bluuebunny/crossref_metadata_2025 huggingface dataset:
A Possible Poststreptococcal Movement Disorder with Chorea and Tics
Authors: Kerbeshian Jacob , Burd Larry , Pettit Ross
Published: July 2010

A 14‐year‐old girl developed a movement disorder after a streptococcal infection. In the acute phase of the illness she exhibited simple and complex motor tics and chorea, but all abnormal movements ceased over the following eight months, without recurrence. This case raises questions about the relationship between tics, chorea and auto‐immune reactivity.

RéSUMé

Possibilité de mouvements anormaux post‐streptococciques avec chorée et tics Une jeune fille agée de 14 ans a dèveloppé des mouvements d“agitations après une infection streptococcique. Lors de la phase aigue de la maladie elle prèsentait des tics moteurs simples et complexes et des mouvements choréiques, mais tous ces mouvements anormaux ont cessé au bout de huit mois sans récidive. Ce cas suscite des questions à propos du rapport entre tics, chorée et réaction auto‐immune.

Eine möglicherweise durch Streptokokken‐Infektion hervorgerufene Bewegungstörung mit Chorea und Tics

Ein 14‐jähriges Mädchen entwickelte nach einer Streptokokkeninfektion eine Bewegungsstörung. In der Akutphase der Erkrankung entwickelte es einfache und komplexe motorische Tics und Chorea, aber im Verlauf der folgenden acht Monate verschwanden alle abnormen Bewegungsmuster ohne Rezidiv. Dieser Fall erhebt Fragen über eine Reltion zwischen Tics, Chorea und autoimmuner Reaktionsfähigkeit.

Una alteración del movimiento con corea y tics posiblemente postestreptocócica

Una niña de 14 años de edad sufrió un alteración del movimiento después de una infección estreptocócica. En la fase aguda de la enfermedad sufrió tics y corea simples y complejos, pero todos los movimientos anómalos cesaron en el curso de ocho meses sin recurrencia. Este caso suscita la cuestión de una relación ente tics, corea y reactividad autoimmune.
Acquired Cervical Spine Impairment in Young Adults with Cerebral Palsy
Authors: Reese Mary E. , Msall Michael E. , Owen Scott , Pictor Sarah P. , Paroski Margaret W.
Published: July 2010

Three patients with spastic cerebral palsy and no associated movement disorder—each of whom presented with loss of functional skills and delay in the definitive diagnosis of cervical myelopathy—are reported, in order to increase awareness of the possibility of cervical spine pathology in these adults. The possibility of myelopathy should be investigated when considering the etiology of functional deterioration. A functional neurological examination for all multiply disabled individuals is proposed as a reference for future comparison.

Atteinte acauise de la moelle épinière cervicale chez les ieunes adultes I.M.C.

L'article rapporte le cas de trios I.M.C. de type spastiqe, sans trouble de rnouvements associes, chacun presentant une perte des capacites fonctionnelles et un retard dans le diagnostic d'une myélopathie cervicale, pour souligner la possibilité d'une pathologie médullaire cervicale chez ces adultes. La possibilité d'une myélopathie doit être évoquée lorsque l'origine d'une détérioration fonctionnelle est recherchée. Un examen neurologiqiie fonctionnel de tous les patients à incapacités multiples est proposé comme référence pour une comparaison future.

Erworbene Schädigung der Halswirbelsäule bei Jugendlichen mil Cerebralparese

Es wird über drei Patienten mit spastischer Cerebralparese ohne assoziierte Bewegungsstörung berichtet, bei denen ein Funktionsverlust auffiel, aber die endgültige Diagnose einer zervikalen Myelopathie erst verspätet gestellt wurde, um auf die Möglichkeit einer zervikalen Wirbelsäulenschädigung bei diesen Heranwachsenden aufmerksam zu rnachen. Die Myelopathie sollte bei der Differentialdiagnose einer funktionellen Verxhlechterung erörtert werden. Für zukünftige Vergleiche wird eine funktionelle neurologische Untersuchung für alle mehrfach behinderten Patienten angeboten.

Alteración adquirida de la columna cervical en adultos jóvenes con parálisis cerebral

Se aportan tres pacientes con paráilis cerebral espástica sin alteracion del movimiento, que presentaban pérdida de habilidades funcionales y retraso en el diagnóstico definitivo de mielopatia cervical. La finalidad era el insistir en pensar en la posibilidad de una patologia de la columna cervical en estos adultos. Debe investigarse la posibilidad de una mielopatia al considerar la etiología de una alteración funcional. Se propone un examen neurologica funcional en los casos de individuos con múltiples minusvalencias como una referencia para futuras comparaciones.
CEREBRAL PALSY IN IBADAN, NIGERIA
Authors: Nottidge Vidal A. , Okogbo Michael E.
Published: July 2010

In a three‐year study of cerebral palsy (CP)., CP accounted for 16·2 per cent of new referrals to a child neurology clinic. 63 per cent of these had potentially preventable causes (not including intracranial infections), associated with chronic shortage of care personnel and inadequate finances for effective rehabilitation services. It is suggested that training and deployment of nurse‐physiotherapists, combined with intensive health education, is a feasible solution to the problem.

