Clinical Advances in Pediatric Neurology

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: closed (15 October 2021) | Viewed by 18308

Special Issue Editor


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Guest Editor
Pediatric Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Interests: pediatric neurology; rehabilitation; cerebral palsy; neurodevelopmental assessments
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Special Issue Information

Dear Colleagues,

In the last 20 years, the advent of neurophysiological, neuromotor, and neuroimaging techniques has provided evidence of the complexity of the developing brain. Using an integrated approach, recent studies in low- and high-risk infants have described the maturation of specific aspects of function and their correlation with neuroimaging.

Parallel to early detection efforts, the improved understanding of neurodevelopmental is leading to an increased availability of early treatment. It has been demonstrated that the response to the intervention is better when it is as early as possible, due to the brain plasticity during the first months of life.

The aim of this Special Issue is to collect the most recent evidence of assessments and interventions for pediatric patients at risk of neurological impairment. The manuscripts may include any format (case repot, original article, systematic review, state-of-the-art review) that may contribute to this issue. This includes but is not limited to manuscripts on neuroimaging, neurophysiology, neuromotor or behavioral assessments for the detection, prediction or classification of neuropediatric disorders. Equally important will be the inclusion of reports or protocols about interventions in the field of pediatric neurology.

Dr. Domenico Romeo
Guest Editor

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Keywords

  • pediatric neurology
  • assessment tool
  • neuroimaging
  • neurophysiology
  • neurological examination

Published Papers (6 papers)

