Characteristics of EEG power spectrum during sleep spindle events in ADHD children

The attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder that interferes with the typical development and both learning and motor functioning in a child's life. Most of the children with ADHD present also sleep problems like difficulties in falling asleep and maintaining sleep. Sleep spindles are characteristic waves of sleep stage 2 in humans and are characterized by a fusiform morphology. In the last years, the empirical evidence indicates that spindles are associated with cognitive faculties and intelligence as well as with several disease states. On the other hand, power spectral analysis of EEG represents a powerful noninvasive tool for examining cerebral behavior. The aim of this study is to evaluate the differences between ADHD and healthy children of the power spectral values in delta, theta, alpha, beta and gamma bands, before, during and after sleep spindles. Our results show significant differences concentrated in the period immediately after spindle epochs, in the left hemisphere of the brain, in almost all bands, with greater values in control than in ADHD children.

Neuroimaging Changes in Menkes Disease, Part 1

Menkes disease is a rare multisystem X-linked disorder of copper metabolism. Despite an early, severe, and progressive neurologic involvement, our knowledge of brain involvement remains unsatisfactory. The first part of this retrospective and review MR imaging study aims to define the frequency rate, timing, imaging features, and evolution of intracranial vascular and white matter changes. According to our analysis, striking but also poorly evolutive vascular abnormalities characterize the very early phases of disease. After the first months, myelination delay becomes evident, often in association with protean focal white matter lesions, some of which reveal an age-specific brain vulnerability. In later phases of the disease, concomitant progressive neurodegeneration might hinder the myelination progression. The currently enriched knowledge of neuroradiologic finding evolution provides valuable clues for early diagnosis, identifies possible MR imaging biomarkers of new treatment efficacy, and improves our comprehension of possible mechanisms of brain injury in Menkes disease.

The Tolosa-Hunt Syndrome in Children: A Case Report

Tolosa-Hunt syndrome (THS) is characterized by unilateral painful ophthalmoplegia with oculomotor paresis, associated with an idiopathic granulomatous inflammation involving the cavernous sinus, with a typical relapsing-remitting course. We report a case of an 8-year-old girl who was admitted because of an ophthalmoplegia with exotropia and ptosis of the left eyelid, accompanied by diplopia and left sovraorbital pain. The clinical data, neuroradiological findings and response to steroid treatment suggested THS, as defined by the 2004 International Classification of Headache Disorders (ICHD)-II criteria. THS must be considered a possible cause of painful ophthalmoplegia in childhood, as well as in adults, and confirmed with a focused neuroradiological investigation. The few paediatric cases described in the literature that meet the 2004 ICHD-II criteria are not sufficient to identify possible differences between the paediatric and the adult forms. Every new paediatric case should therefore be reported in order to gather and compare further information.