[Clinical and videofluoroscopic evaluation of swallowing in patients with spastic tetraparetic cerebral palsy and athetosic cerebral palsy]. / Evaluación clínica y videofluoroscópica de la deglución en pacientes con parálisis cerebral tetraparésica espástica y atetósica.

AIM: To evaluate and to compare the findings of oral and pharyngeal phases of swallowing in children with both spastic tetraparetic cerebral palsy (STCP) and with athetosic cerebral palsy (ACP). PATIENTS AND METHODS: 11 children were evaluated, with their ages ranging from 10 months to 8 years old, through both clinical assessment and videofluoroscopic evaluation. RESULTS: The children with STCP were more involved at the neurologic, clinical and speech-language and hearing aspects. At the oral phases all the children had presented some involvement. At the pharyngeal phases the clinical signs of aspiration were identified in 10 children. It was observed aspirations in 80% of children with STCP and in 67% with ACP. The changes on swallowing were similar in both cerebral palsy groups, but the performance of the children with STCP was inferior. CONCLUSION: The videofluoroscopy was an important method which makes possible the verification of aspirations, helping the professionals at the therapeutical program for these children.

Developmental language disorder associated with polymicrogyria.

BACKGROUND: Subtle disorders of neuronal migration occur in the brains of some dyslexic patients who presented developmental language disorder (DLD) during early childhood. OBJECTIVE: To investigate a possible neuroanatomical substrate based on neuroimaging evaluation in children with DLD. METHODS: The authors obtained psychological assessment, language evaluation, neurologic examination, and neuroimaging investigation. Inclusion criteria were as follows: children should be at least 4 years of age; primary complaint of language delay; normal hearing; IQ >70; and an informed consent form signed by parents or guardians. Exclusion criteria were severe motor and cognitive handicap. RESULTS: Fifteen children met all inclusion criteria. Ages ranged from 4 to 14 years and 11 were boys. Six patients presented diffuse polymicrogyria (PMG) around the entire extent of the sylvian fissure on MRI, and they had severe clinical manifestation of DLD: they did not speak at all or had mixed phonologic-syntactic deficit syndrome. Six children presented PMG restricted to the posterior aspects of the parietal regions, and they had a milder form of DLD: mainly phonologic programming deficit syndrome. The other three children had different imaging findings. CONCLUSIONS: Developmental language disorder can be associated with polymicrogyria and the clinical manifestation varies according to the extension of cortical abnormality. A subtle form of posterior parietal polymicrogyria presenting as developmental language disorder is a mild form of perisylvian syndrome.

Hemiparetic cerebral palsy: etiological risk factors and neuroimaging.

The purpose of this paper, which was conducted on 175 children with hemiparetic cerebral palsy (H-CP), was to verify the etiological risk period for this disease. Etiological risk factors (ERF) were detected through anamnesis: 23% in the prenatal period, 18% in the perinatal period and 59% of the patients the period was undefined (ERF in the prenatal and perinatal period was 41% and no ERF was 18% of the cases. The computerized tomographic scan (CT) and MRI were performed on all the patients, who were then classified according to their etiopathogenic data: CT1= normal (18%); CT 2= unilateral ventricular enlargement (25%); CT 3= cortical/ subcortical cavities (28%); CT4= hemispheric atrophy and other findings (14%); CT 5= malformations (15%). CT 5 was associated with physical malformations beyond the central nervous system and with prenatal ERF's, while CT 2 was associated with the perinatal ERF's, mainly in premature births. Magnetic resonance imaging was performed on 57 patients and demonstrated a good degree of concordance with the CT. Etiology remained undefined in only 37% of the cases after neuroimaging was related to ERF. A high perinatal RF frequency (59%) was observed and emphasized the need for special care during this period.

[Cerebrovascular disease in children: II. Clinical aspects in 42 cases]. / Doença cerebrovascular na infância. II. Aspectos clínicos em 42 casos.

