. Our objective was to perform a pilot study in order to evaluate cortical thickness and brain volume in a sample of Brazilian ADHD children and compare these to those of TDC, taking into account the influence of clinical presentation. METHODS: We performed an analytic study comparing 17 drug-naïve ADHD children of both genders, aged between 7 and 10, and 16 TDC. ADHD subjects were first considered as one group and further separated based on clinical presentation. RESULTS: The brain volume did not differ between patients and TDC. Smaller cortical thicknesses were identified on the left superior, medium and inferior temporal cortex, as well as in the left inferior parietal cortex. When compared to TDC, combined and inattentive ADHD presentations depicted smaller cortical thickness with high significance and power. The same magnitude of results was not observed when comparing inattentive ADHD and TDC. CONCLUSIONS: In this pilot study, ADHD is associated with abnormalities involving the cortical thickness of the posterior attentional system. The cortical thickness in the left superior, medium and inferior temporal cortex, as well as in the left inferior parietal cortex may differ according to ADHD presentations.

Working memory and left medial temporal cortical thickness.

OBJECTIVE: To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. METHODS: Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. RESULTS: Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman's correlation coefficient: 0.499; p < 0.005). CONCLUSIONS: Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.

Working memory and left medial temporal cortical thickness / Memória de trabalho e espessura cortical temporal medial esquerda

ABSTRACT Objective To perform a pilot study to investigate the association between working memory and cortical thickness in a sample of attention deficit/hyperactivity disorder (ADHD) children. Methods Seventeen children aged 7-10 years diagnosed with ADHD and 16 healthy children underwent a magnetic resonance scan for cortical thickness measurements. Data was correlated with working memory performance using the Backwards Digit Span subtest of the Wechsler Intelligence Scale for Children. Results Working memory impairment, evidenced by lower scores on the Backwards Digit Span, was observed in patients with ADHD compared to healthy controls. There was a direct correlation between working memory and cortical thickness of the left medial temporal lobe (Spearman’s correlation coefficient: 0.499; p < 0.005). Conclusions Our data suggests, for the first time, a correlation between working memory, evaluated by the Backwards Digit Span, and left medial temporal cortical thickness.

RESUMO Objetivo Realizar estudo piloto para investigar a associação entre memória de trabalho e espessura cortical em crianças com transtorno de défict de atenção e hiperatividade (TDAH). Métodos Dezessete crianças com TDAH, entre 7 e 10 anos, e dezesseis crianças saudáveis foram submetidas a ressonância magnética para aferição de espessura cortical. Os dados foram correlacionados com desempenho da memória de trabalho usando a ordem inversa do subteste Dígitos da Escala de Inteligência Wechsler para Crianças. Resultados Prejuízos na memória de trabalho, evidenciado pela menor pontuação na ordem inversa do subteste Dígitos, foram observados em pacientes com TDAH, em comparação com crianças saudáveis. Observou-se correlação direta entre memória de trabalho e espessura do lobo temporal médio à esquerda (coeficiente de correlação de Spearman: 0,499; p < 0,005). Conclusões Nossos dados sugerem, pela primeira vez, uma correlação entre memória de trabalho, avaliada através da pontuação na ordem inversa do subteste Dígitos, e espessura do córtex temporal medial à esquerda.

Exploratory analysis of diffusion tensor imaging in children with attention deficit hyperactivity disorder: evidence of abnormal white matter structure.

Abnormalities in the white matter microstructure of the attentional system have been implicated in the aetiology of attention deficit hyperactivity disorder (ADHD). Diffusion tensor imaging (DTI) is a promising magnetic resonance imaging (MRI) technology that has increasingly been used in studies of white matter microstructure in the brain. The main objective of this work was to perform an exploratory analysis of white matter tracts in a sample of children with ADHD versus typically developing children (TDC). For this purpose, 13 drug-naive children with ADHD of both genders underwent MRI using DTI acquisition methodology and tract-based spatial statistics. The results were compared to those of a sample of 14 age- and gender-matched TDC. Lower fractional anisotropy was observed in the splenium of the corpus callosum, right superior longitudinal fasciculus, bilateral retrolenticular part of the internal capsule, bilateral inferior fronto-occipital fasciculus, left external capsule and posterior thalamic radiation (including right optic radiation). We conclude that white matter tracts in attentional and motor control systems exhibited signs of abnormal microstructure in this sample of drug-naive children with ADHD.

