To study the epidemiology of pediatric headache, we conducted a cross-sectional study of a randomized and proportional sample of 538 male and female students, 10 to 18 years old. They were in the 5th to 8th grade of the schools of Porto Alegre, RS, Brazil. The headache disorders were classified on the basis of clinical interview as well as a physical and neurological examination using the operational diagnostic criteria of the International Headache Society (IHS). The following headache prevalences were found: lifetime, 93.2%; last year, 82.9%; last week, 31.4%; last 24 h, 8.9%. Last week and last 24 h headache complaints were twice as prevalent in the female group. During the last year the prevalence of headache disorders was 72.8% for tension-type and 9.9% for migraine headache and was not associated with age distribution. Only the last year and last week prevalences of tension-type headache were significantly higher in the female group. The last year prevalence of headache disorders proved to be positively associated with sex and age variables. The prevalence of headache disorders was found to be extremely high in this population group, requiring more attention on the part of investigators as a public health problem.

Objective: To review the current knowledge on neurobiological aspects of autism and pervasive developmental disorders, as well as to provide pediatricians with up to date information on diagnosis and treatment of autism. Sources of data: Review of MEDLINE and Internet.Summary of the findings: Autism is the 3rd developmental disorder, with an incidence of 40 to 130/100,000 individuals. Diagnosis is based on clinical findings, following DSM IV criteria. Neuroimaging, investigation of fetal neurological status, and genetic investigation contribute towards a better understanding of the neurobiology of autism. Conclusion:Pediatricians are the first health professional to come in contact with patients with autism. Thus, they should be able to diagnose and to coordinate the multidisciplinary treatment of these patients.J Pediatr (Rio J). 2004;80(2 Suppl):S83-S94: Autism, child behavior, child development.

ResumoObjetivo: a revisão da paralisia cerebral tem como objetivo oferecer ao pediatra informações atualizadas sobre o diagnóstico e tratamento.Fontes dos dados: foram utilizados dados de revisão bibliográ-fica não sistematizada e da experiência no atendimento dos pacientes da Unidade de Neurologia do Serviço de Pediatria do HCPA-UFRGS. Síntese dos dados:o diagnóstico e tratamento da paralisia cerebral é multidisciplinar. Ao lado do sintoma principal motor, estão os sintomas associados que requerem igual atenção. Os exames de neuroimagem são importantes para melhor localizar a lesão, e mostrar sua extensão e características. O EEG auxilia no diagnóstico das epilepsias associadas. O tratamento principal é fisioterápico, auxiliado pelo tratamento da espasticidade, com antiespásticos orais, ou com toxina botulínica injetável. O tratamento de epilepsia secundária varia de acordo com o tipo de crise.Conclusões: o pediatra é o primeiro médico a entrar em contato com a criança com paralisia cerebral, e deve estar apto para reconhecer precocemente os desvios do desenvolvimento, orientar o manejo e, dentro das possibilidades e necessidades, encaminhar ao especialista. J Pediatr (Rio J) 2002; 78 (Supl.1):S48-S54: lesão cerebral, neurologia pediátrica, espasticidade. AbstractObjective: to provide pediatrician with updated information about diagnoses and treatment of cerebral palsy. This articles aims at supplying pediatricians with tools that will help them diagnose and treat cerebral palsy. Conclusions: pediatricians are the first physician that see the patient with cerebral palsy. Thus, they should be able to diagnose an treat it.J Pediatr (Rio J) 2002; 78 (Supl.1): S48-S54: cerebral palsy, neurology, pediatrics, spasticity.

