A Brother or a Sister With CP. How Much it Makes a Difference in Childhood and Adulthood?

Every month we see to be published dozens of scientific papers about etiology and physiopathology of CP, imaging, treatment, survival, quality of life of patients and of mothers (just a few) and so on. Papers dealing with the feelings and the problems of siblings of children and adults with CP in the most important scientific journals are extremely rare. However in internet we can find the sites of the most important Cerebral Palsy Societies, like the British, the Australian and the American ones already devoting a special attention to the issue of siblings; we also can see several interesting blogs of parents sharing their experiences not only with the handicapped child but also with the siblings, even counseling some books written for children giving practical advices how to deal and live with a handicapped sibling. What was a surprise to me were the several sites of adults having a disabled sibling, frequently with CP, in a new situation: without parents to care them.

Epilepsy and Cerebral Palsy: Characteristics and Trends in Children Born in 1976 - 1998

Background: Although epilepsy is common in children with cerebral palsy (CP), no data exists on prevalence rates of CP and epilepsy. Aims: To describe epilepsy in children with CP, and to examine the association between epilepsy and neonatal characteristics, associated impairments and CP subtypes. Methods: Data on 9654 children with CP born between 1976 and 1998 and registered in 17 European registers belonging to the SCPE network (Surveillance of Cerebral Palsy in Europe)were analyzed. Results: A total of 3424 (35%) children had a history of epilepsy. Among them, seventy-two percent were on medication at time of registration. Epilepsy was more frequent in children with a dyskinetic or bilateral spastic type and with other associated impairments. The prevalence of CP with epilepsy was 0.69 (99% CI, 0.66e0.72) per 1000 live births and followed a quadratic trend with an increase from 1976 to 1983 and a decrease afterwards. Neonatal characteristics independently associated with epilepsy were the presence of a brain malformation or a syndrome, a term or moderately preterm birth compared with a very premature birth, and signs of perinatal distress including neonatal seizures, neonatal ventilation and admission to a neonatal care unit. Conclusions: The prevalence of CP with epilepsy followed a quadratic trend in 1976e1998 and mirrored that of the prevalence of CP during this period. The observed relationship between epilepsy and associated impairments was expected; however it requires longitudinal studies to be better understood.

Análise Estrutural do Segmento Anterior por Tomografia de Coerência Ótica no Glaucoma Congénito Primário

Objectivo: Analisar a morfologia do segmento anterior por tomografia de coerência ótica de segmento anterior (OCT-SA) em crianças com glaucoma congénito primário (GCP). Material e métodos: Realizou-se um estudo caso-controlo, prospetivo, em crianças com GCP e em crianças sem glaucoma (grupo controlo), seguidas em Consulta de Oftalmologia Pediátrica do Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central. Efectuou-se avaliação oftalmológica completa e OCT-SA utilizando o protocolo A C biometry. Resultados: O estudo incluiu 27 olhos (17 crianças com OCP) e 22 olhos (11 crianças sem glaucoma). Detetaram-se valores significativamente superiores de profundidade central e largura da câmara anterior (CA) (p<0,001) e maiores distâncias de abertura do ângulo a 500 CP<0,001) e 750µm (p=0,00 l), áreas de espaço irido-trabecular a 500 e 750µm (p<0,001) e áreas do recesso do ângulo a 500 (p<0,00l) e 750µm (p=0,001), no grupo GCP. A espessura da íris foi significativamente mais fina a 500µm do ângulo (p=0,011), no centro da íris (p<0,001) e na região mais espessa da mesma (p=0,001) no grupo GCP, assim como o comprimento da íris foi superior (p<0,001). A largura de CA e a acuidade visual (logMAR) apresentam correlação positiva (r=0,688; p<0,001). Outros achados morfológicos: anteriorização e hipoplasia da íris, alteração da morfologia do ângulo no local de intervenção cirúrgica (goniotomia, trabeculotornia, trabeculectomia, válvula de Ahmed). Conclusão: Este primeiro estudo em crianças com GCP sugere que a OCT-SA é de aquisição relativamente fácil, poderá ajudar no seguimento clínico e cirúrgico e ser útil como fator prognóstico destes doentes.