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Research

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8 pages, 492 KiB  
Article
Longitudinal Cognitive Assessment in Low-Risk Very Preterm Infants
by Domenico M. Romeo, Martina Ricci, Federica Mirra, Ilaria Venezia, Maria Mallardi, Elisa Pede and Eugenio Mercuri
Medicina 2022, 58(1), 133; https://doi.org/10.3390/medicina58010133 - 16 Jan 2022
Cited by 5 | Viewed by 1985
Abstract
Background and Objectives: Preterm infants are at higher risk of neurodevelopmental impairment both at preschool and school ages, even in the absence of major neurological deficits. The early identification of children at risk is essential for early intervention with rehabilitation to optimize [...] Read more.
Background and Objectives: Preterm infants are at higher risk of neurodevelopmental impairment both at preschool and school ages, even in the absence of major neurological deficits. The early identification of children at risk is essential for early intervention with rehabilitation to optimize potential outcomes during school years. The aim of our study is to assess cognitive outcomes at preschool age in a cohort of low-risk very preterm infants, previously studied at 12 and 24 months using the Griffiths scales. Materials and Methods: Sixty-six low-risk very preterm infants born at a gestational age of <32 weeks were assessed at 12 and 24 months corrected age using the Griffiths Mental Development Scales (second edition) and at preschool age with the Wechsler Preschool and Primary Scales of Intelligence (third edition) (WPPSI-III). Results: At 12 and 24 months and at preschool age, low-risk very preterm infants showed scores within normal ranges with similar scores in males and females. A statistically significant correlation was observed in the general developmental quotient between 12 and 24 months; a further significant correlation was observed between the early cognitive assessments and those performed at preschool age, with a better correlation using the assessments at 24 months. Conclusion: The present study showed a favourable trajectory of cognitive development in low-risk very preterm infants, from 12 months to preschool age. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
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9 pages, 954 KiB  
Article
Vojta Therapy in Neuromotor Development of Pediatrics Patients with Periventricular Leukomalacia: Case Series
by Elena De-La-Barrera-Aranda, Juan Jose Gonzalez-Gerez, Manuel Saavedra-Hernandez, Laura Fernandez-Bueno, Cleofas Rodriguez-Blanco and Carlos Bernal-Utrera
Medicina 2021, 57(11), 1149; https://doi.org/10.3390/medicina57111149 - 23 Oct 2021
Cited by 7 | Viewed by 3525
Abstract
Background and Objectives: Vojta therapy is used by physiotherapists and is based on stimulation through peripheral pressure that leads to the activation of involuntary motor response patterns, thus triggering patterns of reflex locomotion, hence also called reflex locomotion therapy. Objective: To analyze [...] Read more.
Background and Objectives: Vojta therapy is used by physiotherapists and is based on stimulation through peripheral pressure that leads to the activation of involuntary motor response patterns, thus triggering patterns of reflex locomotion, hence also called reflex locomotion therapy. Objective: To analyze the changes produced by Vojta therapy in the evolution of infant motor development in patients with maturational delay due to periventricular leukomalacia. Materials and methods: One session of Vojta Therapy per week for eleven months, patients’ neuromotor development was evaluated through the Denver II Test and the Baleys Scale. Results: A clinically significant increase in the development of the patients is observed. Conclusions: Neuromotor development seems to generate an adequate progression in the motor area. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
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10 pages, 1501 KiB  
Article
Unraveling the Etiology of Pediatric Vertigo and Dizziness: A Tertiary Pediatric Center Experience
by Nina Božanić Urbančič, Domen Vozel, Jure Urbančič and Saba Battelino
Medicina 2021, 57(5), 475; https://doi.org/10.3390/medicina57050475 - 11 May 2021
Cited by 6 | Viewed by 2858
Abstract
Background and Objectives: Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood—BPV). We aimed to provide the possible etiological background of vertigo and dizziness in Slovenian children. Materials [...] Read more.
Background and Objectives: Numerous authors have reported that the commonest type of vertigo in children is migraine-associated vertigo (vestibular migraine and benign paroxysmal vertigo of childhood—BPV). We aimed to provide the possible etiological background of vertigo and dizziness in Slovenian children. Materials and Methods: A retrospective case series of pediatric vertigo and dizziness children referred to the tertiary pediatric otorhinolaryngology center from 2015 to 2020. Children received a complete audiological and vestibular workup and were referred to pediatric specialists depending on the clinical presentation. Results: Of 257 children (42% male, 58% female) aged 1–17 years (M = 10.9, SD = 4.3 years) in 19.1% vertigo and dizziness were classified as central, in 12.4% as a peripheral vestibular, in 10.9% as a hemodynamic, in 5.8% as a psychological and none as visual by pediatric neurologists, otorhinolaryngologists, cardiologists, psychologists or ophthalmologists, respectively. 40.8% (20) children with central vertigo had BPV (7.8% of all children) and 8.2% (4) migrainous vertigo. In 43.6% (112 children), the etiology remained unclassified. Conclusions: After a thorough multidisciplinary workup, the etiology of vertigo and dizziness was unraveled in the majority of children referred to our tertiary otorhinolaryngology center. The most common cause was central; however, in a considerable number, the etiology remained unclassified. The latter could be attributed to the self-limiting nature of vertigo spells. Hence, a child presenting with dizziness and vertigo requires a multidisciplinary approach, in which referral to a neurologist is, in most cases, essential. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
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10 pages, 285 KiB  
Article
Sleep Disorders in Autism Spectrum Disorder Pre-School Children: An Evaluation Using the Sleep Disturbance Scale for Children
by Domenico M. Romeo, Claudia Brogna, Arianna Belli, Simona Lucibello, Costanza Cutrona, Massimo Apicella, Eugenio Mercuri and Paolo Mariotti
Medicina 2021, 57(2), 95; https://doi.org/10.3390/medicina57020095 - 22 Jan 2021
Cited by 15 | Viewed by 3032
Abstract
Background and Objectives: Sleep disorders are common in children with Autism Spectrum Disorder (ASD). The aims of this study were to describe the incidence and characteristics of sleep disorders using a questionnaire completed by the caregiver in a sample of preschool-aged children with [...] Read more.
Background and Objectives: Sleep disorders are common in children with Autism Spectrum Disorder (ASD). The aims of this study were to describe the incidence and characteristics of sleep disorders using a questionnaire completed by the caregiver in a sample of preschool-aged children with ASD and to identify possible differences in a control group of peers. Materials and Methods: Sleep disorders were investigated with the Sleep Disturbance Scale for Children (SDSC) in a population of pre-school-aged (3–5 years) ASD children and in a control group. The Autism Diagnostic Observation Schedule—second ed. (ADOS-2) was further used to assess autism symptom severity. A total of 84 children (69 males; mean age 3.9 ± 0.8 years) with a diagnosis of ASD and 84 healthy controls (65 males; mean age of 3.7 ± 0.8 years) that were matched for age and sex were enrolled. Results: ASD children reported significantly higher (pathological) scores than the control group on the SDSC total scores and in some of the factor scores, such as Difficulty in Initiating and Maintaining Sleep (DIMS), disorders of excessive somnolence (DOES), and sleep hyperhidrosis. A total of 18% of ASD children had a pathological SDSC total T-score, and 46% had an abnormal score on at least one sleep factor; DIMS, parasomnias, and DOES showed the highest rates among the sleep factors. Younger children (3 years) reported higher scores in DIMS and sleep hyperhidrosis than older ones (4 and 5 years). No specific correlation was found between ADOS-2 and SDSC scores. Conclusions: Pre-school children with ASD showed a high incidence of sleep disorders with different distributions of specific sleep factors according to their age. We suggest a screening assessment of sleep disorders using the SDSC in these children with a more in-depth evaluation for those reporting pathological scores on the questionnaire. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
11 pages, 969 KiB  
Article
Neurodevelopmental Outcome in Extremely Low Birth Weight Infants at 2–3 Years of Age
by Maria Kyriakidou, Ilias Chatziioannidis, Georgios Mitsiakos, Sofia Lampropoulou and Abraham Pouliakis
Medicina 2020, 56(12), 649; https://doi.org/10.3390/medicina56120649 - 26 Nov 2020
Cited by 3 | Viewed by 2047
Abstract
Background and objectives: The aims of this study were to examine the relationship between neurological outcomes at 3- and 6-months corrected age with the neurodevelopmental outcome at 3 years of age; to identify the perinatal/neonatal risk factors for poor neurodevelopmental outcomes at 3 [...] Read more.
Background and objectives: The aims of this study were to examine the relationship between neurological outcomes at 3- and 6-months corrected age with the neurodevelopmental outcome at 3 years of age; to identify the perinatal/neonatal risk factors for poor neurodevelopmental outcomes at 3 years of age. Materials and methods: In our single-centre longitudinal cohort study, of the 73 consecutive infants admitted to our Neonatal Intensive Care Unit (NICU), 49 infants (80%) received both Hammersmith Infant Neurological Examination (HINE) at 3- and 6-months corrected age and Bayley–III neurodevelopmental assessment at 2–3 years chronological age. At 3 months follow up, 8.2% had suboptimal scores (below 10th percentile) on the HINE. At 6 months follow up, 4.1% had suboptimal scores (below 10th percentile) on the HINE. The means(±SD) for Bayley-III cognitive, language, and motor subscales were (96.3 ± 9.8), (99.9 ± 11.9), (93.2 ± 9.9). Results: At 3 months corrected age, higher total HINE scores and subscores for function of cranial nerves, posture, tone, were associated with better cognitive scores while poorer scores for function of cranial nerves, posture, movements, tone, and total HINE score were associated with lower motor scores. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have three times higher odds of having a motor delay. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have more than two times higher odds of having a language delay. At 6 months corrected age, poorer scores for function of cranial nerves, movements, tone, reflexes, and total HINE score were associated with worse Bayley-III motor scores whilst infants who have a total HINE score and a subscore of reflexes in the suboptimal range have four and seven times, respectively, higher odds of having a motor delay. Conclusions: Early identification of infants at risk for adverse long-term outcomes is essential in introducing early intervention therapies for optimizing neurodevelopmental outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
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Review