I.M.C. à Ibadan, au Nigéria

Au cows d'une etude de trois ans sur I'Infirmité motrice cérébrale (I.M.C.), celle‐ci était responsable de 16,2 pour cent des premières consultations dans un service de neurologie infantile. Dans 63 pour cent de ces cas, la cause était potentiellemerit évitatile (sans inclure les infections intra‐craniennes), associeéà un déficit chronique de soins par personnel et un financement insuffisant pour une rééducation efficace. Les auteurs pensent que la formation et la diffusion d'infirmières rééducatrices, associées à une éducation sanitaire intensive, est une solution realiste au problème.

ZUSAIMMENFASSUNG

Cerebral pa rese in Ibadan, Nigeria

Bei einer dreijährigen Studie über Cerebralparese (CP) fand sich, daß 16·2 Prozent der Neuaufnahmen in einer neuropädiatrischen Klinik eine Cerebralparese hatten. 63 Prozent davon hätten möglicherweise verhindert werden können (intracranielle Infektionen ausgenommen), sie mußten im Zusammenhang mit chronischem Personalmangel und unzureichender finanzieller Unterstützung effektiver Rahabilitationsangebote gesehen werden. Die Autoren sind der Ansicht, daß die Ausbildung und Einstellung von Krankenschwester‐Physiotherapeuten, in Verbindung mit intensiver Gesundheitserziehung, eine mögliihe Lösung des Problems ist.

Parálisis cerebral en Ibadan, Nigeria

En un estudio de tres años sobre la Parálisis Cerebral (PC), ésta constituía el 16,2 por ciento de los casos muevos vistos en una clínica neurológica. El 63 por ciento de ellos eran por causas potencalmente prevenibles (sin incluir las infecciones intracraneales), en asociación con una insuficiencia crónica de personal adecuado y una sjtuación financiera insuficiente para cubrir las necesidades de los servicios de rehabilitación. Se sugiere que una posible solución asequible debe consistir en el entrenamiento y expansión de las enfermeras‐fisioterapeutas, en combinación con una intensiva educación sanitaria.
IMPROVEMENT OF FUNCTIONAL SITTING POSITION FOR CHILDREN WITH CEREBRAL PALSY
Authors: Myhr Ulla , von Wendt Lennart
Published: July 2010

Twenty‐three children with cerebral palsy were photographed and video‐filmed in six different sitting positions—including a hypothetical functional position—and the video‐films and photographs were analysed. It was found that pathological movements were minimised and postural control and arm and hand function best when the child was sitting in a forward‐tipped seat, with a firm backrest supporting the pelvis, arms supported against a table and feet permitted to move backward.

Vers une position assise fonctionnelle pour les enfonts IMC

Vingt‐trois enfants IMC ont kte photographie et pris en vidéo dans six positions différentes—incluant une position fonctionnelle hypothétique—et vidéos et photographies ont été analysees. II a été observé que les mouvements anormaux étaient minimises, le controle postural et les fonctions des mains et des bras optimisés, lorsque l'enfant était assis dans un siège incliné vers I'avant, un point d'appui ferme pour supporter le bassin, les bras supportés par une table et les pieds libres de se déplacer vers I'avant.

FunktionelIe Sitzposition bei Kindern mit Cerebralparese

23 Kinder mit Cerebralparese wurden in sechs verschiedenen Positionen photographiert und rnit der Videokamera gefilmt—einschlieljlich einer hypothetischen funktionellen Position. Die Videofilme und Photographien wurden analysiert. Man fand heraus, daß die pathologischen Bewegungen abnahmen und die Haltungskontrolle und die Arm—und Handfunktion am besten waren, wenn das Kind in einem nach vorn geneigten Sitz saß, mit einer festen Rückenstütze zur Stützung des Beckens, die Arme gegen einen Tisch gestützt und mit rückwärtiger Bewegungsfreiheit der Füße.

Hacia una sedestación funcional en niños con parálisis cerebral

Veintitrés niños con parálisis cerebral fueron fotografiados y videofilmados en seis posiciones diferentes, incluyendo una hipotética posicion funcional, analizándose las imagenes obtenidas. Se halló que los movimientos patológicos se minimizaban y que el control postural y la funcion del brazo y la mano mejoraban cuando el niño estaba sentado en un asiento inclinado hacia adelante, con un firme soDorte dorsal Dara descansar la pelvis, los brazos apoyados sobre una mesa y con los pies pudiédose mover hacia atrás
Effect of Early Corticosteroid Therapy for Landau‐Kleffner Syndrome
Authors: Lerman Pinclias , Lerman‐Sagie Tally , Kivity Sara
Published: July 2010

Four children treated for seizures between 1980 and 1986 were diagnosed as having Landau‐Kleffner syndrome (acquired aphasia with convulsive disorder), following the onset of aphasia. They received early and prolonged ACTH or corticosteroid therapy, with high initial doses. In all four cases the EEG promptly became normal, with subsequent long‐lasting remission of the aphasia and improvement of seizure control. Three to six years after discontinuation of hormone therapy the children are off medication and free from seizures and language disability.

Effets du traitement précoce par corticostéroïdes dans le syndrome de Landay‐Kleffner

Un diagnostic de syndrome de Landau‐Kleffner (aphasie acquise et convulsions) a été porté chez quatre enfants traités pour crises comitiales entre 1980 et 1986, à la suite du diagnostic d'aphasie. Ces enfants reçurent un traitment précoce et prolongé par ACTH ou corticostéroïdes, avec des doses initiales élévees. Dans les quatre cas, l'EEG fut rapidement normalisé, avec une rémission ultérieure de longue durée de l'aphasie et amélioration du controle des crises. Trois à six ans après la cessation du traitement hormonal, les enfants sont sans traitement, sans crises ni troubles de langage.

