Parálisis facial periférica en población pediátrica durante la pandemia de la COVID-19 / Peripheral facial nerve palsy in children during the COVID-19 pandemic

Objetivos: Durante la pandemia de la COVID-19 se ha descrito una mayor frecuencia de parálisis facial periférica en adultos y niños. La etiología no está clara, ya que la mayoría de los casos ocurrió en pacientes negativos en las pruebas microbiológicas para confirmar infección por el SARS-CoV-2. Pacientes y métodos: Es un estudio retrospectivo de casos pediátricos de parálisis facial periférica atendidos el primer año de la pandemia en el servicio de urgencias de un hospital pediátrico ubicado en una de las zonas con mayor prevalencia de COVID-19 en España. Los casos de este período se comparan con los casos de los tres años anteriores. Resultados: Se incluyó a 29 pacientes. En los tres años anteriores, 24 pacientes presentaron la misma enfermedad, lo que supone que los casos se triplicaron. No se encontraron diferencias entre períodos, salvo que menos pacientes recibieron corticoides durante la pandemia (13,8 frente a 41,6%; p = 0,022). Catorce niños se sometieron a pruebas microbiológicas para detectar infección activa por el SARS-CoV-2 (12 reacciones en cadena de la polimerasa y dos test rápidos de antígenos), y todas fueron negativas. En 13 pacientes se realizó serología, y dos presentaron inmunoglobulina G positiva (15,3%). Conclusión: Se observó un aumento significativo de los casos de parálisis facial periférica en niños y adolescentes durante el primer año de la pandemia, aunque las pruebas microbiológicas no pueden confirmar un vínculo directo con la infección por el SARS-CoV-2 en la mayoría de los casos. Las características de los pacientes no cambiaron entre los dos períodos. La dificultad para acceder a los centros de atención primaria durante la pandemia pudo influir en este aumento.(AU)

Objectives: During the COVID-19 pandemic, an increased frequency of peripheral facial nerve palsy has been described in adults and children. The etiology of the disease during this time remains unclear, since most cases occurred in patients who tested negative for SARS-CoV-2 infection. Patients and methods: Retrospective study of pediatric cases of facial nerve palsy treated during the first year of the pandemic in the emergency department of a children´s hospital located in one of the areas with the highest prevalence of COVID-19 in Spain. Data from this period are compared with cases from the previous three years. Results: Twenty-nine patients with Bell’s palsy were included. Over the previous three years combined, 24 patients presented with the same condition, a more than threefold increase. No clinical differences were found between the groups apart from the fact that fewer patients received corticosteroids during the pandemic (13.8% vs 41.6%; p = 0.022). Fourteen children underwent microbiologic testing for active SARS-CoV-2 infection (12 polymerase chain reaction, two rapid antigen test); all were negative. Thirteen patients received serologic testing, two with a positive IgG (15.3%). Conclusion: A substantial increase in hospital presentations for facial nerve palsy was observed among children and adolescents during the first year of the pandemic, though findings of microbiologic testing cannot confirm a direct link with SARS-CoV-2 infection in most cases. Patient characteristics did not change between the two time periods. Difficulty accessing primary-care facilities during the pandemic in Spain may have played a role in this increase.(AU)

Educación Médica Continua SOPNIA. Experiencia de Implementación de Cursos E-Learning en Neurología Pediátrica / Continuing medical education SOPNIA. Experience of implementing e-learning courses in Pediatric Neur

Resumen: El programa de Educación Médica Continua (EMC) de SOPNIA consiste en actividades científicas orientadas a la actualización permanente en Neurología y Psiquiatría de niños y adolescentes. Está dirigido a socios SOPNIA, médicos especialistas en Neurología Pediátrica, Psiquiatría de la Infancia y Adolescencia y médicos especialistas certificados de especialidades afines (1).Este programa desde el año 2014 inicia cursos de capacitación de post grado vía e-learning, ya que este sistema permite flexibilidad de tiempo, mayores oportunidades para acceso, favorece el desarrollo de competencias y destrezas específicas como el estudio autorregulado, con una modalidad 100% on-line a través de nuestra plataforma vía página web de SOPNIA. Se analiza experiencia realizada Palabras clave: educación médica continua, Psiquiatría infantil, Neurología pediátrica, curso e-learning, educación en página web.

