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Biomedical subjects

M Téllez de Meneses

Publications and source records attributed to M Téllez de Meneses.

5 recordsLinked to original sources

[Intrathecal baclofen and Botulinum toxin in infantile cerebral palsy].

INTRODUCTION: Infantile cerebral palsy is considered to be a motor disorder affecting both posture and movement. It is the manifestation of a cerebral lesion that took place during the maturing process of the brain. Spastic cerebral palsy is the most frequent variety. The spasticity presented by these patients strongly influences their functioning and gives rise to several complications that affect their quality of life. AIMS AND DEVELOPMENT: The main aim of this study is to determine a set of suitable and effective therapeutic steps that can be used to improve patients' spasticity and to prevent the complications that stem from them, such as contractures, deformities, surgery, etc. Multiple treatments were used, including physiotherapy, rehabilitation and oral pharmacotherapy, with few satisfactory results. At present there are two very promising therapeutic alternatives for patients with infantile cerebral palsy: Botulinum toxin, which we already have a great deal of experience with, and intrathecal treatment with baclofen. We report on a series of 10 patients aged between 8 and 15 years who had had an intrathecal baclofen infusion pump implanted. To date (maximum follow-up: 12 months), their clinical course has been satisfactory in most cases, with no severe complications related to the surgical technique, except in one individual who presented a fistula that resolved spontaneously. CONCLUSIONS: Intrathecal baclofen seems to be a very useful alternative in the treatment of spasticity to improve the quality of life of these patients and those around them.

Baclofen↗

[Adopted children: risk factors and neuropsychological problems].

In recent years there has been a striking increase in the number of transnational adoptions in our country, which follows the trend already observed in other developed European countries. Major contributing factors to this phenomenon have been the improvements in socioeconomic conditions in our country, the drop in the birth rate, with the corresponding decrease in the number of children available for adoption, and the disappearance of orphanages. This growing demand can be met by developing countries, in which the birth rate is still high and there are only limited chances of being able to maintain offspring. The children that are adopted come mainly from countries in Central and South America, Eastern Europe and Asia. Pathologies that can be expected in adopted children include general paediatric conditions, especially infections (which are often autochthonous ailments in their own country) and malnutrition, as well as neuropsychological and developmental disorders, such as psychomotor retardation, conduct and behavioural disorders, which sometimes stem from conflicts arising in the process of adaptation, communication problems, which occasionally reflect an autistic like disorder, and the problems deriving from the circumstances that condition the donation of the child for adoption (perinatal pathology, maternal drug addiction and withdrawal symptoms, maternal psychopathology.). The pathology, history and prognosis of the adopted child depend on several different factors that act in an accumulative fashion. The country of origin plays a decisive role in the type of pathology, according to the level of the health care system that exists there, the existence of adoption programmes that are regulated by law, etc. The child's age at adoption marks the difference in the optimisation of their development, if they have early access to a stable family unit. Having stayed in institutions and the length of time spent there is a risk factor for presenting a neuropsychological pathology. On many occasions the scarce information available about the child's medical history makes it more difficult to anticipate the appearance of certain problems. The existence of social risk factors in the biological families is a conditioning factor in increased morbidity. We describe a short series of adopted patients who were attended in our Neuropaediatric clinic, and we analyse the above mentioned conditioning variables and the most frequent pathologies.

Adolescent↗

[Spontaneous resolution of a congenital depressed skull fracture].

Congenital depressed skull fracture is rare and in most cases its etiology remains unclear. We present a female newborn infant with a congenital depressed skull fracture and no evidence of antepartum or intrapartum traumatism. The baby had normal neurological status and the depressed fracture healed spontaneously in a few weeks. Based on our experience of this case and a literature review, we conclude that congenital depressed skull fractures should be managed conservatively if the skull depression is less than 2cm, there is no previous trauma, no local edema or hematoma, and if the neonate shows normal neurological status.

Female↗

[Periventricular leukomalacia: neurological and radiological sequelae and long term neuropsychological repercussions].

INTRODUCTION: Periventricular leukomalacia is an anatomical diagnosis made by neuroimaging technics, of hypoxic-ischemic origin and a characteristic neurological syndrome consisting in cerebral palsy, visual impairment and/or mental retardation. Is more frequently seen in pre-term infant (5-10%) as a spastic diplegia or tetraplegia. Real prevalence in a-term infant is unknown and is presented as hemiplegia. The correlation between periventricular leukomalacia severity and clinical severity is not absolutely clarified. Is not still known if we can predict mental retardation in an infant with periventricular leukomalacia on magnetic resonance image. DEVELOPMENT: This paper revise the clinical and radiological diagnosis of periventricular leukomalacia and shows the results of a series of 31 patients diagnosed radiologically of periventricular leukomalacia. We correlate the degree of neurological and mental disabilities with the severity of periventricular leukomalacia. CONCLUSION: We reach a good correlation between the severity of periventricular leukomalacia and the severity of neurological disturbances and mental retardation.

Brain↗

[Attention deficit hyperactivity disorder and epilepsy].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is currently one of the morbid clinical pictures in childhood and adolescence that is most frequently diagnosed in the Neuropaediatric clinic. DEVELOPMENT: ADHD is sometimes associated to other important neurological problems, such as behavioural disorders, tics or headaches, and may occasionally be related to epilepsy, although in this particular case the epileptic syndromes often involve disorders affecting behaviour and attention. Due to the frequent association of these disorders (epilepsy and ADHD) it is wise to perform an electroencephalographic study in patients who visit because of symptoms of disattention. Likewise, the neuropsychological assessment of epileptic children must not be neglected. We analyse the therapeutic options regarding the use of stimulants when both disorders coexist and we endorse the association of antiepileptic and psychostimulant drugs when necessary.

Adolescent↗