Die Wirkumg frühzeitiger Corticoidtherapie beim Landau‐Kleffner Syndrom

Bei vier Kindern, die in den Jahren 1980 bis 1986 wegen Krampfanfällen behandelt wurden, wurde mit dem Auftreten einer Aphasie die Diagnose Landau‐Kleffner Syndrome (erworbene Aphasie mit Krampfleiden) gestellt. Sie bekamen frühzeitig und über längere Zeit ACTH oder Corticoide in hoher Anfangsdosis. In allen vier Fällen normalisierte sich das EEG sofort, und es folgte eine anhaltende Remission der Aphasie und eine bessere Anfallskontrolle. Drei bis sechs Jahre nach dem Absetzen der Hormontherapie sind die Kinder ohne Medikamente, anfallsfrei und ohne Sprachbehinderung.

El efecto de la terapia precoz con corticosteroides en el sindrome de Landau‐Kleffner

Cuatro niños tratados por convulsiones entre 1980 y 1986 fueron diagnosticados de sindrome de Landau‐Kleffner (afasia adquirida con alteración convulsiva) a consecuencia del inicio de una afasia. Recíbieron una terapia precoz y prolongada con ACTH o con corticoides con dosis iniciales altas. En los cuatro casos el EEG se normalizó rápidamente con una remisión posterior de larga duración de la afasia y mejoría en el control de las convulsiones. Tres y seis años después de interrumpir la hormonoterapia los niños no toman ninguna medicación y estan libres de convulsiones y alteraciones en el lenguaje.
PURINE METABOLITES AND PYRIMIDINE BASES IN CEREBROSPINAL FLUID OF CHILDREN WITH SIMPLE FEBRILE SEIZURES
Authors: Rodríguez‐Núñez Antonio , Camiña Félix , Lojo Santiago , Rodríguez‐Segade Santiago , Castro‐Gago Manuel
Published: July 2010

Adenosine monophosphate, inosine monophosphate, inosine, adenosine, guanosine, adenine, guanine, hypoxanthine, xanthine, uric acid and pyrimidine bases were determined in the CSF of 18 children after simple febrile seizures and in a control group. There was no statistically significant difference between the two groups for any of these metabolites. This suggests that simple febrile seizures neither significantly disturb the metabolism of nucleotides, nucleosides or bases, nor significantly deplete neuron adenosine triphosphate ATP levels.

Métabolites puriques et bases pyrimidiques dans le LCR d'enfant avec crises hyperthermiques L'adénosine monophosphate, l'inosine monophosphate, l'inosine, l'adénosine, la guanosine, l'adénine, la guanine, l'hypoxanthine, la xanthine, l'acide urique et les bases pyrimidiques ont été mesurés dans le LCR de 18 enfants après crises comitiales hyperthermiques simples et dans un groupe contrôle. II n'y avait de différences significatives entre les deux groupes pour aucun des métabolites. Cela suggère que les crises hyperthermiques simples ne perturbent pas le métabolisme des nucléotides des nucléosides ou des bases et n'abaissent pas significativement les taux d'adénosine triphoshate (ATP) neuronique.

Purinmetabolite und Pyrimidinbasen im Liquor von Kindern mit einfachen Fieberkrämpfen Adenosinmonophosphat, Inosinmonophosphat, Inosin, Adenosin, Guanosin, Adenin, Guanin, Hypoxanthin, Xanthin, Harnsäure und Pyrimidinbasen wurden im Liquor von 18 Kindern mit einfachen Fieberkrämpfen und bei Kontrollkindern bestimmt. Für keinen dieser Metaboliten fand sich zwischen den beiden Gruppen ein signifikanter Unterschied. Das bedeutet, daß einfache Fieberkrämpfe weder den Metabolismus von Nukleotiden, Nukleosiden oder Basen signifikant stören, noch die neuronalen Adenosintriphosphatspiegel (ATP) signifikant verändern.

Metabolitos púricos y bases pirimidínicas en el LCR de niños con convulsiones febriles simples Se determinaron adenosina monofosfato, inosina monofosfato, inosina, adenosina, guanosina, guanina, hipoxantina, xantina, acido, úrico y bases pirimidinicas en el LCR de niños tras convulsiones febriles simples, así como en un grupo control. No había diferencia estadísticamente significativa entre ambos grupos para ninguno de los metabolitos citados. Esto sugiere que las convulsiones febriles simples no alteran el metabolismo de los nucleótidos, nucleósidos o bases, ni ocasiona ninguna depleción significativa en los niveles neuronales de adenosin trifosfato ATP.
Krabbe Disease in Monozygotic Triplets
Authors: Arroyo Hugo A. , Grippo Jorge , Taratuto Analia , Duffau Jorge , Chamoles Nestor
Published: July 2010

The authors report an extremely rare case of monozygotic triplets with globoid cell leukodystrophy (Krabbe disease). Born to healthy, non‐related, heterozygous parents, all three girls presented with typical signs of β‐galactocerebrosidase deficiency before one year of age and died within the first 41 months of life. The literature is briefly reviewed.

Maladie de Krabbe chez des triplets monozygotes

Les auteurs rapportent le cas extrèmement rare de triplets monozygotes atteints de leucodystrophie à cellules globoïdes (Maladie de Krabbe). Nées de parents en bonne santé, hétérozygotes non consanguins, les trois filles ont présenté les signes typiques d'une déficience en β‐galactocérébrosidase avant l'âge d'un an et moururent durant les 41 premiers mois de vie. Une brève revue de la littérature est faite.

