42 research outputs found
Childhood Absence Epilepsy
No full textChildhood absence epilepsy (CAE) is a common epilepsy syndrome characterized by absence seizures aecting young children and representing 18% of all diagnosed cases of epilepsy in school-age children. Absence seizures are classically very frequent during the day and each seizure lasts a short time, from about 10 to 20 seconds, it ends abruptly, and awareness and responsiveness are severely impaired. The typical EEG pattern in CAE is a bilateral, synchronous, and symmetrical discharge of complex spike-wave rhythms at 3 Hz (range of 2.5–4 Hz), with sudden onset and termination. CAE is genetically determined, the mode of inheritance and genes involved remain not fully clarified but the final outcome is the dysregulation of cortico-thalamic-cortical circuit that plays a crucial role in the pathophysiology of absence seizures. CAE may have an impact on patients’ lives in terms of negative consequences in neurocognitive and neuropsychological aspects that should always be considered during a global evaluation of a child with epilepsy
Relationship between sleep quality and rhinitis in children: role of medical treatment with isotonic and hypertonic salines
No full textThe nose represents the port of entry, the first part of the upper airway and accounts for 50% of its total resistance. Many authors identified rhinitis as relevant factor affecting quality of life, and sleep habits of sufferers and their caregiver's, particularly between 4-17 years old children. Both allergic rhinitis and non-allergic rhinitis may represent an important risk for obstructive sleep apnea syndrome in children. We evaluated the quality of sleep and the role of nasal irrigations with saline solutions in children with sign and symptoms of rhinitis
Trattamento profilattico della Cefalea Tensiva Episodica Frequente in età evolutiva: efficacia del complesso nutraceutico Griffonia simplicifolia/Magnesio
No full textRIASSUNTO
Background. La cefalea tensiva è un’algia di tipo gravativo-costrittivo, di intensità medio moderata, frequentemente bilaterale, di durata variabile da pochi minuti a diversi giorni, talvolta associata a fotofobia o fonofobia, osmofobia la cefalea tensiva episodica è stata ulteriormente suddivisa in due sottotipi: infrequente e frequente. Non esistono terapie codificate per tale forma di cefalea pediatrica.
Scopo dello studio è verificare l’efficacia e sicurezza di un composto nutraceutico a base di griffonia simplicifolia/magnesio nella terapia preventiva in una popolazione pediatrica di soggetti affetti da cefalea tensiva episodica di tipo frequente
(FETTH).
Metodi. 79 bambini (38 M, età media 9,24 ± 2,07 anni) affetti da FETTH sono stati sottoposti a un trattamento profilattico con il complesso nutraceutico griffonia simplicifolia/magnesio per via orale due volte al giorno per 3 mesi, l’efficacia del trattamento è stata stimata con il confronto della frequenza e intensità degli attacchi prima e dopo tale trattamento.
Risultati. A T0, la frequenza media al mese era pari a 6,81 attacchi (SD ± 1,98) e al T1 era 1,25 (SD ± 0,93) (F = 510,35, p < 0,001), con una media frequenza percentuale delta era 86,04 (SD ± 15.73) a T1.
Conclusioni. Pertanto il presente studio si propone come studio preliminare sulla efficacia di tale complesso nella forma di cefalea tensiva definita come episodica frequente.Summary
Background. Tension-type headache (TTH) is common primary headache typically bilateral, pressing or tightening in quality and of mild to moderate intensity, lasting minutes to days. The pain does not worsen with routine physical activity and is not associated with nausea, but photophobia or phonophobia may be present. TTH can be distinguished into two subtypes: infrequent and frequent.
There is no specific coded treatment in pediatric TTH. Aim of study is evaluating efficacy and safety of Griffonia simplicifolia/Magnesium nutraceutical complex as prophylactic therapy in a pediatric sample with frequent episodic tension type headache (FETTH).
Methods. A prophylactic treatment with the complex nutraceutical Griffonia simplicifolia/ Magnesium orally twice a day for 3 months was administered to 79 children (38 M, mean age 9,24 ± 2,07 years) affecting by FETTH, efficacy of the treatment was estimated by comparison of the frequency and intensity of attacks before and after such treatment.
Results. At T0, the mean frequency per month was equal to 6,81 attacks (SD ± 1,98) and the T1 was 1,25 (SD ± 0,93) (F = 510,35, p < 0,001), with an average rate Delta percentage was 86,04 (SD ± 15,73) to T1.
