Search

Children and adults may suffer seizures that appear to be epileptic but are actually psychogenic, that is, of mental origin. These seizures may have both subconscious and volitional, or willed, components to them, and may involve thrashing motions, jerking of limbs, staring, and unresponsiveness. In children, such episodes are frequently associated with specific stresses or anxiety. Psychogenic seizures were diagnosed in a group of 21 nonepileptic children aged 8 to 18, using video and electroencephalographic (EEG) recording techniques. The diagnosis and cause of psychogenic seizures were discussed with each child and family, and the discontinuation of seizure medication was strongly urged. All except one child agreed to stop taking the medication. Patients were also urged to obtain psychiatric counseling, and 16 did so. Of the 18 patients who could be contacted by follow-up phone calls made 6 to 66 months after diagnosis of psychogenic seizures, 14 were seizure-free. Due to the small number of children studied, no differences in outcome could be attributed to gender, psychiatric treatment, or belief in the diagnosis of psychogenic seizure. The authors discuss the critical need to rule out epileptic seizures in these patients, which is made possible by the video-EEG recordings. The patients, once reassured, are then more likely to participate in their own psychiatric care. Specific criteria for differentiating among psychogenic seizures, partial epileptic seizures, and nonepileptic paroxysmal behavior are also discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background The objective of this study was to characterize the clinical features, course, and treatment of essential tremor ( ET) in children. Methods A retrospective chart review was conducted over 25 years (1984-2011). Inclusion criteria were age <21 years and satisfying the core diagnostic criteria for ET. Primary exclusion criteria included other neurological findings, tremorogenic medications, sudden onset/stepwise progression, primary orthostatic tremor, and isolated task specificity; and secondary exclusion criteria were abnormal neuroimaging or metabolic/thyroid studies. Cases were reviewed for age, sex, family history, tremor characteristics, functional impairment, treatment, and follow-up. Results In total, 211 children had ET, including 130 males and 81 females. The mean ± standard deviation age was at diagnosis was 14.09 ± 5.0 years, the age of onset was 9.71 ± 5.62 years, and the age of onset was birth in 7 children. One hundred ninety-nine children had bilateral hand tremor, 34 had asymmetry, 9 had unilateral onset but later became bilateral. Twelve children had voice tremors, 13 had leg tremors, 5 had head tremors, and 7 had trunk tremors. Tremor at rest was present in 20 children. Thirty-five percent of the children had a family history of ET, including in a father (n = 21), mother (n = 13), brother (n = 6), sister (n = 3), and other family member (n = 28). Fifty-five percent of patients had functional disabilities, including writing (n = 66), eating (n = 28) drinking from a cup (n = 13), typing (n = 4), playing instruments (n = 6), buttoning (n = 6), and playing (n = 3). For treatment, 33 patients received propranolol, 1 received atenolol, 13 received primidone, 3 received metoprolol, and 1 received nadolol. In total, 99 patients were followed for a mean ± standard deviation of 1.82 ± 2.21 years. If left untreated, tremor remained unchanged in 33 patients, and 7 had an apparent short-term improvement. On propranolol, 15 of 20 patients significantly improved. Conclusions This is the largest series to date of ET in children. The current findings indicate that onset at birth is possible, family history is less common in children than in adults, and tremor at rest is possible. Functional disability was noted in 55% of children, and 29.4% required medication. [ABSTRACT FROM AUTHOR]

This study compares primary stereotypies (repetitive, self-stimulating, and seemingly nonsensical movements that can occur within typically developing children) and secondary stereotypies (those occurring within autistic or mentally retarded children). Utilizing a retrospective chart review from 1995 to 2010, the current study compares primary and secondary stereotypies by the application of a classification system that organizes the movement by its type (motor only, phonic only, mixed) and complexity. In addition, it investigates other parameters associated with the movements such as duration, frequency, age, functional impairment, and progression. The sample group consisted of 28 primary and 28 secondary cases. Primary stereotypies were predominantly motor, simple, of shorter duration, and of less frequency, whereas secondary stereotypies had more vocalization, complexity, longer durations, and higher frequencies. Moreover, functional impairment due to stereotypies was noted in 3 primary and 7 secondary cases, and worsening of stereotypies was noted in 70% of primary versus 44% of secondary cases. [ABSTRACT FROM PUBLISHER]

Abstract. Paroxysmal choreoathetosis is a rare, involuntary movement disorder. Attacks occur spontaneously or may be induced by movement, startle, or anxiety. The movements are tonic, dystonic, or choreoathetotic. Sporadic and, more commonly, familial cases have been reported. Onset occurs most often during childhood, and the course is nonprogressive. Response to anticonvulsant therapy is usually excellent. Five cases of the sporadic form of paroxysmal choreoathetosis are reported. Three of the five patients had attacks after initiation of movements such as rising from a chair. Results of physical examination were normal in four patients. One child had mild hemiatrophy and unilateral hyper-reflexia. Results of laboratory studies, including determinations of serum calcium and ceruloplasmin levels, EEGs, and CAT scans of the head, were normal. The attacks ceased in all patients after treatment with either phenytoin or carbamazepine. [ABSTRACT FROM AUTHOR]

Provides information on the role and the pharmacology of medications used to treat children with attention deficit disorders. Potentially useful drugs; Dose levels; Adverse effects.

Discusses the Supplemental Security Income (SSI) program for children that was implemented by Congress in 1974. Financial and resource eligibility criteria; Evaluation process; Role of pediatricians in ensuring that eligible children receive the SSI cash and associated benefits.

Tourette Syndrome (TS) is a developmental disorder that has one of the highest familial recurrence rates among neuropsychiatric diseases with complex inheritance. However, the identification of definitive TS susceptibility genes remains elusive. Here, we report the first genome-wide association study (GWAS) of TS in 1285 cases and 4964 ancestry-matched controls of European ancestry, including two European-derived population isolates, Ashkenazi Jews from North America and Israel, and French Canadians from Quebec, Canada. In a primary meta-analysis of GWAS data from these European ancestry samples, no markers achieved a genome-wide threshold of significance (p<5 × 10−8); the top signal was found in rs7868992 on chromosome 9q32 within COL27A1 (p=1.85 × 10−6). A secondary analysis including an additional 211 cases and 285 controls from two closely-related Latin-American population isolates from the Central Valley of Costa Rica and Antioquia, Colombia also identified rs7868992 as the top signal (p=3.6 × 10−7 for the combined sample of 1496 cases and 5249 controls following imputation with 1000 Genomes data). This study lays the groundwork for the eventual identification of common TS susceptibility variants in larger cohorts and helps to provide a more complete understanding of the full genetic architecture of this disorder.

Focuses on the growth of the field of infant and child development. Increase in the knowledge about special services that can improve early development of children; Debate on the factors involved in the developmental outcome of a child; Awareness of the importance of the family in the development of children.

Defines the context in which rehabilitation therapies should be prescribed, emphasizing the identification and enhancement of the child's function and abilities. Therapy prescriptions; Spectrum of motor impairments; Multiple needs of children.

Presents guidelines for screening infants and young children for developmental disabilities. Importance of early identification to effective therapy; Utilization multiple sources of information for screening; Issues in methodology; Essential components of the screening process; Required skills and procedures.