Trastorno del espectro autista y prematuridad: hacia un programa de cribado prospectivo / Autism spectrum disorder and prematurity: towards a prospective screening program

Introducción. La prevalencia de trastornos del espectro autista (TEA) comunicada en estudios actuales en grupos de riesgo como son los recién nacidos pretermino o con bajo peso al nacer, es más alta que en la población normal. Este hecho ha supuesto el incremento en los últimos anos de estudios de cribado que investigan posibles factores de riesgo de TEA en los recién nacidos pretermino y su trayectoria evolutiva. Objetivo. Exponer los resultados de los principales estudios de cribado de recién nacidos pretermino a fin de presentar recomendaciones de cribado en esta población de riesgo. Desarrollo. Los resultados de los estudios presentados sugieren la posibilidad de que la trayectoria del desarrollo sociocomunicativo y conductual de los recién nacidos pretermino difiera de lo esperado si su nacimiento se hubiera producido a término, lo que apoya el hecho de que se realicen programas de cribado basados en una monitorización evolutiva del desarrollo y se utilicen herramientas de cribado adaptadas a esta población de riesgo. Conclusión. Los menores prematuros son un grupo de riesgo que muestra características diferenciales para el cribado de TEA (AU)

Introduction. The prevalence of autism spectrum disorders (ASD) reported in current studies in risk groups such as preterm or low birth weight infants is higher than in the normal population. This fact has led to the increase in recent years of screening studies that investigate possible risk factors for ASD in preterm newborns and their developmental trajectory. Aim. To present the results of the main screening studies of preterm newborns in order to propose screening recommendations for this population at risk. Development. The results of the studies presented suggest the possibility that the trajectory of socio-communicative and behavioral development of preterm infants differed from what was expected if their birth had occurred at term. This supports the fact that screening programs are carried out based on developmental surveillance and that it is advisable to use screening tools adapted to this population at risk. Conclusion. Premature children are a risk group that shows differential characteristics for the screening of ASD (AU)

Crisis parainfecciosas: estudio retrospectivo multicéntrico / Para-infectious seizures: a retrospective multicentre study

INTRODUCCIÓN: Las crisis parainfecciosas son crisis convulsivas afebriles en el contexto de infecciones banales en niños sin afectación neurológica, siendo aún una patología poco conocida en nuestro medio. MÉTODOS: Estudio retrospectivo multicéntrico donde se incluye a pacientes con crisis única o múltiple en el contexto de una infección banal afebril, con desarrollo psicomotor normal. RESULTADOS: Se recogió a 38 pacientes (47% varones, 53% mujeres) en un periodo de 3 años (2012-2015) con edad media de 2,1 años. El 7,9% presentaba antecedentes de crisis febriles. La media de crisis por paciente fue de 2,2, siendo el 57,9% crisis tónico-clónicas generalizadas, con una duración media de 3,2 min. Se realizó electroencefalograma durante su ingreso al 73,7%. Se efectuó punción lumbar en un 34,2% (todas normales) y prueba de neuroimangen en el 36,9%, siendo la más realizada la RM craneal en el 21,1%, sin hallazgos patológicos. El proceso infeccioso más frecuente (68%) fue tener gastroenteritis aguda seguida de la infección respiratoria de vías altas (32%). El 63,2% no precisó medicación anticomicial. En urgencias el fármaco más usado fue el diazepam rectal. Posteriormente, debido a la agrupación de crisis, un 28,9% de los casos precisó administración de fármacos por vía intravenosa (el más usado fue el ácido valproico), manteniéndose en el 16% tratamiento antiepiléptico al alta. El 76,3% de los pacientes fue diagnosticado al alta de crisis parainfecciosas. CONCLUSIONES: Es fundamental el conocimiento de las crisis parainfecciosas, su diagnóstico clínico y evolución benigna, ya que su identificación evita la realización de pruebas complementarias y tratamientos innecesarios

INTRODUCTION: Para-infectious seizures are afebrile seizures that are associated with mild infections, and occur in children with no pre-existing neurological illness. They are still little known in our environment. METHODS: A multicentre retrospective study was conducted that included patients with normal psychomotor development and had presented with one or more seizures in the context of a mild afebrile infection. RESULTS: A total of 38 patients (47% male, 53% female) were included in the study over a period of three years (2012-2015). The mean age was 2.1 years. A previous history of febrile seizures was found in 7.9% of them. Mean number of seizures per patient was 2.2, with 57.9% of them being tonic-clonic seizures. The mean duration of seizures was 3.2minutes. An EEG was performed during admission in 73.7% of cases. Lumbar punctures were performed in 34.2% of cases. All were normal. Neuroimaging tests were carried out in 36.9% of cases. Brain MRI was the imaging test performed in most cases (21.1%), with no any pathological findings. The most frequent infection found was acute gastroenteritis (68%), followed by upper respiratory tract infection (32%). Almost two-thirds (63.2%) of patients did not require anticonvulsant medication. Rectal diazepam was the most frequently used drug in emergencies. Intravenous medication was required by 28.9% of patients due to repeated seizures. The most frequently used drug in the non-emergency setting was valproic acid. Anticonvulsant treatment was continued after discharge in 16% of patients. Para-infectious seizures was the diagnosis in 76.3% of cases when discharged. CONCLUSIONS: Knowledge of para-infectious seizures, their clinical diagnosis and benign course is crucial, as this would avoid further testing and unnecessary treatments

[Para-infectious seizures: A retrospective multicentre study]. / Crisis parainfecciosas: estudio retrospectivo multicéntrico.

INTRODUCTION: Para-infectious seizures are afebrile seizures that are associated with mild infections, and occur in children with no pre-existing neurological illness. They are still little known in our environment. METHODS: A multicentre retrospective study was conducted that included patients with normal psychomotor development and had presented with one or more seizures in the context of a mild afebrile infection. RESULTS: A total of 38 patients (47% male, 53% female) were included in the study over a period of three years (2012-2015). The mean age was 2.1 years. A previous history of febrile seizures was found in 7.9% of them. Mean number of seizures per patient was 2.2, with 57.9% of them being tonic-clonic seizures. The mean duration of seizures was 3.2minutes. An EEG was performed during admission in 73.7% of cases. Lumbar punctures were performed in 34.2% of cases. All were normal. Neuroimaging tests were carried out in 36.9% of cases. Brain MRI was the imaging test performed in most cases (21.1%), with no any pathological findings. The most frequent infection found was acute gastroenteritis (68%), followed by upper respiratory tract infection (32%). Almost two-thirds (63.2%) of patients did not require anticonvulsant medication. Rectal diazepam was the most frequently used drug in emergencies. Intravenous medication was required by 28.9% of patients due to repeated seizures. The most frequently used drug in the non-emergency setting was valproic acid. Anticonvulsant treatment was continued after discharge in 16% of patients. Para-infectious seizures was the diagnosis in 76.3% of cases when discharged. CONCLUSIONS: Knowledge of para-infectious seizures, their clinical diagnosis and benign course is crucial, as this would avoid further testing and unnecessary treatments.