Conclusions. Therefore, the present study aims as a preliminary study on the effectiveness of this complex in the form of tension headache defined as frequent episodic
Visuomotor integration skills in children affected by obstructive sleep apnea syndrome: A case-control study
No full textIntroduction: Sleep related breathing disorders (SRBD) consist of frequent and repetitive episodes of pharyngeal obstruction during sleep, with consequent intermittent hypoxia, sleep architecture fragmentation, daytime sleepiness and/or behavioural problems and executive impairment in children. When untreated, SRBD and obstructive sleep apnea syndrome (OSA) mainly, may impact school performance, cognition, metabolism, and cardiovascular function. Aim of the present study is assessing the visuomotor integration skills in children affected by OSA. Materials and methods: 57 subjects affected by mild-to severe OSA, PSG diagnosed according to international diagnostic criteria, (31 males and 26 females) (mean age 10.8; SD ± 2.49) and 83 healthy children (45 males and 38 females) (mean age 9.95; SD ± 1.87; p = 0.725). All subjects underwent assessment of motor coordination skills with Movement-ABC tests and visual-motor integration ability with Visual Motor Integration (VMI) test. Results: The subjects with OSA show a worse average performances in all items of Movement ABC (p < 0.001) respect of controls. Specifically, children with OSAS show significantly higher values of total points (p < 0.001), manual dexterity (p < 0.001), ball skills (p < 0.001) and balance (p < 0.001). Accordingly, the average centile in OSA children at the MABC-test is significantly reduced compared with controls (p < 0.001). (Table 1) On the other hand, the VMI test evaluation among children with OSAS shows worst result in total Visuo-Motor Integration (p < 0.001), and in Motor Coordination sub-item (p < 0.001) than controls. (Table 1). Conclusion: Our results also support for children and adolescents the hypothesis that executive functioning deficits might be linked primarily to the degree of severity nocturnal hypoxemia rather than daytime sleepiness, although several other studies are needed
Memory performances and personality traits in mothers of children with obstructive sleep apnea syndrome
No full textBackground: Chronic diseases in pediatric age have been identified as stressful risk factors
for parents. Studies on caregivers have documented the impact of chronic parenting stress on
emotion and cognition.
Aim: To investigate the differences between a group of mothers of children affected by
obstructive sleep apnea syndrome (OSAS) for at least 4 years and a group of mothers of
typically developing children (TDC) in relation to parental stress, self-esteem, locus of
control, and memory performances.
Methods: A group of 86 mothers (mean age 35.6±4.9, ranged between 32 and 41 years) of
children with OSAS diagnosis, and a group of 52 mothers of TDC (mean age 35.9±4.2,
ranged between 32 and 41 years) participated in the study. All participants were administered
stress level, global self-esteem, internal/external locus of control scales, and memory
assessment.
Results: Mothers of OSAS children, compared to mothers of TDC, had a significantly
higher level of stress, lower self-esteem, more external locus of control and poorer memory
performance.
Conclusions: The child respiratory disease, with its sudden and unpredictable features,
appeared as a significant source of stress for the mother. Such stress condition may have an
impact on mothers’ personality traits (self-esteem, locus of control) and on their memory
performances. The data have suggested a need for psychological support programs for
mothers to better manage stress associated with children’s respiratory disease
Visuomotor competencies and primary monosymptomatic nocturnal enuresis in prepubertal aged children
No full textMaria Esposito,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Giuseppina Patriciello,1 Francesco Precenzano,1 Marco Carotenuto1 1Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Italy; 4Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy Background: Primary monosymptomatic nocturnal enuresis (PMNE) is a common problem in the developmental ages; it is the involuntary loss of urine during the night in children older than 5 years of age. Several clinical observations have suggested an association between bedwetting and developmental delays in motricity, language development, learning disability, physical growth, and skeletal maturation. The aim of the present study is to evaluate the prevalence of fine motor coordination and visuomotor integration abnormalities in prepubertal children with PMNE. Methods: The study population included 31 children (16 males, 15 females; mean age 8.14 years ± 1.36 years), and the control group comprised 61 typical developing children (32 males, 29 females; mean age 8.03 years ± 1.44 years). The whole population underwent a clinical evaluation to assess total intelligence quotient level, visuomotor integration (VMI) skills, and motor coordination performance (using the