RESUMO
INTRODUCTION: Obstructive sleep apnea syndrome (OSAS) is a common problem in children. It is characterized by a partial airway obstruction associated with hypoxemia and hypoventilation rather than complete airway obstruction. DEVELOPMENT: Adeno-tonsillar hypertrophy is the leading cause but there are other risk factors like craniofacial abnormalities. OSAS may lead to neurodevelopmental abnormalities, growth and cardiorespiratory failure. It differs significantly from adult OSAS in its clinical presentation, polysomnographic findings and management. In spite of the fact that the diagnosis is often made on a clinical basis, the definitive and differential one only can be made by polysomnography. CONCLUSION: An overview of this pathology and the different polysomnographic parameters used are reported. Efforts to detect sleep apnea syndrome should be employed in children who present with the symptoms discussed. New guidelines for pediatric polysomnography should help standardize methods.
Assuntos
Apneia Obstrutiva do Sono , Adenoidectomia , Tonsila Faríngea/patologia , Adolescente , Obstrução das Vias Respiratórias/complicações , Arritmias Cardíacas/etiologia , Criança , Pré-Escolar , Anormalidades Craniofaciais/complicações , Morte Súbita , Síndrome de Down/complicações , Transtornos do Crescimento/etiologia , Humanos , Hipertrofia , Hipóxia/etiologia , Lactente , Obesidade/complicações , Tonsila Palatina/patologia , Polissonografia , Respiração com Pressão Positiva , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/terapia , Fases do Sono , Ronco , Tonsilectomia , Traqueostomia , Redução de PesoRESUMO
INTRODUCTION: Digital treatment of electrical signals coming from the central nervous system on stimulation of the optic nerve path offers an objective method for evaluation of visual evoked potentials (VEP) shown graphically on a cerebral map. OBJECTIVE: To evaluate the topographical distribution of VEP in cases of optic neuropathy adding this parameter to the usual parameters of latency and amplitude. MATERIAL AND METHODS: We studied 35 patients with suspected optic neuropathy and normal findings on basic ophthalmological examination, in whom VEP and VEP mapping (VEPM) was done. RESULTS: In 26% of the cases there was no response for evaluation with the usual VEP recording techniques, whilst in those with VEPM this percentage was reduced to 11.5%. In the other cases there was a potential with characteristic distribution in the occipital areas and a maximally positive dipole posteriorly. CONCLUSION: VEPM is an objective method for evaluation of the visual pathway offering better discrimination than the usual VEP in more severe cases of neuropathy.