Advanced techniques in magnetic resonance imaging of the brain in children with ADHD.

Attention deficit hyperactivity disorder (ADHD) affects about 5% of school-aged child. Previous published works using different techniques of magnetic resonance imaging (MRI) have demonstrated that there may be some differences between the brain of people with and without this condition. This review aims at providing neurologists, pediatricians and psychiatrists an update on the differences between the brain of children with and without ADHD using advanced techniques of magnetic resonance imaging such as diffusion tensor imaging, brain volumetry and cortical thickness, spectroscopy and functional MRI. Data was obtained by a comprehensive, non-systematic review of medical literature. The regions with a greater number of abnormalities are splenium of the corpus callosum, cingulate gyrus, caudate nucleus, cerebellum, striatum, frontal and temporal cortices. The brain regions where abnormalities are observed in studies of diffusion tensor, volumetry, spectroscopy and cortical thickness are the same involved in neurobiological theories of ADHD coming from studies with functional magnetic resonance imaging.

Advanced techniques in magnetic resonance imaging of the brain in children with ADHD / Técnicas avançadas de ressonância magnética do crânio em crianças portadoras de TDAH

Attention deficit hyperactivity disorder (ADHD) affects about 5 percent of school-aged child. Previous published works using different techniques of magnetic resonance imaging (MRI) have demonstrated that there may be some differences between the brain of people with and without this condition. This review aims at providing neurologists, pediatricians and psychiatrists an update on the differences between the brain of children with and without ADHD using advanced techniques of magnetic resonance imaging such as diffusion tensor imaging, brain volumetry and cortical thickness, spectroscopy and functional MRI. Data was obtained by a comprehensive, non-systematic review of medical literature. The regions with a greater number of abnormalities are splenium of the corpus callosum, cingulated girus, caudate nucleus, cerebellum, striatum, frontal and temporal cortices. The brain regions where abnormalities are observed in studies of diffusion tensor, volumetry, spectroscopy and cortical thickness are the same involved in neurobiological theories of ADHD coming from studies with functional magnetic resonance imaging.

O transtorno do déficit de atenção e hiperatividade (TDAH) afeta cerca de 5 por cento das crianças em idade escolar. Diversos trabalhos publicados utilizando diferentes técnicas de ressonância magnética mostram que pode haver diferenças entre o cérebro de portadores e não-portadores deste transtorno. Esta revisão visa fornecer aos neurologistas, pediatras e psiquiatras uma atualização sobre diferenças entre o cérebro de portadores e não-portadores deste transtorno, utilizando técnicas avançadas de ressonância magnética, como imagem pelo tensor da difusão, volumetria e espessura cortical, espectroscopia e ressonância magnética funcional. Os dados foram obtidos pela revisão abrangente não-sistemática da literatura médica. As regiões com maior número de anormalidades são: esplênio do corpo caloso, giro do cíngulo, núcleo caudado, cerebelo, estriado, córtex frontal e temporal. As regiões do cérebro onde as anormalidades são observadas em estudos de tensor de difusão, volumetria, espectroscopia e espessura cortical são as mesmas envolvidas nas teorias neurobiológicas do TDAH provenientes de estudos com ressonância magnética funcional.

Academic performance in ADHD when controlled for comorbid learning disorders, family income, and parental education in Brazil.

OBJECTIVE: Scholastic achievement in a nonclinical sample of ADHD children and adolescents was evaluated taking into consideration variables such as comorbid learning disorders, family income, and parental education which may also be associated with poor academic performance. METHOD: After screening for ADHD in 396 students, the authors compared academic performance of 26 ADHD individuals and 31 controls paired for gender, age, and intelligence level considering both mathematics and Portuguese language scores. Learning disorders were investigated and the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV ) criteria were met using structured interviews. RESULTS: The prevalence of academic underachievement was 2.98 times higher in students with ADHD, the most frequent subtype being predominantly inattentive. Parental educational level, family income, and comorbid learning disorders could not explain the discrepancies between ADHD students and controls. CONCLUSIONS: ADHD seems to be associated with poor academic performance even in the absence of comorbid learning disorders, lower family income, and parental educational level.