Movement Assessment Battery for Children, or M-ABC). Results: No significant differences between the two study groups were found for age (P = 0.725), gender (P = 0.886), z-body mass index (P = 0.149), or intellectual abilities (total intelligence quotient) (P = 0.163). The PMNE group showed a higher prevalence of borderline performance on M-ABC evaluation and in pathologic performance on VMI Total Task compared to controls (P < 0.001). No significant differences between the two study groups were found for pathologic performances on the M-ABC (P = 0.07), VMI Visual Task (P = 0.793), and VMI Motor Task (P = 0.213). Conclusion: Our findings pinpointed that PMNE should not be considered as a voiding disorder alone and, consequently, the children affected should be referred to specific rehabilitative programs that aim to improve motor coordination and visuomotor integration. Keywords: primary monosymptomatic nocturnal enuresis, visuomotor integration, childhood rehabilitation, VMI, M-AB
Evaluation of neurocognitive abilities in children affected by obstructive sleep apnea syndrome before and after adenotonsillectomy
No full textObstructive sleep apnoea syndrome (OSAS) is the most severe form of sleep-related disordered breathing (SRDB) and is characterised by snoring, apnoeas, and/or hypopnoeas associated to hypoxia, hypercarbia, or repeated arousals from sleep. OSAS has three major categories of morbidities: neurobehavioural, cardiovascular and somatic growth failure. The gold standard for objective diagnosis of obstructive-SRDB severity is polysomnography (PSG). The indication for surgical treatment in children is moderate-severe OSAS (AHI, apnoea hypopnoea index > 5/h) and in mild OSAS (AHI 2-5/h) with complications or morbidity. The entire spectrum of PSG-defined SRDB (ranging from Primary Snoring to severe OSAS) may correlate with behavioural, attentional and executive function deficits relating to hypoxia and sleep disruption: in some cases, these alterations may mimic attention deficit hyperactivity disorder (ADHD). The aim of this research was to evaluate visuoperceptual and constructional abilities, paediatric sleep questionnaire and polysomnographic scores before and 6 months after adenotonsillectomy with objective and subjective information. We included 59 children who underwent neuropsychiatric and otolaryngologist clinical evaluation and the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI); children parents were asked to fill in the Paediatric Sleep Questionnaire (PSQ); each child underwent PSG. At 6 months after adenotonsillectomy, all patients were evaluated again. There is a significant difference in PSQ parameters, VMI standard, visual tests scores and PSG parameters before and after adenotonsillectomy in children affected by OSAS. These results showed the achievement of therapeutic benefits with improvement of the quality of life for both children and their parents
Parental Stress and Parental Ratings of Behavioral Problems of Enuretic Children
No full textBackground: Primary monosymptomatic nocturnal enuresis (PMNE) may have a
stressful impact on the everyday life of children and parents, and it may represent a
cumulative stress factor increasing feelings of “learned helplessness.”
Methods: The current study investigated parental stress in a group of parents (n = 330)
of children affected by PMNE, compared to a group of parents (n = 330) of typical
developing children (TDC). In addition, the study evaluated whether parents of PMNE
children experience more emotional, social, and behavioral problems in their children,
compared to parents of TDC. Finally, the study correlated frequency of enuresis with
stress values and Child Behavior Checklist (CBCL) subscales and total stress with CBCL.
Both groups were given The Parental Stress Inventory-Short Form (PSI-SF) and the Child
Behavior Checklist (CBCL).
Results: Parents of PMNE children showed significantly higher stress level than
parents of TDC. Nocturnal enuresis, as a demanding clinical condition difficult to
control, represents a relevant stress factor. Mothers appeared as more vulnerable
to stress than fathers. Parents of PMNE children reported higher behavioral and
emotional problems, compared to reports of parents of TDC. PMNE children appeared
to their parents as having lower competency in social activities, school performance,
and social relationships than TDC. Moreover, they were rated as more withdrawn,
anxious-depressed,more aggressive, inattentive, and withmore somatic complaints than
healthy children. It was always the mother who rated a significantly higher number of
emotional, social, and behavioral problems compared to fathers. Correlational analysis
showed that the higher the frequency of enuresis, the greater the parental stress
level, the lower the social activities, school performance and relational competencies
and the higher the emotional, social and behavioral problems in children, according
to the parents’ evaluations. The greater the parental stress level, the lower the
competencies rated and the higher the behavioral problems detected by parents.
