Wendy S. Matthews

Emotional Concomitants of Childhood Epilepsy

Summary: On the basis of the distinguishing features of unpredictability, overt manifestation of symptom, and loss of control in epilepsy, a number of hypotheses about possible emotional concomitants of childhood epilepsy are offered. Comparing fifteen epileptic children with groups of diabetic and healthy children, matched for chronological age, sex, mental age, socioeconomic status, and family variables, the following findings emerged. Epileptic children are more likely than their diabetic or healthy peers to attribute control over even successful events in their lives to external sources. The perception of control by powerful others or by unknown factors was especially pronounced with regard to social events. In addition, epileptic children as a group were found to have lower self‐concepts (particularly with regard to their popularity) and to be more anxious than their peers. The clinical and research significance of the findings are discussed.

Childhood migraine and somnambulism

Based on a sample of 222 children from four diagnostic groups, a high frequency of somnambulism in children suffering from migraine headache is reported. The strength of the association between somnambulism and childhood migraine raises the possibility that somnambulism might be considered as a minor diagnostic criterion in the clinical diagnosis of childhood migraine. This association may further clarify the nature of the serotonin abnormality underlying migraine.

Disorders of arousal in Gilles de la Tourette's syndrome

Article abstract-Disorders of arousal (somnambulism and night terrors) were significantly more common among children with Gilles de la Tourettes syndrome (n = 57) than among children with seizure disorders(n = 58) or learning disabilities (n = 53). Neurohumoral disturbances may account for the differences.

Children with Tourette syndrome: results of psychological tests given prior to drug treatment.

There have been several recent reports on the neuropsychological integrity of children and adults with Tourette syndrome (TS). However, the possible effects of tic-controlling medications on the test performance of subjects have not been thoroughly investigated, although drugs commonly used in the treatment of TS, such as haloperidol, have been shown to affect learning and behavior. In this study, 10 children diagnosed as having Gilles de la Tourette syndrome were individually administered a battery of psychological tests prior to starting drug treatment. Since a wide range of deficits and processing inefficiencies has been reported in association with the psychological functioning of children with Tourettes disorder, the test battery used was designed to include both measures of contemporary global functioning and measures designed to focus upon particular functional areas. Data analyses revealed a number of specific impairments in TS children relative to (1) age-appropriate levels and (2) levels of global functioning (i.e., IQ scores). The study revealed a number of graphomotor, nonmotor visual-perceptual, and receptive verbal deficits. In addition, a high frequency (50%) of the sample manifested significant Verbal-Performance IQ discrepancies. Results of this study, on a population of nonmedicated TS children, substantiated and extended findings of several previous reports which identified a number of circumscribed weaknesses in the functioning of children with Tourettes disorder.

Coincident infantile autism and Tourette syndrome: a case report.

A 15-year-old boy who had been diagnosed as having infantile autism (IA) at two years of age was found to have Tourette Syndrome (TS) in adolescence. This case report represents the second coincident finding of IA and TS in an adolescent autistic boy. The implications of a co-occurrence of IA and TS are discussed in the light of our current understanding of abnormalities in neurotransmitter metabolism common to both conditions.

COGNITIVE FUNCTIONING IN LESCH‐NYHAN SYNDROME

The present study represents the first effort to assess systematically the cognitive functioning of a population of individuals with Lesch‐Nyhan syndrome using standardized psychometric instruments. Seven residents from a special hospital setting participated. They ranged in age from 10 years 1 month to 22 years 3 months (mean 13 years 7 months). Using the Stanford‐Binet Intelligence Scale: IV, scores in each of the four domains assessed by this battery (Verbal Reasoning, Abstract/Visual Reasoning. Quantitative and Short‐Term Memory), as well as the general composite score, ranged from moderately mentally retarded to low average. Areas of weakness included attention, the manipulation of complex visual images, the comprehension of complex or lengthy speech, mathematical ability, and multi‐step reasoning.

Coincident Down's and Tourette syndromes: three case reports.

Three patients with Downs syndrome and coincident Tourette syndrome are presented. Two patients had trisomy for G-group chromosome and one patient had mosaic trisomy. All had characteristic features of Gilles de la Tourette syndrome with multiple motor and vocal tics. While Tourette syndrome has been reported in other chromosomopathies, this report appears to be the first to note an association with Downs syndrome. The authors hypothesize that neurotransmitter abnormalities existing in Downs syndrome may predispose such individuals to basal ganglia dysfunction and the subsequent development of tics. In particular, abnormalities in serotonin metabolism may be involved. (J Child Neurol 1986;1:358-360)

Social Development in Childhood

From the moment of birth, a child is enmeshed in a social milieu, a network that, ideally, will offer security, love, and intimacy but will also require the acquisition and maintenance of an entire repertoire of social behaviors deemed appropriate by a particular group or culture. Social development encompasses the task of growing up within a social system such that one is able to behave in that system’s socially accepted ways (Lewis, 1982). Traditionally, the study of social systems has fallen under the purview of anthropologists or sociologists, the study of interpersonal relationships has been a major focus of clinicians, and the study of social behaviors (e.g., aggression, empathy) has captured the attention of social and developmental psychologists. The past few years have heralded the emergence of interpersonal relationships and social knowledge as relevant topics of inquiry for developmentalists of all persuasions (cf. Hinde, 1974; Lewis & Brooks-Gunn, 1979; Youniss, 1980).

The Palmo-Mental Reflex in Cerebral Palsy

The palmo-mental reflex (PMR) is a neurological sign found in normal children under the age of 3 years, but disappearing with age. A study population consisting of 45 children with cerebral palsy (CP) and control populations of 136 children with attention deficit disorder/learning disabilities (ADD/LD) and 33 children with idiopathic epilepsy were examined for the presence or absence of the PMR and for the prominence of the reflex (on a 0 to 16 point scale) within three developmental periods (3-8 years; 8 to 13 years, and 13 years and over). Findings indicated that 87% of the children with CP demonstrated the PMR, in contrast to 32% of children with AD/LD and 36% of children with idiopathic epilepsy. The PMR was found to be more intense as well as more persistent among children with CP. The findings are consistent with existence of other primitive reflexes in cerebral palsy that under normal circumstances would be expected to disappear with age. The marked persistence of PMR in cerebral palsy can be viewed as an indicator of pyramidal and/or extrapyramidal tract injury resulting in the dishinbition of “primitive” subcortical and brain-stem centers.