Alice H. Masuko

Translation and validation into the Brazilian Portuguese of the restless legs syndrome rating scale of the International Restless Legs Syndrome Study Group

BACKGROUND Restless legs syndrome (RLS) is a chronic sensory-motor disorder characterized by unpleasant limb sensations and an irresistible urge to move. The International Restless Legs Syndrome Study Group developed the Restless Legs Syndrome Rating Scale (IRLS) to assess the severity of RLS symptoms. The objective of this study was to translate and validate the IRLS into Brazilian Portuguese. METHOD The IRLS was translated into Brazilian Portuguese, analyzed, back translated to English, and compared to the original version. It was applied to 10 patients for cultural verification. The language was adjusted and the final version was administered to 30 patients (13 male, mean age 58.88+/-14.82). RESULTS There was correlation among the IRLS evaluation of three experts. Many linguistic adaptations were required to achieve cultural adequacy and the Cronbachs alpha coefficient showed reliability of 80%. CONCLUSION IRLS was translated, adapted, and validated to Brazilian Portuguese language, showing good reliability and validity.

Intermittent diazepam and continuous phenobarbital to treat recurrence of febrile seizures: a systematic review with meta-analysis

UNLABELLED Convulsions triggered by fever are the most common type of seizures in childhood, and 20% to 30% of them have recurrence. The prophylactic treatment is still controversial, so we performed a systematic review to find out the effectiveness of continuous phenobarbital and intermittent diazepam compared to placebo for febrile seizure recurrence. METHOD Only randomized, double-blind, placebo-controlled trials were analyzed. The recurrence of febrile seizure was assessed for each drug. RESULTS Ten eligible clinical trials were included. Febrile seizure recurrence was smaller in children treated with diazepam or phenobarbital than in placebo group. Prophylaxis with either phenobarbital or diazepam reduces recurrences of febrile seizures. The studies were clinical, methodological, and statistically heterogeneous. CONCLUSION The effectiveness of phenobarbital and diazepam could not be demonstrated because clinical trials were heterogeneous, and the recommendation for treatment recurrence should rely upon the experience of the assistant physician yet.

Relationship Between Sleep Bruxism and Migraine in Children—Is It a Different History?

The interesting review performed by Graziela De Luca Canto et al entitled “Association between tension-type headache and migraine with sleep bruxism: a systematic review” demonstrated a weak level of evidence to support the relationship between tensional-type headache or migraine and sleep bruxism. Unfortunately, little published work exists that investigates the issue. Only 2 studies of adults possessed the necessary, full criteria for inclusion in their systematic review. Such a situation is frustrating as the association between sleep bruxism and migraine in children has been poorly investigated. The estimated prevalence of sleep bruxism can be greater than 25% in children, and the predominance of migraine can be higher than 20% during childhood depending on the studies. Sleep bruxism can disrupt sleep with a consequent impairment of other chronic diseases, such as migraine. Migraine and sleep bruxism have common paroxysmal characteristics and they can share similar comorbidity and symptoms. It is possible that concomitant physiological mechanisms may overlap. Sleep bruxism and different kinds of headaches are related to stress, anxiety, and possible autonomic dysfunctions. We recently published a paper that demonstrates a higher prevalence of sleep bruxism in sporadic migraine children when compared with controls (25% vs zero). Interestingly, the subjective self-report used to identify sleep bruxism in patients and controls showed sensibility of 100% and specificity of 88.3%. Although a few limitations of this study exist, it seems that the subjective perception of sleep bruxism was a real and important issue in this studied population of children with sporadic migraine. Further and better studies must be performed to clarify this possible relationship between sleep bruxism and migraine, especially in children.

Análise da assimetria funcional hemisférica de crianças com epilepsia parcial e QI normal pelo desempenho nos subtestes do WISC

We studied 87 normal IQ children, 26 partial epileptic (epileptic group) and 61 non-epileptic children (control group) with mean age of 9 years in relation to cognitive performance in Wechsler Infant Scale for Children (WISC) battery. The epileptic group showed lower score in IQ performance and in three verbal subtests (Information, Digit span, Arithmetic) and three performance subtests (Block Design, Object Assembly and Coding). Patients with right hemisphere EEG focus showed low score in subtests related to spatial ability and non-verbal attention, whereas patients with left hemisphere EEG focus showed low score only in Digit span subtest (related to immediate memory and verbal attention). The authors suggest that cognitive deficits in partial non-lesional epileptic children is related to the side of EEG interictal abnormalities, even in children with normal IQ.Foram avaliadas 26 criancas, sem deficiencia mental, com media de idade de 9±2 anos, com epilepsia parcial sem lesao cerebral evidenciavel a TCC e com atividade paroxistica no EEG intercritico localizada apenas em um hemisferio cerebral. Essas criancas foram submetidas a Escala de Inteligencia Wechsler para Criancas (WISC) e a analise dos varios subtestes verbais e execucao em relacao a localizacao hemisferica da descarga no EEG. Os dados foram comparados ao desempenho no WISC de um grupo de 61 criancas sem epilepsia na mesma faixa etaria (Grupo Controle). As criancas epilepticas apresentaram desempenho inferior no QI execucao, em tres subtestes verbais (Informacao, Digitos e Aritmetica) e em tres subtestes execucao (Cubos, Armar Objetos e Codigo). Os pacientes com foco eletrencefalografico no hemisferio direito apresentaram desempenho inferior ao Grupo Controle nos subtestes relacionados a habilidade espacial e atencao nao-verbal (Cubos, Armar Objetos e Codigo), enquanto as criancas com foco no hemisferio esquerdo apresentaram desempenho inferior apenas no subteste de Digitos (relacionado a memoria imediata e atencao verbal). Os autores sugerem que a localizacao hemisferica do foco no EEG intercritico tem relacao com o tipo de deficit cognitivo associado a epilepsia parcial nao-lesional, mesmo em criancas com QI normal.