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3 results on '"Marco Del Pozzo"'

1. Pediatric hypnic headache: a systematic review

Author

Alessandro Ferretti, Margherita Velardi, Claudia Fanfoni, Giovanni Di Nardo, Melania Evangelisti, Thomas Foiadelli, Alessandro Orsini, Marco Del Pozzo, Gianluca Terrin, Umberto Raucci, Pasquale Striano, and Pasquale Parisi

Subjects
hypnic headache, child, sleep, melatonin, systematic review, primary headache, Neurology. Diseases of the nervous system, RC346-429
Abstract

IntroductionHypnic headache (HH) is a primary headache, and it is considered a rare condition in children. The underlying mechanisms of HH are not yet fully understood. This systematic review aims to provide a comprehensive description of the clinical features of all published cases of pediatric HH. It will also discuss the differences in headache features between children and adults, the increased diagnostic sensitivity of the new diagnostic criteria (ICHD-3), potential pathophysiological hypotheses explaining the higher incidence in adults, differential diagnoses, and therapeutic options for children.MethodsA systematic search was conducted to identify and analyze articles reporting cases of HH in patients under the age of 18. The search was performed in major medical databases including Cochrane Library, EBSCO, Embase, Medline, PubMed, Science Direct, Scopus, and Web of Science. The search covered the period from 1988 to April 2023. Relevant studies were screened for eligibility, and data extraction was performed using a standardized approach.ResultsSeven children with HH were included in the analysis. The mean age of onset for headache attacks was 10 ± 4.3 years (range 3–15 years). The average time from the start of headaches to diagnosis was 15.8 ± 25.0 months (range 1–60 months). Headache features in children differed from those observed in adult HH patients. Children experienced throbbing/pulsating pain, while adults reported dull/pressure-like pain. Children also had lower frequency and shorter duration of attacks compared to adults. The use of ICHD-3 criteria appeared to be more sensitive and inclusive for diagnosing HH in children compared to the previous ICHD-2 criteria. The association of headache attacks with sleep suggests that HH may be a primary disorder with a chronobiological origin. Hypothalamic dysfunction and melatonin dysregulation, which are more prevalent in older individuals, could potentially explain the higher incidence of HH in adults. Other primary headaches and secondary causes should be ruled out. Melatonin prophylactic therapy may be considered for pediatric patients.DiscussionFurther evaluation of the clinical features of HH in children is needed. The development of specific diagnostic criteria for pediatric cases could improve diagnostic rates and enhance the management of children with HH.

Published
2023
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2. Can myofunctional therapy increase tongue tone and reduce symptoms in children with sleep-disordered breathing?

Author

Mario Barreto, Susy Martella, Melania Evangelisti, Marco Del Pozzo, and Maria Pia Villa

Subjects
Male, Myofunctional Therapy, 03 medical and health sciences, 0302 clinical medicine, Tongue, medicine, Humans, Respiratory system, Child, Oxygen saturation (medicine), Sleep Apnea, Obstructive, medicine.diagnostic_test, business.industry, medicine.disease, Hypotonia, Obstructive sleep apnea, Pulse oximetry, medicine.anatomical_structure, Italy, 030228 respiratory system, Otorhinolaryngology, Anesthesia, Breathing, Female, Neurology (clinical), medicine.symptom, business, children, myofunctional therapy, obstructive sleep apnea, oropharyngeal exercises, 030217 neurology & neurosurgery
Abstract

Data in the literature suggest that myofunctional therapy (MT) may be able to play a role in the treatment of children with sleep-disordered breathing (SDB). Our study investigated the effectiveness of MT in reducing respiratory symptoms in children with SDB by modifying tongue tone. Polysomnographic recordings were performed at baseline to assess obstructive sleep apnea (OSA) severity in 54 children (mean age 7.1 ± 2.5 years, 29 male) with SDB. Patients were randomly assigned to either the MT or no-MT group. Myofunctional evaluation tests, an assessment of tongue strength, tongue peak pressure, and endurance using the Iowa Oral Performance Instrument (IOPI), and nocturnal pulse oximetry were performed before (T0) and after (T1) 2 months of treatment. MT reduced oral breathing (83.3 vs 16.6%, p

Published
2017

3. Autonomic imbalance during apneic episodes in pediatric obstructive sleep apnea

Author

Marco Del Pozzo, Jole Rabasco, Giorgio Baccari, Mario Barreto, Ottavio Vitelli, Maria Pia Villa, and Nicoletta Pietropaoli

Subjects
Male, Apnea, autonomic nervous system, obstructive sleep apnea, children, heart rate variability, pediatric, autonomic impairment, Polysomnography, Blood Pressure, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, Heart Rate, Physiology (medical), Humans, Medicine, Heart rate variability, Child, Sleep Apnea, Obstructive, business.industry, Apneic episodes, medicine.disease, Sensory Systems, nervous system diseases, respiratory tract diseases, Obstructive sleep apnea, Autonomic nervous system, Autonomic Nervous System Diseases, 030228 respiratory system, Neurology, Apnea–hypopnea index, Child, Preschool, Anesthesia, Autonomic imbalance, Diagnostic assessment, Poincaré plot, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

To investigate the activity of the autonomic nervous system (ANS) during sleep in children with obstructive sleep apnea (OSA), in order to detect a possible cardiac ANS imbalance analyzing heart rate variability (HRV).43 subjects between 4 and 12 years of age (7.26 ± 2.8 years), undergoing a diagnostic assessment for OSA were evaluated. A time domain index (R-apnea index) was developed to evaluate HRV strictly related to obstructive events during sleep. Poincaré plot of RR intervals during the whole night was calculated.R-apnea index was negatively correlated with apnea hypopnea index (AHI) (r=-0.360, p=0.028). AHI and the duration of the disease were the only variables that were significantly correlated with R-apnea index. Three groups were subsequently created according to polysomnographic findings considering AHI. R-apnea index resulted significantly lower in patient with severe OSA compared to primary snoring/mild OSA subjects (p0.05). Looking at Poincaré plot, SD1 showed a diminishing trend with severity of OSA, however not reaching statistical significance.Our findings suggest an autonomic impairment in OSA children evidenced by the altered HRV both in the very short term (R-apnea index) and in short term (SD1).R-apnea index is an easy and cheap method to undelay early ANS imbalance.

Published
2015

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