Krabbe Syndrom bei monozygoten Drillingen

Die Autoren berichten über einer äußerst seltenen Fall von monozygoten Drillingen mit einer Globoidzell‐Leukodystrophie (Krabbe Syndrom). Als Kinder gesunder, nicht verwandter, hetrozygoter, Eltern zeigten alle drei Mädchen bereits im erstan Lebensjahr die typischer Symptome eines β‐Galaktocerebrosidasemangels und starben innerhalb der ersten 41 Lebensmonate. Es wird ein kurzer Literaturüberblick gegeben.

Enfermedad de Krabbe en trillizas monozigotas

Los autores presentan una caso extremadamente raro de triplete monozigotas con leucodistrofia de células globoides (enfermedad de Krabbe). Nacidas de padres sanos, no consanguineos, heterozigotas, las tres niños presentaban signos típicos de deficiencia de β‐galactocerebrosidasa antes del año de edad y fallecieron dentro de los 41 meses de vida. Se revisa brevemente la literatura.
The Surgical Management of Drooling
Authors: BURTON MARTIN J.
Published: July 2010

As with all branches of surgery, selection of the appropriate operative procedure for a particular patient involves careful weighing of all the alternatives and full discussion with the patient and carers. Each of the procedures described has its devotees and detractors. For an individual patient, however, the risks of each, the likely postoperative course and the results of the surgery‐both in terms of the expected chance of improvement in drooling and the presence or otherwise of residual scarring or taste‐must be balanced to determine the optimum plan for treatment.

The long‐term results of submandibular duct transposition for drooling in the author's own institution have recently been reported41. An initial improvement in the drooling of all patients was maintained for at least two years in 17 of 20 patients. Only two patients experienced complications requiring further surgery (ranulas in each case). It is suggested that these very satisfactory results, achieved without external scarring and without compromising the sense of taste, support the contention that submandibular duct transposition is the surgical treatment of choice for children and young people with cerebral palsy who drool excessively.
Positional Asphyxia in Individuals with Severe Cerebral Palsy
Authors: Brogan Thomas , Fligner Corrinne L. , McLaughlin John F. , Feldman Kenneth W. , Kiesel Eric L.
Published: July 2010

The authors report the accidental death by positional asphyxia of three individuals with cerebral palsy occurring after they had been placed in bed for the night. During the five‐year period between 1984 and 1989, 12 per cent of deaths from positional asphyxia in King County, Washington, involved individuals with cerebral palsy. Such accidents are similar to those occurring among healthy young children, perhaps because both groups have limited motor skills. Further research into accidents among disabled persons may clarify their special risks and possibly lead to modifications in bed design.

Asphyxie de position chez certains grands I.M.O.C.

Les auteurs ràpportent la mort accidentelle par asphyxie de position de trois I.M.O.C. après qu'ils aient été mis au lit pour la nuit. Durant la période de cinq ans, entre 1984 et 1989, 12 pour cent des décès par asphyxie de position dans le comté de King, Washington, concernaient des I.M.O.C. De tels accidents sont comparables à ceux qui surviennent chez de très jeunes enfants en bonne santé, peut‐être du fait d'un caractère commun de capacités motrices Iimitées. Des recherches ultérieures sur les accidents chez les personnes atteintes d'incapacité devraient préciser les risques propres et peutêtre conduire à une modification de l'architecture des lits.

Positionsasphyxie bei Patienten mit schwerer Cerebralparese

Die Autoren berichten über den plötzlichen Tod durch Positionsasphyxie bei drei Patienten mit Cerebralparese, nachdem sie zur Nacht ins Bett gelegt worden waren. In den fünf Jahren von 1981 bis 1989 waren im King County, Washington, 12 Prozent der Todesfälle durch Positionsasphyxie Patienten mit Cerebralparese. Solche Unglücksfälle ähneln denen, die bei gesunden Kleinkindern auftreten, vielleicht weil beide Gruppen begrenzte motorische Fähigkeiten besitzen. Weitere Untersuchungen von Unglücksfällen bei behinderten Patienten können eventuell ihre besonderen Risiken aufklären und möglicherweise dazu führen, adß die Bettform modifiziert wird.

Asfixia posicional en individuos con parálisis cerebral grave

Los autores refieren la muerte accidental por asfixia posicional de tres casos con parálisis cerebral, después de haber sido colocados en la cama para pasar la noche. En el periodo de cinco años entre 1984 y 1989 el 12 por ciento de asfixias posicionales en el condado de King, Washington, tuvo lugar en individuos con parálisis cerebral. Estos accidentes son semejantes a los ocurridos en niños pequeños sanos, tal vez porque ambos grupos tienen una limitación de la capacidad motora. Una investigación de los accidentes acaecidos en personas minusválidas puede esclarecer sus riesgos especiales y posiblemente lleve a modificar el diseño de las camas.
Development of postural adjustments during reaching in infants with CP
Authors: Hadders‐Algra Mijna , Van Der Fits Ingrid B M , Stremmelaar Elisabeth F , Touwen Bert C L
Published: July 2010

