[Childhood headaches: new concepts and recent advances]. / Cefaleas infantiles: nuevos conceptos y recientes avances.

This study reports on the latest advances in childhood headaches that have been made in the last few years, with special emphasis on the important new modifications that have been produced with respect to the previous ones, published in the beta version of the third edition of the International Classification of Headache Disorders. These include headaches that have undergone important qualifications, the appearance of new entities and a section which reports the existence of new headaches, but which have still not been considered as new entities. Additionally, other points that are highlighted include the strong relation between childhood headaches and attention deficit hyperactivity disorder, the weak relation between glutamate intake and the appearance of headaches, and the scant usefulness of magnetic resonance imaging of the brain in the diagnosis of these processes. Moreover, the new modification produced in childhood episodic syndromes is highlighted.

TITLE: Cefaleas infantiles: nuevos conceptos y recientes avances.En el presente trabajo se exponen los recientes avances sobre cefaleas infantiles que se han producido en los ultimos años, y se da una especial importancia a las nuevas e importantes modificaciones que se han producido con respecto a las anteriores, publicadas en la tercera edicion, version beta, de la clasificacion de la Sociedad Internacional de Cefaleas; entre ellas, cefaleas que han sufrido importantes matizaciones, la aparicion de nuevas entidades y un apartado en el que se recoge la existencia de nuevas cefaleas, pero que aun no se han considerado como nuevas entidades. Ademas, se resalta la fuerte relacion existente entre las cefaleas infantiles y el trastorno por deficit de atencion/hiperactividad, la poca relacion de la toma de glutamato con la aparicion de cefaleas y la escasa utilidad de la resonancia cerebral en el diagnostico de estos procesos. Por otra parte, se resalta la nueva modificacion producida en los sindromes episodicos de la infancia.

[The psychoneurological status of newborn infants with congenital heart disease before surgical intervention]. / Estado psiconeurológico de los recién nacidos afectados de cardiopatía congénita antes de su intervención.

AIMS: This study was conducted to evaluate, from a psychological and neurological point of view, the situation of newborn infants (NI) suffering from congenital heart disease before they are treated surgically. At the same time, we aimed to compare this group of patients with another group of children who were considered to be healthy. PATIENTS AND METHODS: Patients psychological development was evaluated using developmental landmarks from the Observational Scale of Development (OSD), which provides a percentage of elements acquired in different areas. Behaviour was evaluated by the observational recording of particular patterns of behaviour. The neurological study was based on a detailed neonatal examination, performed by people from the Child Neurology Section at our hospital, and which took into account the different behaviours displayed by the NI: reactive, grasping, communicative and affective. RESULTS: Findings show significant differences both in the psychological and neurological variables studied. They show how, generally speaking, healthy infants score higher in the areas of development that were evaluated than children suffering from heart disease. Likewise, lower average scores were observed in heart disease patients who require an early intervention, as compared with those who will be submitted to surgery later on. From the neurological point of view, a number of significant differences were found in their muscular activity. CONCLUSIONS: This analysis, a groundbreaker in the study of infants suffering from heart disease before their surgical intervention, shows how newborn infants who have been submitted to surgery in the neonatal period present a significant degree of hypotonia, a certain frailness and retardation in their motor development.

Estado psiconeurológico de los recién nacidos afectados de cardiopatía congénita antes de su intervención / The psychoneurological status of newborn infants with congenital heart disease before surgical intervention

Objetivo. Este estudio se llevó a cabo para evaluar, desde un punto de vista psicológico y neurológico, la situación de los recién nacidos que padecen una cardiopatía congénita, antes de tratarse quirúrgicamente, y, a su vez, comparar este grupo de pacientes con otro grupo de niños considerados sanos. Pacientes y métodos. El desarrollo psicológico se evaluó mediante hitos evolutivos procedentes de la escala observacional del desarrollo, la cual proporciona un porcentaje de elementos adquiridos en diversas áreas. El comportamiento se evalúa mediante el registro observacional de determinados patrones de conducta. El estudio neurológico se basó en un detallado examen neurológico neonatal, realizado por personas adscritas a la Sección de Neurología Infantil de nuestro hospital, en el que se tuvieron en cuenta las distintas conductas del recién nacido: reactiva, prensora, comunicativa y afectiva. Resultados. Los resultados muestran diferencias significativas, tanto en las variables psicológicas estudiadas como en las neurológicas. Muestran que, en general, los niños sanos obtienen puntuaciones más altas en las áreas de desarrollo evaluadas que los niños afectados de cardiopatías. Asimismo, se observan menores puntuaciones medias en los cardiópatas que deben intervenirse precozmente, que en los que se intervendrán con posterioridad. Desde el punto de vista neurológico, se encontraron unas diferencias significativas en la actividad muscular. Conclusiones. El presente análisis, pionero en el estudio de los niños cardiópatas antes de su intervención, demuestra que los neonatos que se han intervenido en el período neonatal ya presentaban, de forma significativa, hipotonía, cierta fragilidad y retraso en el desarrollo motor (AU)

Aims. This study was conducted to evaluate, from a psychological and neurological point of view, the situation of newborn infants (NI) suffering from congenital heart disease before they are treated surgically. At the same time, we aimed to compare this group of patients with another group of children who were considered to be healthy. Patients and methods. Patients’ psychological development was evaluated using developmental landmarks from the Observational Scale of Development (OSD), which provides a percentage of elements acquired in different areas. Behaviour was evaluated by the observational recording of particular patterns of behaviour. The neurological study was based on a detailed neonatal examination, performed by people from the Child Neurology Section at our hospital, and which took into account the different behaviours displayed by the NI: reactive, grasping, communicative and affective. Results. Findings show significant differences both in the psychological and neurological variables studied. They show how, generally speaking, healthy infants score higher in the areas of development that were evaluated than children suffering from heart disease. Likewise, lower average scores were observed in heart disease patients who require an early intervention, as compared with those who will be submitted to surgery later on. From the neurological point of view, a number of significant differences were found in their muscular activity. Conclusions. This analysis, a groundbreaker in the study of infants suffering from heart disease before their surgical intervention, shows how newborn infants who have been submitted to surgery in the neonatal period present a significant degree of hypotonia, a certain frailness and retardation in their motor development (AU)