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Encephalomyelo-radiculoneuropathy. Involvement of the central nervous system in acute polyradiculitis in children
No full textThirty eight cases of polyneuritis are described. Nine of them also presented with signs of CNS impairment during the acute phase. At controls, performed at least 2 yr later, major symptoms of CNS disorder were absent in all cases. The nosologic definition of polyneuritis and the role of atypical symptoms for the prognosis are discussed
Headache in children with brain tumors
No full textTo study the criteria for early differential diagnosis between migraine and headache due to brain tumors, we analyzed the symptoms and signs of two groups of children. The first group consisted of 67 children in whom a brain tumor had been diagnosed. The second group was composed of 600 children who had been diagnosed as migraine cases. Among the features of headache that are considered to be alarming symptoms of a brain tumor, the following were found to indicate a brain tumor with the greatest sensitivity: nocturnal headache or headache present on arising, both associated with vomiting, and increased frequency of headache. Nocturnal headache or headache present on arising, associated with vomiting, and/or progressive neurological symptoms or signs occurred in 65 of 67 children with brain tumor within 2 months of the onset of their headaches and in all 67 within 6 months
Brain tumors in childhood. Clinical aspects
No full textThe analysis of 76 case histories of children suffering from brain tumor revealed a majority in preschool age. The diagnosis at admission to the hospital was correct in 2/3 of the cases. The main causes for admission among unclear cases were headache, a history of head trauma, and epilepsy. An evaluation is made of the diagnostic value of symptoms, neurological signs, and of auxiliary investigations
Headache in childhood
No full textMigraine in children is diagnosed in presence of paroxystic episodes of headache which recur with free intervals, provided intracranial diseases are excluded. Pathogenesis of this disorder is unclear; migraine with and migraine without aura may be different entities. Many factors can precipitate a migraine attack. In school age, psychologic stress is the commonest factor. Main characteristics of attacks in children are headache, which may be hemicranial; nausea and vomiting, abdominal pain, paraesthesiae. Scotomata are not very common in the pediatric age. In some cases, migraine attacks are complicated by sensory or motor symptoms (paraesthesiae, paresis), usually at one hemisoma. In the basilar artery migraine syndrome, features of brain-stem dysfunction predominate. In a few patients a migraine attack presents itself as an acute confusional state. In migraine, EEG abnormalities are frequent (predominance of diffuse or focal slowing). In some cases a CSF pleocytosis is found after an attack of complex migraine. Prognosis is good. Preventive treatment is necessary if the attacks are severe and if they cannot be relieved by rest or sleep. Symptomatic headaches may be produced by a variety of causes. Rarely, it is secondary to increased intracranial pressure. In the great majority of cases recurrent headache is due to migraine. Usually, clinical data are sufficient for diagnosis, though in some cases the diagnosis is difficult and it is necessary to perform laboratory examinations in order to exclude symptomatic headache
Un caso di glicogenosi di tipo VI con associata sindrome di de Toni-Debré-Fanconi
No full textA case of type VI glycogenosis, associated with de Toni Debre Fanconi Syndrome in a 12 mth old patient, is described. The problem of nosological classification of this unusual case is discussed
Obstetrical lesions of the brachial plexus. Natural history in 34 personal cases
No full text34 subjects with 36 obstetrical paralysis of the brachial plexus were studied. The diagnosis was made immediately after birth in the great majority. 5 pareses of the lower plexus, however, were only recognized later. All subjects were first seen by us under the age of 13 years, 25 during the first year of life. At follow-up the age of the 34 subjects varied between 3 and 24 years. 32 patients had undergone daily physiotherapy, in 5 electrotherapy had also been applied. There was no correlation between these treatments and the outcome. Of the 20 cases of paresis of the lower plexus 3 were severely handicapped after the age of 3. This was the case for 9 of the 12 patients with total paresis. Everyday activities of these patients are influenced by the motor deficit. Even subjects with relatively serious sequelae apparently enjoy an almost normal life and have a good self-image. A significant improvement generally occurred as early as the first 3 years of life
Complicated migraine (migraine accompagnée) in children. Clinical characteristics and course in 40 personal cases
No full textForty cases of complicated migraine (c.m.) were analysed. The onset was before the age of 16 years, in the majority, however, after the 10th year. In 20 patients the first crisis of c.m. occurred in the absence of a previous history of migraine. 38 of the children had paresthesia during the crises, localized mostly to one hemisoma or a part thereof, in 3 bilateral from the beginning. In the majority of these patients the same hemisoma was always affected, the upper limb almost always. The preferred localisation of paresthesia in the face were the mouth and/or the tongue. A progression of paresthesia with a "march" of several minutes duration was frequent. In 5 children a paresis occurred, mostly at the upper part of one hemisoma, in another 4 children hemiplegia was present. In several cases signs of brainstem lesion occurred. Headache was mostly localized on the opposite side to the neurological signs. Vomiting and scotoma were frequent. In EEG done during the periods of crisis anomalies were demonstrated in the majority of our patients with a predominance of diffuse or focal slowing. In our patients there was a spontaneous tendency for c.m. to disappear upon reaching adult age. None of our 25 patients who had a neurological examination at the last check-up has shown residual deficits
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