The development of postural adjustments during reaching movements was longitudinally studied in seven infants with cerebral palsy (CP) between 4 and 18 months of age. Five infants developed spastic hemiplegia, one spastic tetraplegia, and one spastic tetraplegia with athetosis. Each assessment consisted of a simultaneous recording of video data and surface EMGs of arm, neck, trunk, and leg muscles during reaching in various lying and sitting positions. The basic organization of postural adjustments of the children developing spastic CP was intact. Their main problem was a deficient capacity to modulate the postural adjustments to task‐specific constraints ‐ a deficit which was attributed to a combination of an impaired motor coordination and deficits in sensory integration. The child with spastic‐dyskinetic CP showed distinct abnormalities in the basic organization of postural adjustments.
Presentation and outcome of sacral agenesis: 20 years' experience
Authors: Wilmshurst Jo M , Kelly Rosemary , Borzyskowski Malgorzata
Published: July 2010

The underlying risk factors, presenting features, and outcome of 22 children with sacral agenesis and associated neuropathic bladder were studied retrospectively. The age of children at presentation was bimodally distributed, with peaks below 1 year and between 4 and 5 years of age. Ten patients presented after 1 year. The oldest was diagnosed at 12 years of age. In 12 children there was maternal diabetes, orthopaedic anomalies in 14, skin defects in 11, and anorectal/tracheooesophageal anomalies in three. Most children had persistent dribbling of urine on presentation associated with frequency, urgency, recurrent urinary tract infections, failure to respond to medication, and/or constipation. Twenty‐one children had abnormal neurology in the lower limbs. Videourodynamics showed neuropathic vesicourethral dysfunction in all children and vesicoureteric reflux in 10. Nineteen had a history of urinary tract infections. Seven had renal scarring, with renal impairment in three at presentation. Clean intermittent catheterization was recommended for 20 of the children. Bladder or bowel surgery has been carried out in seven and neurosurgery performed in two. Twenty of the 22 children underwent operative procedures. Ten operations were performed before sacral agenesis was diagnosed. Over a third of the children have required psychological support. The combination of urinary symptomatology and any of the above risk factors should give rise to a high level of suspicion and low threshold to perform investigations to exclude sacral agenesis. All these children have abnormal bladder and urethral function which not only causes incontinence but puts the kidneys at risk. Early detection allows effective multidisciplinary input specifically aimed at continence, preservation of renal function, and adequate psychological support.
Pseudoseizures as a complication of painful cervical ribs
Authors: Evans A L
Published: July 2010

An 8‐year‐old girl is described who presented with seizures. These were subsequently found to be pseudoseizures, with no EEG changes. They were provoked by pain from cervical ribs. This cause of pain‐provoked pseudoseizures has not previously been described.
Development of lateralized behaviour in the human fetus from 12 to 27 weeks’gestation
Authors: McCartney Glenda , Hepper Peter
Published: July 2010

Handedness is the most prominent manifestation of behavioural lateralization in the human population. However, little is known about its ontogeny. This study examined the prenatal development of behavioural lateralization by observing, longitudinally, the occurrence of left‐ and right‐arm movements in 17 human fetuses at 3‐week intervals from 12 to 27 weeks gestational age. Fetuses exhibited significantly more right‐arm movements than left‐arm movements at every gestational age. Throughout all periods of observation, 83.3% of fetuses showed more right‐arm than left‐arm movements. The number of arm movements observed peaked at 15 to 18 weeks’gestation and declined rapidly in mid‐gestation. The occurrence of laterality in early gestation indicates that asymmetric behaviour is probably under muscular or spinal, rather than cortical, control and points to a‘genetic’origin for such behaviour. The presence of lateralized motor behaviour in early gestation suggests it may have a potential causative role for subsequent lateralized behaviour and asymmetric brain development.
Use of melatonin to treat sleep disorders in tuberous sclerosis
Authors: O'Callaghan F J K , Clarke A A , Hancock E , Hunt A , Osborne J P
Published: July 2010

The results of a therapeutic trial of the use of melatonin in patients with tuberous sclerosis complex who also have severe sleep problems are reported. We used a randomized double‐blind placebo‐controlled crossover design. Seven patients with confirmed diagnoses of tuberous sclerosis and significant sleep disorder were recruited. We employed three outcome measures: total sleep time, time to sleep onset, and number of awakenings. Patients treated with melatonin had a small but clinically significant improvement in total sleep time (mean improvement 0.55 hours, P<0.05). They also tended to have an improvement in sleep‐onset time but this did not reach statistical significance. Melatonin, in this trial, had no discernible effect on sleep fragmentation. We conclude that melatonin does have a beneficial effect in prolonging the total sleep time of patients with tuberous sclerosis and sleep disorder and that further trials are necessary to investigate the issues of optimal dosage, tolerance, and possible interactions with other medications.
Motor coordination and kinaesthesis in boys with attention deficit–hyperactivity disorder
Authors: Piek Jan P , Pitcher Thelma M , Hay David A
Published: July 2010

In the current study, movement ability and underlying kinaesthetic processes of boys with attention deficit–hyperactivity disorder (ADHD) were compared with a group of control children. Two groups of 16 boys with either predominantly inattentive subtype ADHD (ADHD‐PI) or combined subtype ADHD (ADHD‐C) were compared with 16 control boys matched on age and verbal IQ. The findings demonstrated that the children with ADHD had significantly poorer movement ability than the control children. A high percentage of children with ADHD displayed movement difficulties consistent with developmental coordination disorder. In addition, the current study found that the type and degree of movement difficulty differed between subtypes. Children with ADHD‐PI had significantly poorer fine motor skill while children with ADHD‐C were found to experience significantly greater difficulty with gross motor skill. The severity of the children's inattentive symptomatology was found to be a significant predictor of motor coordination difficulties. Kinaesthetic sensitivity was not found to differ significantly between the groups.
Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. I: Anticipatory scaling
Authors: Gordon Andrew M , Duff Susan V
Published: July 2010

