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Search Results: 1 - 10 of 185086 matches for " Paulo Breno de Noronha;Mehl "
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Ictal patterns in children: an illustrated review
Spinosa, M?nica Jaques;Liberalesso, Paulo Breno de Noronha;Mehl, Larissa;L?hr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2011, DOI: 10.1590/S1676-26492011000400008
Abstract: detailed knowledge of electroencephalographic patterns accompanying epileptic seizures in children is paramount to the correct identification of epileptic seizures and syndromes. in this article, we present a review of ictal patterns of different seizure types in children, illustrating with examples collected in our video-eeg laboratory at pequeno príncipe hospital.
Challenges in the surgical treatment of epilepsy: hypothalamic hamartoma in infancy - case report
Mehl, Larissa Alessandra;Liberalesso, Paulo Breno Noronha;Spinosa, M?nica Jaques;Machado, Sílvio;L?hr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2012, DOI: 10.1590/S1676-26492012000100004
Abstract: introduction: hypothalamic hamartoma is a rare congenital malformation, characterized by epilepsy, especially gelastic seizures, psychomotor developmental delay, mental retardation, behavioral disorders and precocious puberty. epilepsy has early onset and is usually medically refractory. etiology and pathophysiological mechanisms are unclear. the eeg can present disorganization and slowing of background activity and multifocal and/or generalized epileptogenic discharges. objective: to report the difficulties and challenges of neurosurgical treatment of a hypothalamic hamartoma in an infant. case report: infant with seizures since eight months old of age. the neurological investigation revealed a lesion in tuber cinereum suggestive of hamartoma. the epilepsy evolved with resistance to antiepileptic drugs, requiring neurosurgical procedure. the endoscopic resection could not be performed because the hamartoma was firmly attached to the hypothalamus. currently, the child remains with tonic, clonic and atonic seizures. discussion: lesionectomy performed by microsurgery or radiosurgery seems to be the most effective treatment for seizure control in patients with hypothalamic hamartomas who do not respond to clinical treatment. callosotomy may be effective in selected cases, and lobectomy/cortical resections are not related to seizure control. in some patients, particularly in infants, lesionectomy and radiosurgery may be technically unfeasible.
Achados otoneurológicos em um caso de miopatia inflamatória Otoneurological findings in an inflammatory myopathy case
Bianca Simone Zeigelboim,Karlin Fabianne Klagenberg,Diego Augusto de Brito Malucelli,Paulo Breno Noronha Liberalesso
Revista CEFAC , 2012,
Abstract: TEMA: a polimiosite é uma enfermidade sistêmica idiopática caracterizada por um processo inflamatório n o supurativo que acomete a musculatura esquelética e manifesta-se clinicamente por fraqueza muscular proximal e simétrica. Possui incidência variável, cerca de um caso para cada 100 mil habitantes, havendo predominancia no sexo feminino. PROCEDIMENTOS: avaliou-se no Setor de Otoneurologia de uma Institui o, um paciente com diagnóstico de polimiosite, com 60 anos, do sexo feminino, que referiu dificuldade para escutar no ouvido direito, zumbido, ansiedade, ins nia, dificuldade nos movimentos do pesco o e dor irradiada para ombros e bra os. Foram realizados os seguintes procedimentos: anamnese, inspe o otológica, avalia o audiológica e vestibular. RESULTADOS: a) na avalia o audiológica apresentou, perda auditiva neurossensorial de grau moderado na orelha direita e limiares auditivos dentro dos padr es de normalidade na orelha esquerda; b) na imitanciometria apresentou, curva timpanométrica do tipo "A" e presen a dos reflexos estapedianos bilateralmente; c) no exame vestibular observou-se, nistagmo semi-espontaneo do tipo múltiplo e ausência do efeito inibidor da fixa o ocular. CONCLUS O: observou-se altera o nos exames realizados, principalmente, no exame labiríntico que demonstrou a importancia de sua realiza o e a sensibilidade na capta o de altera o que sugeriu envolvimento do sistema nervoso central contribuindo dessa forma, para uma interven o e acompanhamento terapêutico mais rápido e eficaz. BACKGROUND: polymyositis is an idiopathic systematic disease characterized by a non-suppurative inflammatory process which attacks the skeletal musculature and manifests itself clinically by proximal and symmetrical muscular debility. It shows a variable incidence, approximately one in every hundred thousand inhabitants, predominately in females. PROCEDURES: a patient, 60 years, female and diagnosed with polymyositis was evaluated in the Otoneurology Sector of an Institution, referred having hearing difficulties in the right ear, tinnitus, anxiety, insomnia, difficulties in neck movement and shoulders and arms disseminated pain. The following procedures were carried out: anamnesis, otological inspection, audiological evaluation and vestibular exam. RESULTS: a) in the audiological evaluation there was sensorineural hearing loss from moderate degrees in the right ear and normal hearing thresholds in the left ear; b) in the imitanciometry there was a type "A" tympanometric curve and the presence of the stapedial reflexes, bilaterally; c) in the vestibu
Etiologia e a morbi-letalidade do coma agudo em crian as
L?hr Junior Alfredo,Liberalesso Paulo Breno Noronha,Luzzi Gisele Claudino Reck,Faria Antonio Carlos de
Arquivos de Neuro-Psiquiatria , 2003,
Abstract: OBJETIVO: Analisou-se a etiologia e a morbi-mortalidade de 104 crian as em coma agudo, ou seja, com uma pontua o menor ou igual a 8 da escala de Glasgow, internadas na Unidade de Terapia Intensiva do Hospital Infantil Pequeno Príncipe(UTI-HIPP) no período entre mar o/98 e janeiro/2001. RESULTADOS: A idade variou de 2 meses a 13 anos, com média de 30,3 ± 27,4 meses e mediana de 20 meses, sendo 57 (54,8%) do sexo masculino. O tempo de permanência hospitalar variou de 1 a 114 dias, e 3 casos permaneceram em estado vegetativo persistente. Com rela o à etiologia: 31 (29,8%) dos casos foram devidos a meningoencefalite, 24 (23,1%) estado de mal epiléptico, 19 (18,3%) causa tóxico-metabólica, 16 (15,4%) hipertens o intracraniana, 7 (6,7%) choque/anóxia, 4 (3,8%) etiologia indeterminada, 3 (2,9%) miscelanea. Com rela o à evolu o das crian as, 23 (22,1%) foram a óbito, 32 (30,8%) evoluíram sem seqüelas, 39 (37,5%) tiveram alta com seqüelas neurológicas e10 (9,6%) n o informado. CONCLUS O: De acordo com a análise do presente estudo conclui-se que cerca de um ter o dos pacientes em coma agudo falece, um ter o apresenta seqüelas neurológicas na alta hospitalar e um ter o evoluim sem seqüelas.