-Objective: To verify if the clinical behavior of auditory hypersensitivity, reported in interviews with parents/caregivers and therapists/teachers of 46 children and teenagers suffering from autistic spectrum disorder, correspond to audiological findings. Method: The clinical diagnosis for auditory hypersensitivity was investigated by means of an interview. Subsequently, a test of the acoustic stapedial reflex was conducted, and responses to intense acoustic stimulus in open field were observed. Results: Of the 46 subjects, 11 (23.9%) were clinically diagnosed as oversensitive to sound and only 2 showed discomfort when exposed to intense acoustic stimulus in open field. There was no statistically significant difference for the test of the ipsilateral acoustic stapedial reflex between the groups. Conclusion: Behavioral manifestations to sounds are not associated to hypersensitivity of the auditory pathways, but instead these are associated to difficulties in the upper processing, involving systems that usually are impaired in autistic spectrum patients, such as the limbic system. KEY WORDS: autism, hypersensitivity, sound.Hipersensibilidade auditiva em crianças e adolescentes com transtorno do espectro autista RESUMO -Objetivo: Verificar se o comportamento clínico de hipersensibilidade auditiva, relatado nas entrevistas com os pais/cuidadores e terapeutas/professores de crianças e adolescentes com transtorno do espectro autista, corresponde aos achados audiológicos. Método: O diagnóstico clínico para a hipersensibilidade auditiva foi investigado a partir do protocolo de entrevista. Após, foi utilizada a pesquisa do reflexo acústico estapédico e observadas as reações ao estímulo sonoro intenso em campo aberto. Resultados: Dos 46 sujeitos, 11 (23,9%) foram diagnosticados clinicamente como hipersensíveis ao som, e somente 2 demonstraram desconforto quando expostos ao estímulo sonoro intenso em campo aberto. Não houve diferença estatisticamente significante para a pesquisa do reflexo acústico estapédico ipsilateral entre os grupos. Conclusão: As manifestações comportamentais aos sons não estão associadas à hipersensibilidade das vias auditivas, mas, sim, a dificuldades no processamento superior, envolvendo sistemas que comumente estão comprometidos nos pacientes do espectro autista, como o sistema límbico. PALAVRAS-CHAVE: autismo, hipersensibilidade, som.

Attention-deficit hyperactivity disorder (ADHD) is a common childhood condition, recognized as an important social-medical problem. The syndrome is characterized by motor system, perception, cognition and behavioral disturbances, compromising the learning of children with adequate intellectual potential. To investigate its prevalence in first grade pupils 484 children with DSM-IV diagnostic criteria and neuropsychological criteria were examined. The prevalence of ADHD was 18% when the diagnosis was made using DSM-IV criteria; 3.5% when neuropsychological criteria was used, including, in addition to behavioral and psychometric aspects, a discrepancy in the evolutionary neurological examination, and 3.9% when motor persistence was taken into account. The prevalence of ADHD was higher among older children (92.4 months) only when DSM-IV criteria were used. We conclude that the use of DSM-IV criteria probably overestimates the prevalence of ADHD, since it detects another behavioral disorders. In this context, they may be useful as screening, since they have adequate pre-testing performance.

To analyze cranial growth and size of anterior fontanel during the first year of life, we undertook a cohort study with a sample of 33 infants assessed at birth and reexamined at 1, 2, 3, 4, 5, 6, 9, and 12 months. Examination included assessment of head circumference, anterior fontanel size, anteroposterior distance, biauricular distance, and cephalic index. All infants were neurologically normal. Mean size of the anterior fontanel at birth was 1.77 cm(2) and, in disagreement with literature data, fontanel size increased up to 2 months of age; fontanel was closed at 1 year for 27.3% of infants. Significant differences in cranial anthropometry were not found in relation to method of delivery (vaginal or cesarean section), gender and gestational age. Our results indicate the need to reevaluate anthropometric examination data and to establish patterns of normality, particularly for miscegenated populations that have not been widely investigated.

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Este estudo relaciona a aquisição da linguagem oral com o desenvolvimento da escrita em 236 crianças provenientes de escola particular, da cidade de Porto Alegre, RS, Brasil. O objetivo desta pesquisa foi identificar fatores não-lingüisticos envolvidos na aquisição fonológica e descrever a relação da aquisição fonológica com alterações de escrita. Aos 6 anos de idade, os estudantes do jardim de infância foram divididos em 2 grupos, com base no teste de Avaliação Fonológica da Criança. No seguimento, aos 9 anos de idade, foram avaliados através de Ditado Balanceado e produção textual. Ao comparar os resultados dos grupos casos e controles houve diferença estatisticamente significativa na quantidade de erros cometidos na avaliação da escrita, apontando para a aquisição da linguagem oral como fator preditivo para o desenvolvimento ortográfico.