Previous studies of grasping and object manipulation in children with cerebral palsy (CP) have suggested a dichotomy in the ability to use anticipatory control (planning) of the fingertip force output, depending on the type of sensory information (tactile or proprioceptive) on which it is based. The present study further explores this issue by testing the ability of 15 children with hemiplegic CP aged between 8 and 14 years to scale the fingertip force output in advance during the lifting of small objects whose weight and surface texture are varied. The results indicate that children with hemiplegia can use anticipatory control based on both the weight and texture of the object, but require a greater number of trials than age‐matched children without CP (control children) before they can do so. We suggest that the initial lack of anticipatory control results from an indistinct internal representation of the object's physical properties due to disturbed sensory mechanisms, which may have direct implications for therapeutic intervention.
Long‐term follow up of childhood tuberculous meningitis
Authors: Schoeman J , PhD J Wait , Hons M Burger , van Zyl F , Fertig G , van Rensburg A Janse , Springer P , Donald P
Published: July 2010

The purpose of the present study was to determine the long‐term outcome of 76 children (40 females and 36 males) diagnosed and treated with modern antituberculosis drugs. The median age of the children on admission was 29.5 months and on follow‐up 9 years. Antituberculosis therapy consisted of daily isoniazid (20mg/kg), rifampicin (20mg/kg), ethionamide (20mg/kg), and pyrazinamide (40mg/kg) for 6 months. Twenty‐three children received daily prednisone (2–4mg/kg) for the first month of treatment. Raised intracranial pressure was actively monitored and treated. Patients with non‐communicating hydrocephalus received ventriculo‐peritoneal shunts shortly after admission while communicating hydrocephalus was treated with oral acetazolamide (100mg/kg/day) and furosemide (1mg/kg/day) in 3–4 divided doses. Communicating hydrocephalus that did not respond to this regimen within the first month of treatment also underwent ventriculo‐peritoneal shunting. Only 20% of children were functionally completely normal at follow‐up. Main areas of functional deficit were cognitive impairment (80%), poor scholastic progress (43%), and emotional disturbance (40%). Twenty‐five per cent of children had evidence of motor impairment, but all could walk and only 5 of 76 children (6% of total) were unable to run. One child was blind but no child had sensori‐neural deafness. It was concluded that these disabilities in children from mainly deprived socioeconomic backgrounds have serious implications for their future social, academic, and career prospects. A high index of suspicion of TBM in high tuberculosis incidence communities will help prevent the morbidity documented in this study.
Automatic processing of tones and speech stimuli in children with specific language impairment
Authors: Uwer Ruth , Albrecht Ronald , von Suchodoletz W
Published: July 2010

It is well known from behavioural experiments that children with specific language impairment (SLI) have difficulties discriminating consonant‐vowel (CV) syllables such as /ba/,/da/, and /ga/. Mismatch negativity (MMN) is an auditory event‐related potential component that represents the outcome of an automatic comparison process. It could, therefore, be a promising tool for assessing central auditory processing deficits for speech and non‐speech stimuli in children with SLI. MMN is typically evoked by occasionally occurring‘deviant’stimuli in a sequence of identical 'standard’sounds. In this study MMN was elicited using simple tone stimuli, which differed in frequency (1000 versus 1200Hz) and duration (175 versus 100 ms) and to digitized CV syllables which differed in place of articulation (/ba/, /da/, and /ga/) in children with expressive and receptive SLI and healthy control children (n=21 in each group, 46 males and 17 females; age range 5 to 10 years). Mean MMN amplitudes between groups were compared. Additionally, the behavioural discrimination performance was assessed. Children with SLI had attenuated MMN amplitudes to speech stimuli, but there was no significant difference between the two diagnostic subgroups. MMN to tone stimuli did not differ between the groups. Children with SLI made more errors in the discrimination task, but discrimination scores did not correlate with MMN amplitudes. The present data suggest that children with SLI show a specific deficit in automatic discrimination of CV syllables differing in place of articulation, whereas the processing of simple tone differences seems to be unimpaired.
High incidence of language disorder in children with focal epilepsies
Authors: Parkinson Gillian M
Published: July 2010

To investigate the relationship between the presence of language disorder, type of epilepsy, and epileptic seizures in childhood, language levels, types of language impairment, and aetiologies were examined in 109 children, aged between 5 and 17 years, attending a national children's epilepsy assessment unit over a 4‐year period. There were 70 males and 39 females. Median age was 11 years 4 months (range 5 to 18 years 9 months). In addition to neurological assessment, simultaneous video and EEG monitoring and prolonged ambulatory EEG, each child underwent a comprehensive series of multidisciplinary tests, including intelligence, language, and communication assessments. Classification of seizures and epilepsy syndromes was agreed in conference by a physician specializing in childhood epilepsies, a paediatric neurologist, and a neuropsychiatrist. Other test procedures were administered by a speech and language pathologist with assistance from a neuropsychologist when relevant. Level of language disability in these children was associated with a range of aetiological factors. Evidence was found of a significant number of associations between focal epilepsies, certain seizure types, and language disorder. Of the 46 (42.2%) children with language disorders in the research sample, 30 had localization‐related epilepsies and a further three had epilepsies which were undetermined as to whether focal or generalized. Children with focal epilepsies were 30% more likely to have language disorder than other language disability subtypes. The research demonstrated a clear though often subtle association between focal (localization‐related) epilepsy and language disorder, indicating an increased risk in this patient group. Children with simple or complex partial seizures were more likely to have language disorder than other language disability subtypes; they also tended to have the lowest number of seizure types per case. This is of importance to clinicians managing children with epilepsy and has implications for their educational and social welfare.
Psychomotor development in children with early diagnosed giant interhemispheric cysts
Authors: Haverkamp Fritz , Heep Axel , Woelfle Joachim
Published: July 2010

