Evaluación cognitiva en niños que presentaron gastrosquisis: estudio de casos y controles / Cognitive assessment in children who presented gastroschisis: a case-control study

Introducción. La gastrosquisis es una malformación de la pared abdominal que se corrige mediante cirugía y requiere cuidados hospitalarios especiales, como inmovilización, restricción alimenticia y separación de la madre durante tiempo variable, entre otros; para analizar las posibles repercusiones cognitivas se aplicó la prueba de Bayley III a 14 niños. Sujetos y métodos. Siete casos (nacidos con gastrosquisis) y siete controles, en los hospitales civiles de Guadalajara, en el período enero-abril de 2013. Resultados. Los casos no evidenciaron retraso en las evaluaciones relacionadas con la cognición, el lenguaje y la conducta motora, en tanto que en las asociadas a la conducta socioemocional y adaptativa las puntuaciones favorecieron al grupo control, lo que refleja que poseen mejores estrategias de adaptación e interacción respecto al grupo de casos. Conclusiones. La gastrosquisis no afectará el neurodesarrollo ulterior, por lo menos en este grupo que presentó esta única anormalidad y déficits explicables por sus circunstancias perinatales, sin que este pronóstico pueda generalizarse a otros casos con un cuadro clínico más grave, mayor duración de la estancia hospitalaria y comorbilidad asociada. De cualquier forma, es importante informar a los padres desde la etapa prenatal respecto a las consecuencias esperadas de esta patología (AU)

Introduction. Gastroschisis is a malformation of the abdominal wall that is corrected by surgery and requires special hospital care, such as immobilisation, dietary restriction and separation from the mother for a variable period of time, among others. To analyse the possible cognitive repercussions, the Bayley III test was administered to 14 children. Subjects and methods. The study was conducted with seven cases (born with gastroschisis) and seven controls, in civil hospitals in Guadalajara, over the period January-April 2013. Results. No evidence of retardation was found in the cases in the cognition, language and motor conduct assessments, whereas in those associated with socio-emotional and adaptive behaviour the scores favoured the control group. This shows that the latter have better adaptation and interaction strategies with respect to the cases group. Conclusions. Gastroschisis will not affect later neurodevelopment, at least in this group which presented only this abnormality and deficits that can be explained by their perinatal circumstances. Nevertheless, this prognosis cannot be generalised to other cases with a more severe clinical picture, a longer stay in hospital and associated comorbidity. In any case, it is important to inform the parents as of the prenatal stage about the expected consequences of this pathology (AU)

Hypercalculia in savant syndrome: central executive failure?

BACKGROUND: The existence of outstanding cognitive talent in mentally retarded subjects persists as a challenge to present knowledge. We report the case of a 16-year-old male patient with exceptional mental calculation abilities and moderate mental retardation. METHODS: The patient was clinically evaluated. Data from standard magnetic resonance imaging (MRI) and two 99mTc-ethyl cysteine dimer (ECD)-single photon emission computer tomography (SPECT) (in resting condition and performing a mental calculation task) studies were analyzed. RESULTS: Main neurologic findings were brachycephalia, right-side neurologic soft signs, obsessive personality profile, low color-word interference effect in Stroop test, and diffuse increased cerebral blood flow during calculation task in 99mTc-ECD SPECT. MRI showed anatomical temporal plane inverse asymmetry. CONCLUSIONS: Evidence appears to support the hypothesis that savant skill is related to excessive and erroneous use of cognitive processing resources instigated by probable failure in central executive control mechanisms.