We report the findings recorded in 42 children suffering cerebrovascular disease and assisted at the Hospital das Clínicas FCM-UNICAMP, over a 8 years period (January 1990 until April 1998). The ischemic type was the most common, and involvement of the middle cerebral artery, sudden onset of clinical manifestation with seizures and motor disability were more common in early aged children. Motor sequelae predominated in the follow-up of these children.

[Discitis in children. Study of 8 cases]. / Discite em crianças. Estudo de oito casos.

The authors report the study of eight children with discitis diagnosed through clinical, neurological and orthopedic evaluation. The evidence of self limiting inflammation or infection of the intervertebral disk space and of soft tissue were available by image studies. Findings with routine roentgenograms, computed tomography and magnetic resonance imaging are discussed.

Discite em crianças: estudo de oito casos / Discitis en children: study of 8 cases

Os autores apresentam o estudo de oito crianças com diagnóstico de discite estabelecido através da avaliaçäo clínica, neurológica e ortopédica. A comprovaçäo de alteraçöes inflamatórias em um espaçäo discal, vertebral e em tecidos moles foi possível em estudos por imagem, sendo discutidos aqueles obtidos por radiologia convencional, tomografia computadorizada e ressonância magnética

[Congenital hemiparesis: complementary neuropsychological evaluation with computer]. / Hemiparesia congênita: avaliação neuropsicológica complementar utilizando computador.

We present the neuropsychological assessment with computer aid of six cerebral palsy children. Three children had right hemiparesis and three, left hemiparesis. The tomographic examination showed parietal cavities (porencephalic cyst in 4 children, ischemic injury in 1 case and subarachnoid cyst in 1 case). We have proposed to assess the visuo-spatial function since we suspected the children could have disturbance of this function. We did not detect this disturbance. On the other hand, the children had astereognosia and the right hemiparetic children preferred to execute signs on the right part of the computer visor. We discuss and propose explanations for both findings.

[Neurologic semiology in a population of hearing impaired children]. / Semiologia neurológica numa população de crianças deficientes auditivas.

A random sample of 42 sensorineural hearing impaired children (severe and bilateral) was studied, from special classes in Campinas, with chronological ages varying between 4 and 7 years old. The children of this sample were compared with two control groups of 42 children of the same chronological age, from regular classes of private and public schools. All of them were submitted to the traditional neurological examination. Hearing impaired children showed differences as to head circumference and muscle tonus. In the other examined items we found motor hyperactivity, cerebellar and ocular syndromes although there were no significant differences between the groups.

[Evaluation of the static equilibrium in a population of hearing impaired children]. / Avaliação do equilíbrio estático numa população de crianças deficientes auditivas.

A random sample was organized with 42 children with congenital sensorineural auditory deficit (severe and bilateral) from special education schools in Campinas. Chronological ages ranged from 4 to 7 years of age. This sample was compared with two control groups of 42 children of the same chronological age but attending normal classes. All were submitted to 9 tests of the set of static equilibrium of the Evolutive Neurologic Examination. It was observed that in the position of equilibrium with opened eyes (test 8) there were no differences between the groups. In the Romberg position, the hearing impaired children of 4, 5 and 6 years of age showed a significant decrease in the ability to do the test (test 9); those of 7 years of age had equal ability whether of the control or the deficient groups. Hearing impaired children were less able to do other static equilibrium tests (heel-toe or one foot or tip-toe standing tests, with opened or closed eyes: tests 10, 12, 16, 20, 24, 25 and 26). The use of detailed neurological semiology allowed us to support the alteration of the static equilibrium in this group of hearing impaired children.

[Infratentorial malignant neurinoma: report of a case]. / Neurinoma maligno infratentorial: relato de um caso.

A solitary malignant schwannoma of the foramen jugular, unassociated with von Recklinghausen's disease in a two years and nine months old girl is presented. A partial removal of the tumor was carried out. The low incidence in this age group is emphasized in report to the literature reviewed.