Systematic studies of cognitive development in individuals with congenital giant interhemispheric cysts (GIC) without neurosurgical intervention are rare. However, data from such studies are of great importance in deciding whether or not to perform cerebral shunting in otherwise asymptomatic patients. In this study, psychomotor function was examined in 13 children (three females, 10 males; mean age at follow‐up: females 1 year 6 months, males 3 years 2 months; age range: females 13 months to 4.2 years, males 10 months to 10 years) all diagnosed with GIC during the neonatal period after indicative foetal ultrasound. Eight patients received neurosurgical treatment due to increased intracerebral pressure during the first year of life. Psychomotor development was evaluated using Griffith's Psychomotor Developmental Scales, the Sniders‐Oomen Non‐verbal Intelligence Scale for Young Children and the Kaufmann Assessment Battery for Children. The majority of patients showed normal intelligence, irrespective of the presence or absence of neurosurgical intervention. Evidence was found that the cognitive outcome might be related to an association of GIC with agenesis of the corpus callosum or additional congenital cerebral malformations, such as gyration anomalies. Main postoperative complications were chronic subdural effusions with spastic cerebral (hemi)‐paresis; were present in three patients. In view of the risk of severe postoperative neurological complications and a comparable psychomotor development in patients without neurosurgical treatment, recommendations for early neurosurgical intervention in otherwise asymptomatic patients with a foetal or neonatal diagnosis of GIC should be viewed with caution.
Learning and memory of school children with epilepsy: a prospective controlled longitudinal study
Authors: Schouten A , Oostrom K J , Pestman WR , Peters A C B , Jennekens‐Schinkel A
Published: July 2010

The aim of the study was to determine whether learning and memory are compromised in school children with recently diagnosed idiopathic and/or cryptogenic epilepsy and to study relationships between learning and memory and psychosocial and epilepsy variables. Word span and learning of locations were assessed within 48 hours after diagnosis of epilepsy and three and 12 months later, in 69 school children with epilepsy (aged 9.1 years, SD 2.7; 33 males, 36 females) and 66 classmates. Results showed that patients and controls performed similarly in registration, recall, and retention. Patients recalled slightly less than controls when probed under conditions of increased demand on working memory. Maladaptive reactions of parents and children to the onset of epilepsy and not reaching 6‐months of seizure remission contributed to poor performance. Individually, those patients who required special assistance at school, under‐performed occasionally in one or the other component of memory. Although the proportion of under‐performers was stable over time, the children composing the group did change. It was concluded that school children with new onset idiopathic or cryptogenic epilepsy are inordinately vulnerable when processing memory tasks. The vulnerability is neither persistent nor memory‐specific.
Rehabilitation in severe head injury in children: outcome and provision of care
Authors: Tomlin Pam , Clarke Mike , Robinson Gilly , Roach Julie
Published: July 2010

Functional outcome and provision of care to 82 children (males: females 2.7: 1; age range 0 to 16 years) with severe head injury were investigated. The children were admitted to the intensive care units of the Regional Neuroscience Units of the Greater Manchester and Lancashire districts of the North West Region of the UK between 1994 and 1996. A questionnaire was devised based on 12 areas of recovery and data were collected at discharge and 6 weeks, 6 months and 12 months from discharge. Data were collected during home visits and at joint assessment at 12 months with the district consultant community paediatrician (CCP). Early involvement of the CCP enhanced the provision of needs at discharge and 6 weeks after discharge, as did a period of stay in district‐level care before discharge home. CCPs received formal notification of the injured child in only 32% of cases by discharge, and 54% of cases by 6 months. Sixty‐five per cent of children required early educational support but structured help reached only 55% of these children by the end of the study. Integrated planning between health and education was achieved in about half of the study population. Good physical recovery was achieved by the majority of children but parents said they did not feel prepared for the degree of help which their child still required 12 months after discharge. Children who required anticonvulsants at 12 months’follow‐up scored significantly lower on cognitive potential. Psychosocial family functioning deteriorated in a substantial number of families according to parental perception. Prevalence of this perception did not diminish over the study period. Aspects of caregivers’understanding and the child's language deficits, self‐care skills, fine and gross motor performance, as well as family, social, and financial consequences were assessed. A dedicated and integrated approach to assessment and provision of care across the domains of hospital, education, and community is discussed.
Architecture of the medial gastrocnemius in children with spastic diplegia
Authors: Shortland Adam P , Harris Charlotte A , Gough Martin , Robinson Richard O
Published: July 2010

Due to an error in the December 2001 version of this article the corrected version is published below.