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13 pages, 775 KiB  
Review
Early Neurological Assessment and Long-Term Neuromotor Outcomes in Late Preterm Infants: A Critical Review
by Domenico M. Romeo, Martina Ricci, Maria Picilli, Benedetta Foti, Giorgia Cordaro and Eugenio Mercuri
Medicina 2020, 56(9), 475; https://doi.org/10.3390/medicina56090475 - 15 Sep 2020
Cited by 13 | Viewed by 3912
Abstract
Background and Objectives: Late preterm (LP) infants (born between 34 and 36 weeks of gestational age) are considered at higher risk of neonatal morbidities, mortality, and neurological impairments than full-term born infants (FT). The aim of this study was to provide a [...] Read more.
Background and Objectives: Late preterm (LP) infants (born between 34 and 36 weeks of gestational age) are considered at higher risk of neonatal morbidities, mortality, and neurological impairments than full-term born infants (FT). The aim of this study was to provide a critical review of the literature outlining the different aspects of neurological function reported both in the neonatal period and in the follow up of late preterm infants. Materials and Methods: A comprehensive search of the MEDLINE, Embase, PsycINFO, and CINAHL electronic databases was made, using the following search terms: ‘Late preterm infants’, ‘Near term infants’, ‘neurological assessment’, ‘neurological outcome’, ‘neuromotor outcome’, cerebral palsy’, ‘CP’, ‘motor impairment’, including all the studies reporting clinical neurological assessment of LP (including both neonatal period and subsequent ages). Results: A total of 35 articles, comprising 301,495 children, were included as fulfilling the inclusion criteria: ten reported neonatal neurological findings, seven reported data about the first two years after birth, eighteen reported data about incidence of CP and motor disorder during the infancy. Results showed a more immature neurological profile, explored with structured neurological assessments, in LP infants compared with FT infants. The LP population also had a higher risk of developing cerebral palsy, motor delay, and coordination disorder. Conclusion: LP had a higher risk of neurological impairments than FT infants, due to a brain immaturity and an increased vulnerability to injury, as the last weeks of gestational age are crucial for the development of the brain. Full article
(This article belongs to the Special Issue Clinical Advances in Pediatric Neurology)
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