[Prevalence of attention deficit hyperactivity disorder and its comorbidities in a sample of school-aged children]. / Prevalência do transtorno do déficit de atenção e hiperatividade e suas comorbidades em uma amostra de escolares.

UNLABELLED: Attention deficit hyperactivity disorder (ADHD) is a frequent condition in school-age children and commonly presents in comorbidity with other psychiatric diseases. In Brazil, there are few studies concerning non-clinical samples. PURPOSE: The present study aims to calculate the prevalence of this disorder and its comorbidities in a sample of school-age children. METHOD: Cross-sectional analytic study was conducted on a non-clinical sample of children and adolescents registered in 2003 in the elementary school of the Federal University of Rio de Janeiro. A screening questionnaire was used and parents of those possible affected children were invited for a clinical structured interview. RESULTS: The prevalence of ADHD was 8.6%. Comorbidities were present in 58% of the cases and oppositional-defiant disorder was the most common, found in 38.5%. CONCLUSIONS: The prevalence of ADHD and its comorbidities in this sample is similar to that observed in the literature.

Prevalência do transtorno do déficit de atenção e hiperatividade e suas comorbidades em uma amostra de escolares / Prevalence of attention deficit hyperactivity disorder and its comorbidities in a sample of school-aged children

O transtorno do déficit de atenção e hiperatividade (TDAH) é comum em crianças na idade escolar e freqüentemente apresenta-se em comorbidade com outros distúrbios psiquiátricos. No Brasil, há escassez de estudos em amostras não-clínicas. OBJETIVO: Calcular a prevalência deste transtorno e suas comorbidades numa amostra de escolares. MÉTODO: Estudo observacional analítico seccional realizado numa amostra de escolares do Colégio de Aplicação da Universidade Federal do Rio de Janeiro. Utilizou-se questionário de triagem seguido por entrevista clínica estruturada com os pais de crianças suspeitas de serem portadores do transtorno. RESULTADOS: A prevalência encontrada para o TDAH foi 8,6 por cento. As comorbidades deste transtorno se mostraram presentes em 58 por cento dos casos, sendo transtorno opositivo-desafiador, encontrado em 38,5 por cento dos casos, o mais prevalente. CONCLUSÃO: A prevalência do TDAH e suas comorbidades na amostra estudada é semelhante àquela observada na literatura internacional.

Attention deficit hyperactivity disorder (ADHD) is a frequent condition in school-age children and commonly presents in comorbidity with other psychiatric diseases. In Brazil, there are few studies concerning non-clinical samples. PURPOSE: The present study aims to calculate the prevalence of this disorder and its comorbidities in a sample of school-age children. METHOD: Cross-sectional analytic study was conducted on a non-clinical sample of children and adolescents registered in 2003 in the elementary school of the Federal University of Rio de Janeiro. A screening questionnaire was used and parents of those possible affected children were invited for a clinical structured interview. RESULTS: The prevalence of ADHD was 8.6 percent. Comorbidities were present in 58 percent of the cases and oppositional-defiant disorder was the most common, found in 38.5 percent. CONCLUSIONS: The prevalence of the ADHD and its comorbidities in this sample is similar to that observed in the literature.

Desempenho escolar e transtorno do déficit de atencão e hiperatividade / School achievement and attention deficit hyperactivity disorder

OBJETIVO: esta revisão visa fornecer aos pediatras, neurologistas infantis e psiquiatras infantis nocões atualizadas sobre a relacão entre desempenho escolar e transtorno do déficit de atencão e hiperatividade (TDAH). FONTE DE DADOS: revisão abrangente não-sistemática da literatura médica sobre a relacão entre desempenho escolar e TDAH. SíNTESE DE DADOS: os dados da literatura demonstram que o TDAH, principalmente o tipo desatento está relacionado a mau desempenho escolar. CONCLUSÕES: criancas com TDAH estão sob risco de mau-desempenho escolar e devem receber cuidados especiais.

