Neuroleptic Malignant Syndrome in Children with Autism Spectrum Disorder (ASD): A Case Report and Brief Review of Recent Literature.

Neuroleptic malignant syndrome (NMS) is a rare, life-threatening, idiosyncratic adverse reaction to antipsychotic drugs. Despite the increasing rates in the prescription of antipsychotics in pediatric patients with autism spectrum disorder (ASD), little is known about the occurrence and hallmarks of NMS in this specific population. NMS appears to be part of the larger catatonia domain, based on the frequent relationship between ASD and catatonia, on the shared, when not overlapping, clinical features with malignant catatonia, and on the effectiveness of catatonia treatments on the NMS/MC symptoms. The intrinsic difficulties of exploring NMS in ASD in controlled studies accounts for the subsequent lack of available information. Based on recent reports and on our case report, clinical features of NMS in the pediatric ASD population appear to be the same as the non-ASD population. Further studies are needed to confirm these results.

The COVID-19 Pandemic: A Longitudinal Study on the Emotional-Behavioral Sequelae for Children and Adolescents with Neuropsychiatric Disorders and Their Families.

This study aimed to investigate the immediate and short-term impact of the pandemic on the psychological well-being of Italian children and adolescents with psychiatric disorders and their families. Overall, 56 patients aged 6-18 (M = 13.4 years, SD = 2.77) and their parents were evaluated during the COVID-19 lockdown (T0) and after 4 months (T1). An ad hoc data sheet, Youth Self-Report 11-18 (YSR), Child Behavior Checklist 6-18 (CBCL), and Depression Anxiety Stress Scale-21 (DASS-21) were administered. Patients, mainly suffering from internalizing disorders, overall demonstrated a good adaptation to the pandemic context. Moreover, patients with behavioral disorders showed a greater psychological discomfort at both T0 and T1 compared to patients with internalizing disorders. Over time, patients presented an improvement on the emotional side, as proven by a significant decrease in internalizing and post-traumatic stress problems. Finally, no significant differences were found in the emotional-behavioral profile of patients according to the means of conducting neuropsychiatric interventions during the lockdown (i.e., in person/remotely/interrupted), thus allowing us to exclude important negative effects caused by the transition to remote therapy. Concerning parents, an inverse relationship emerged between the DASS-21 scores and the level of resilience, which therefore represents a protective factor against psychological maladjustment. Over time, an improvement in the psychological well-being of parents was observed, as shown by a significant decrease in mothers' anxiety and fathers' stress.

Children with Psychopathology and Their Parents Facing the Covid-19 Pandemic: A Case-Control Study.

OBJECTIVE: This case-control study aimed to explore the effects of the COVID-19 outbreak on the mental well-being of pediatric psychiatric outpatients and their families, comparing them with children/adolescents and their parents from the general population. METHOD: The case group consisted of 168 subjects: 56 patients (6-18 years old) with psychiatric disorders, and their 112 parents. The healthy control group included 189 subjects: 63 children and adolescents with no psychopathologies, and their 126 parents. Both groups were assessed during the first COVID-19 lockdown in Italy (T0) and 4 months later (T1), by administering the CBCL6-18 and DASS-21. RESULTS: Patients showed a good adaptation to the pandemic situation, while the children/adolescents in the healthy sample showed a greater variation in their general habits and a higher prevalence of stress symptoms during the lockdown. The patients' parents likewise had fewer stress-related symptoms than caregivers in the healthy control group, both during the lockdown and 4 months later. At T0, patients' mothers reported higher anxiety levels than mothers in the healthy group, while at T1 fathers of healthy children scored higher on the DASS-21 anxiety and stress scales than patients' fathers. As concerns changes over time (T0-T1) in the parents' psychological well-being, a general improvement was detected in both groups. CONCLUSIONS: The pandemic and quarantine measures were confirmed as significant stressors for all children and adolescents, and negatively affected their parents' adaptation. The findings of this study point to the need for preventive interventions to support the mental health of all parents and their children in uncertain and stressful times.

LGI1 and CASPR2 autoimmunity in children: Systematic literature review and report of a young girl with Morvan syndrome.

Leucine-rich glioma-inactivated protein 1 (LGI1) and contactin-associated protein-like 2 (CASPR2) neurological autoimmunity in adults has been associated with various clinical syndromes involving central, peripheral and autonomic nervous system, while data in children is limited. We perform the first systematic literature review on paediatric LGI1 and CASPR2 autoimmunity, with focus on clinical data, in order to contribute to the definition of clinical features of LGI1 and CASPR2 autoimmunity in paediatric age and favour early diagnosis. Additionally, we report the youngest-to-date case of Morvan syndrome. We identified 37 published paediatric cases of LGI1 and/or CASPR2 autoimmunity. Most frequent syndromes were encephalitis in LGI1-positive and isolated epilepsy in CASPR2-positive children, while syndromes with predominant peripheral symptoms were most frequent in double-positive children. With the limitations imposed by the low number of cases, differences to published adult cohorts included: absence of faciobrachial dystonic seizures and hyponatremia in patients with LGI1-positive encephalitis; slightly higher proportion of isolated epilepsy syndromes in CASPR2-positive patients; absence of tumour in the whole cohort.