The continued medical education program (EMC) of SOPNIA consists of scientific activities aimed at updating physicians on pediatric neurology and psychiatry. It is aimed at SOPNIA members, specialists in pediatric neurology, child and adolescent psychiatry and certified physicians of related medial specialties.Since 2014, this program began graduate training via e-learning, for this system allows time flexibility, greater access opportunity, favors the development of specific skills and competencies such as self-regulated study, with a 100% online mode through our platform via SOPNIA website. We analyze our experience.Key words: continued medical education, child and adolescent psychiatry, pediatric neurology, e-learning, online education, website education

Has clinical activity in paediatric neurology changed in the past 11 years? / ¿Ha cambiado la actividad asistencial de la neurología pediátrica en 11 años?

INTRODUCTION: We believe that the demand for paediatric neurology (PN) care has increased over the past decade, and that reasons for requesting consultations have also changed. The objective of this study is to complete a registry study to profile the demand for PN care in 2013 and compare results to those from a study performed in 2002. METHODS: A prospective registry of PN healthcare activities was completed at Hospital Universitario de Getafe in 2013. Results were compared with those from a prospective registry study conducted in 2002. RESULTS: The number of visits increased from 1,300 in 2002 to 1,982 in 2013 (a 52.46% increase), and from 32.6 visits per 1,000 children to 57.48 (a 76.32% increase). Outpatient consultations accounted for 92.2% of all PN consultations in 2013. Currently, attention deficit-hyperactivity disorder (ADHD) is the most frequent diagnosis (27.6% in 2013 vs. 8.1% in 2002). Although the percentage of headache consultations has decreased (19% in 2013 vs. 22% in 2002), headache was still the most common reason for an initial visit in 2013 (32.1%), followed by ADHD (19.1%). Epilepsy remains the most frequent diagnosis in hospitalised patients (30.3% in 2013 vs. 36.7% in 2002). CONCLUSIONS: PN is fundamentally an outpatient activity that has increased considerably in recent years. This increase is mainly due to neurodevelopmental disorders, especially ADHD. We might state that the role of ADHD in PN is comparable to that of dementia in general neurology.

Professor Antonio Branco Lefèvre: the forefather of child neurology in Brazil / Professor Antonio Branco Lefèvre o pai da neurologia infantil no Brasil

OBJECTIVE: To report on the life and works of Prof. Antonio Branco Lefèvre and the relevance that led him to be considered the Forefather of Child Neurology in Brazil. METHOD: The method utilized was the historical documents research; bibliographical. RESULTS: Antonio Branco Lefèvre (1916-1981) was born in São Paulo city; graduated in 1941 from the São Paulo Medical School. The date - 1950 - can be considered when Child Neurology took shape for a fully specialty, when Lefèvre presented his two internationally acclaimed thesis. Lefèvre was recognized as he founder of Child Neurology in Brazil since the early years of his brilliant academic activities. In 1967 achieved the title of professor in the Child Neurology Clinic. His numerous trainees and Residents - from -1950 to 1981 - held today key positions in Brazilian Child Neurology. CONCLUSION: The extension and importance of the Child Neurology School of which he is the legitimate founder is recognized.

OBJETIVO: Relatar a vida e obra do Prof. Antonio Branco Lefèvre e a relevância que leva a ser denominado o Pai da Neurologia Infantil no Brasil. MÉTODO: Pesquisa de documentos históricos e bibliográfica. RESULTADOS: Antonio Branco Lefèvre (1916-1981) nascido em São Paulo; formou-se na Faculdade de Medicina de São Paulo em 1941. A data de 1950 pode ser considerada quando a Neurologia Infantil tornou-se uma especialidade completa quando Lefèvre defendeu suas duas teses aclamadas internacionalmente. Lefévre foi reconhecido como o Pai da Neurologia Infantil no Brasil desde os primeiros anos de sua carreira acadêmica brilhante. Em 1967 atingiu o título de Professor de Neurologia Clínica Infantil. Seus numerosos estagiários e Residentes - de 1950 a 1981 - têm hoje posições de destaque na Neurologia Infantil brasileira. CONCLUSÃO: É reconhecida a extensão e a relevância da escola de Neurologia Infantil da qual Lefèvre é o legítimo fundador.