Executive functions in a non-clinical sample of children and adolescents with attention-deficit hyperactivity disorder (ADHD)

Introdução: Déficits de funções executivas (FEs) já foram demonstrados no transtorno do déficit de atenção e hiperatividade (TDAH). Objetivo: O objetivo deste estudo é comparar medidas de FEs entre portadores de TDAH e controles de uma amostra não-clínica. Métodos: Trezentos e quatro alunos foram rastreados com a Swanson, Nolan and Pelham rating scale (SNAP-IV); todos os casos positivos (60) foram entrevistados com o P-ChiPs e 26 casos (8,6 por cento) de TDAH foram encontrados. Um grupo controle pareado (n=26) foi obtido a partir dos casos negativos na SNAP-IV. Foram utilizados os testes Torre de Hanói, de Stroop, Labirintos, Dígitos e Códigos (WISC-III). O quociente intelectual (QI) estimado também foi calculado. Resultados: Não foram observadas diferenças estatisticamente significantes entre os QIs (na faixa médio-superior em ambos os grupos) e em nenhuma das demais medidas neuropsicológicas. Conclusões: Numa amostra não-clínica de crianças e adolescentes portadores de TDAH com QI médio-superior não foram evidenciadas diferenças clinicamente significantes em relação a controles quanto a medidas de FEs.

The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder.

OBJECTIVE: To assess the effect of methylphenidate on the diagnosis of oppositional-defiant disorder (ODD) comorbid with attention-deficit hyperactivity disorder (ADHD). METHOD: We conducted an open-label study in which 10 children and adolescents with a dual diagnosis of ODD and ADHD were assessed for their ODD symptoms and treated with methylphenidate. At least one month after ADHD symptoms were under control, ODD symptoms were reevaluated with the Parent form of the Children Interview for Psychiatric Syndromes (P-ChIPS). RESULTS: Nine of the 10 patients no longer fulfilled diagnostic criteria for ODD after they were treated with methylphenidate for ADHD. CONCLUSION: Methylphenidate seems to be an effective treatment for ODD, as well as for ADHD itself. The implications for the treatment of patients with ODD not comorbid with ADHD needs further investigation.

The effect of methylphenidate on oppositional defiant disorder comorbid with attention deficit/hyperactivity disorder

OBJETIVO: Avaliar o efeito do metilfenidato sobre o diagnóstico de transtorno opositivo-desafiador (TOD) comórbido com transtorno do déficit de atenção e Hiperatividade (TDAH). MÉTODO: Conduzimos um estudo aberto em que 10 crianças e adolescentes com diagnóstico de TOD e TDAH foram avaliados para seus sintomas de TOD e tratados com metilfenidato. Pelo menos um mês após os sintomas e TDAH estarem controlados, os sintomas de TOD foram reavaliados com a entrevista P-ChIPS (Children Interview for Psychiatric Syndromes-Parent form). RESULTADOS: Nove dos dez pacientes não preenchiam mais critérios diagnósticos para TOD após serem tratados com metilfenidato para TDAH. CONCLUSAO: Metilfenidato parece ser um tratamento eficaz para TOD, além de para TDAH. As implicações para o tratamento de pacientes com TOD não comórbido com TDAH necessita mais investigação.

Efeitos colaterais do metilfenidato / Side effects of methylphenidate

OBJETIVOS: Revisar os principais efeitos colaterais do metilfenidato, em curto e longo prazos, no tratamento de crianças com Transtorno do Déficit de Atenção (TDAH). FONTES DE DADOS: Revisão de literatura nos últimos doze anos através de pesquisa no Medline e Lilacs. RESULTADOS: Dentre os efeitos colaterais que surgem em curto prazo, prevalecem a redução de apetite, insônia, cefaléia e dor abdominal, sendo a maioria autolimitada, dose-dependente e de média intensidade. Dentre aqueles em longo prazo, são descritas alterações discretas de pressão arterial e freqüência cardíaca e uma possível discreta diminuição da estatura. O abuso e a dependência ao medicamento são observados muito raramente. CONCLUSÕES: O perfil de efeitos colaterais do metilfenidato é seguro, não parecendo justificar o seu uso constrito no Brasil, ante os benefícios robustos amplamente demonstrados na literatura.