Conclusion: The physicians who deal with PMNE children have taken into account
the stressful role and emotional dimensions of this clinical condition, both for children
and mothers, in order to improve clinical management. Psychological support is needed
for parents, and mothers especially, for a more functional stress management related to
the PMNE
Anxiety and depression levels in prepubertal obese children: a case-control study
No full textMaria Esposito,1 Beatrice Gallai,2 Michele Roccella,3 Rosa Marotta,4 Francesco Lavano,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Domenico Bove,6 Michele Sorrentino,1 Francesco Precenzano,1 Marco Carotenuto1 1Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Second University of Naples, Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 4Department of Psychiatry, “Magna Graecia” University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy; 6Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy Introduction: Childhood obesity has become a worldwide epidemic in Western and in developing countries and has been accompanied by many serious and severe comorbidities, such as diabetes, hypertension, sleep apnea syndrome, depression, dyslipidemia, impaired glucose homeostasis, steatohepatitis, and intracranial hypertension, as well as medical concerns unique to youth, such as accelerated pubertal and skeletal development and orthopedic disorders. To date, no specific studies about the psychological assessment in pediatric obesity are present. Therefore, the aim of this study was to evaluate the putative relationship between psychological troubles and obesity in a sample of school-aged children. Materials and methods: The study population consists of 148 obese subjects (body mass index [BMI] >95th percentile) (69 males, mean age 8.9±1.23 years) consecutively referred from clinical pediatricians to the Child and Adolescent Neuropsychiatry department at the Second University of Naples. In all subjects, weight, height, and BMI z-score were evaluated. In order to assess the anxiety levels and the presence of depressive symptoms, the Children Depression Inventory (CDI) and the Italian Self-Administered Psychiatric Scales for Children and Adolescents (SAFA) were administered. The control group consisted of 273 healthy children (129 males and 144 females) (mean age 9.1±1.8 years), enrolled in schools within the Campania region of Italy. Results: No significant differences between the two study groups were found for age (8.9±1.23 years in the obese sample and 9.1±1.8 years in the control group) (P=0.228) or sex (ratio male/female: 69/79 in the obese group versus 129/144 in the control group) (P=0.983). Obviously, significant difference was found for the BMI z-score (2.46±0.31 in the obese group vs 0.73±0.51 in the control group) (P<0.001). The obese subjects showed significant higher level of depressive symptoms (CDI total score) (16.82±7.73 vs 8.2±2.9) (P<0.001) and anxiety (SAFA – Anxiety [SAFA-A]) scale score (58.71±11.84 vs 27.75±11.5) (P<0.001) compared with the control group. Moreover, the Pearson’s correlation analysis showed a significantly positive relationship between the BMI z-score and both the CDI (r=0.677; P<0.001) and SAFA-A scores (r=0.591; P<0.001). Conclusion: Our findings highlighted the importance of assessing the presence of internalizing problems, such as anxiety and depression, in the common management of childhood obesity. Keywords: childhood obesity, internalizing problems, SAFA, CD
Executive dysfunction in children affected by obstructive sleep apnea syndrome: an observational study
No full textMaria Esposito,1 Lorenzo Antinolfi,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Giovanni Mazzotta,5 Francesco Precenzano,1 Marco Carotenuto1 1Sleep Clinic for Developmental Age, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health and Preventive Medicine, Second University of Naples, Naples, Italy; 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy; 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, Italy; 4Department of Psychiatry, Magna Graecia University of Catanzaro, Catanzaro, Italy; 5Unit of Child and Adolescent Neuropsychiatry, AUSL Umbria 2, Terni, Italy Introduction: The role of sleep in cognitive processes can be considered clear and well established. Different reports have disclosed the association between sleep and cognition in adults and in children, as well as the impact of disturbed sleep on various aspects of neuropsychological functioning and behavior in children and adolescents. Behavioral and cognitive dysfunctions can also be considered as related to alterations in the executive functions (EF) system. In particular, the EF concept refers to self-regulatory cognitive processes that are associated with monitoring and controlling both thought and goal directed behaviors. The aim of the present study is to assess the impact of the obstructive sleep apnea syndrome (OSAS) on EF in a large sample of school aged children. Materials and methods: The study population comprised 79 children (51 males and 28 females) aged 7–12 years (mean 9.14 ± 2.36 years) with OSAS and 92 healthy children (63 males and 29 females, mean age 9.08 ± 2.44 years). To identify the severity of OSAS, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Modified Card Sorting Test to screen EFs. Moreover, to check the degree of subjective perceived daytime sleepiness, all subjects were administered the Pediatric Daytime Sleepiness Scale (PDSS). Results: No significant differences between the two study groups were found for age (P = 0.871), gender (P = 0.704), z-score of body mass index (P = 0.656), total intelligence quotient (P = 0.358), and PDSS scores (P = 0.232). The OSAS children showed a significantly higher rate of total errors (P < 0.001), perseverative errors (P < 0.001), nonperseverative errors (P < 0.001), percentage of total errors (P < 0.001), percentage of perseverative errors (P < 0.001), and percentage of nonperseverative errors (P< 0.001). On the other hand, OSAS children showed a significant reduction in the number of completed categories (P = 0.036), total correct sorts (P = 0.001), and categorizing efficiency (P < 0.001). The Pearson's correlation analysis revealed a significant positive relationship between all error parameters and apnea-hypopnea index, oxygen desaturation index, and percentage of mean desaturation of O2 with a specular negative relationship between the error parameters and the mean oxygen saturation values, such as a significant negative relationship between apnea-hypopnea index, oxygen desaturation index, percent of mean desaturation of O2, and the number of completed categories. Conclusion: Our study identified differences in the executive functioning of children affected by OSAS and is the first to identify a correlation between alteration in respiratory nocturnal parameters and EF that has not yet been reported in developmental age. These findings can be considered as the strength and novelty of the present report in a large pediatric population. Keywords: OSAS, polysomnography, executive functions, sleep, sleepiness, childre