Ultrasound images were obtained of the medial gastrocnemius at different ankle joint positions with the knee extended. Fascicle length and deep fascicle angle were measured in five normally developing adults (mean age 33 years, age range 24 to 36 years) and in five normally developing children (mean age 7.8 years, age range 7 to 11 years), and in seven children with spastic diplegia (mean age 10 years, age range 6 to 13 years). These architectural variables were similar in the groups of normally developing adults and children. Importantly, no statistical difference could be found between the normally developing children and those with diplegia for fascicle length. Deep fascicle angles were reduced significantly in the clinical group at a particular ankle joint angle but not at the resting angles. The difference in deep fascicle angles is explained as a function of resting muscle length and is not attributed any clinical importance. Our results do not explain the structural origin of muscle contracture explicitly. However, they do indicate that most of the fixed shortness in the medial gastrocnemii of ambulant children with spastic diplegia is not due to reduced muscle fibre length. We suggest that muscle contracture may be better explained in terms of shortness of the aponeuroses of pennate muscles, such as the medial gastrocnemius, through reduced muscle fibre diameter.
A gait nomogram used with fuzzy clustering to monitor functional status of children and young adults with cerebral palsy
Authors: Vaughan Christopher L , O'Malley Mark J
Published: July 2010

We have developed a gait nomogram based on dynamic similarity to characterize and compare neuromuscular function. We used temporal‐distance data based on 669 normal participants (age range 5 to 98 years), and 78 children and young adults with spastic diplegia (43 males, 35 females; mean age 10y 8mo, standard deviation 3y 11mo, range 5 to 20y), all of whom were independent ambulators. A new statistical algorithm known as fuzzy clustering was implemented and five cluster centres were identified, each representing distinct walking strategies adopted by children with cerebral palsy. Using just three easily obtained parameters ‐ leg length in metres, stride length in metres, and cadence in steps per minute ‐ our program calculates a child's dimensionless step length and step frequency, generates the individual's membership values for each of the five clusters, and plots the gait nomogram. The clinical utility of our approach has been demonstrated for two test participants with spastic diplegia, using pre‐ and postoperative data (one neurosurgical and one orthopaedic), where changes in membership of the five clusters provide objective measures of improvement in their neuromuscular function.
Deficits in motor control processes involved in production of graphic movements of children with attention‐deficit‐hyperactivity disorder
Authors: Schoemaker Marina M , Ketelaars Cees E J , Van Zonneveld Marion , Minderaa Ruud B , PhD Theo Mulder
Published: July 2010

This study aimed to investigate whether two distinct motor control processes, i.e. motor planning and parameter setting, were impaired in children with attention‐deficit‐hyperactivity disorder (ADHD). An experiment was designed in which children copied figures of increasing complexity under increasing accuracy levels on a digitizer. Sixteen children with ADHD (11 males, 5 females; mean age 8y 4mo, SD 1y 1mo) and 16 comparison children, without impairment, matched for age and sex participated. ADHD was diagnosed by a psychiatrist following the criteria of the DSM‐V. Only children with IQ scores greater than 80 were included. Across all graphic tasks, children with ADHD made slower, inaccurate strokes with relatively high axial pen force compared with the comparison group. No evidence was found for a deficit in motor planning, but parameter setting appeared to be deficient as the ADHD group made less accurate strokes when accuracy demands increased.
Behavioral profiles of children with infantile nephropathic cystinosis
Authors: Delgado Gustavo , Schatz Amy , Nichols Sharon , Appelbaum Mark , Trauner Doris
Published: July 2010

Children with infantile nephropathic cystinosis have evidence of visuospatial and arithmetic deficits on a background of normal intellectual and verbal skills. This study aimed to define further their behavioral phenotype. The Achenbach Child Behavior Checklist was completed by parents of: 64 children and adolescents with cystinosis (33 females, 31 males; mean age 8y 8mo, range 4 to 16y, SD 2y 11mo); 101 healthy controls (47 females, 54 males; mean age 8y 4mo, range 4 to 16y, SD2y 11mo); 21 children and adolescents with cystic fibrosis (CF), termed chronic‐disease controls (9 females, 12 males; mean age 11y 3mo, age range 4 to 17y, SD 3y 5mo). Compared with healthy controls, individuals with cystinosis had evidence of a significantly higher incidence of behavioral problems, including social problems, somatic complaints, and attention problems. Compared with the chronic‐disease control group, the cystinosis group differed only on the Social Problems scale, with 22% of participants with cystinosis scoring in the‘at risk’range whereas no participant with CF received an elevated score on this scale. We conclude that children and adolescents with cystinosis have evidence of a significant incidence of social difficulties compared with individuals with another chronic illness and healthy participants. The combination of visuospatial problems, difficulty with arithmetic, attention problems, and social difficulties seen in the cystinosis group constitutes a behavioral phenotype of this genetic disorder. This cluster of cognitive and behavioral symptoms is also seen in the nonverbal learning disabilities syndrome, and suggests a possible early difference in brain development in children with cystinosis compared with children who do not share this genetic disorder.
Understanding Economic Crises: The Great Depression and the 2008 Recession
Authors: OHANIAN LEE E.
Published: July 2010

Economic crises, involving large and persistent declines in output and employment, are puzzles, particularly in developed countries with economies that typically function at a high level. This article analyses the Great Depression and the 2008 recession using recent developments in business cycle diagnostic procedures, and finds that the key to both episodes is understanding labour market distortions that resulted in the marginal product of labour being much higher than the marginal rate of substitution between consumption and leisure. This finding stands in sharp contrast to the received wisdom, which focuses on the role of banking crises and capital market distortions. The article also discusses possible hypotheses for these labour market distortions.