Efeitos da priva o aguda de sono sobre o processamento auditivo central em adultos saudáveis Acute effects of sleep deprivation on the central auditory processing in healthy adults
Paulo Breno Noronha Liberalesso
Revista da Sociedade Brasileira de Fonoaudiologia , 2012, DOI: 10.1590/s1516-80342012000200026
Abstract:
Altera??es eletrencefalográficas como fator prognóstico no coma agudo em crian?as n?o epilépticas
Moraes, Jacqueline Dompsin de;Liberalesso, Paulo Breno Noronha;Klagenberg, Karlin Fabianne;Jurkiewicz, Ari Leon;Zeigelboim, Bianca Simone;
Journal of Epilepsy and Clinical Neurophysiology , 2011, DOI: 10.1590/S1676-26492011000300003
Abstract: introduction: although the neurological examination remains the main parameter for assessment of the brain impairment in many pediatric icu in brazil, the eeg is an easy exam to perform, with low costs and offers no significant risk to the patient. our aim was to evaluate the presence of specific and non specific abnormalities and epileptogenic paroxysms in the eegs of children in coma and to relate these findings with the risk of death. methods: retrospective study. results: 36 eegs were performed in 18 children. 10 were male (55.6%), aged between two months and 15.5 years (median: 3.2±4.7 years). different causes for the coma state were described. all eegs were abnormal and the slowing and voltage depression patterns were the most common abnormalities observed. only one test showed asymmetry between the cerebral hemispheres. 30.6% of the patients had focal, multifocal or generalized epileptogenic paroxysms on the eegs. the mortality rate was 38.9%. analyzing the 19 eegs obtained from seven children who died during the icu stay, 21.1% had epileptogenic paroxysms. conclusion: in spite of the fact that our sample is relatively small, we infer that epileptogenic paroxysms in the eegs of non-epileptic children in coma is relatively common, even not observing a consistent association of this finding with high risk of death.
Achados otoneurológicos em um caso de miopatia inflamatória
Zeigelboim, Bianca Simone;Klagenberg, Karlin Fabianne;Malucelli, Diego Augusto de Brito;Liberalesso, Paulo Breno Noronha;Paulin, Fabiane;
Revista CEFAC , 2012, DOI: 10.1590/S1516-18462010005000054
Abstract: background: polymyositis is an idiopathic systematic disease characterized by a non-suppurative inflammatory process which attacks the skeletal musculature and manifests itself clinically by proximal and symmetrical muscular debility. it shows a variable incidence, approximately one in every hundred thousand inhabitants, predominately in females. procedures: a patient, 60 years, female and diagnosed with polymyositis was evaluated in the otoneurology sector of an institution, referred having hearing difficulties in the right ear, tinnitus, anxiety, insomnia, difficulties in neck movement and shoulders and arms disseminated pain. the following procedures were carried out: anamnesis, otological inspection, audiological evaluation and vestibular exam. results: a) in the audiological evaluation there was sensorineural hearing loss from moderate degrees in the right ear and normal hearing thresholds in the left ear; b) in the imitanciometry there was a type "a" tympanometric curve and the presence of the stapedial reflexes, bilaterally; c) in the vestibular exam, semi-spontaneous multiple nystagmus and an absence of the inhibiting effect for ocular fixation were observed. conclusion: alterations were observed in the accomplished exams, mainly in the vestibular exam, which demonstrated the importance for being carried out; and the sensitivity in the acquisition of the alteration which suggested an involvement of the central nervous system, contributing, thus, to a faster and more effective intervention and therapeutic accompaniment.
Estudo comparativo entre a qualidade do sono em crian?as de 7 a 15 anos com epilepsia clinicamente controlada e refratária
Vidotto, Gisele A. Frederich;Liberalesso, Paulo Breno Noronha;Farias, Ant?nio Carlos de;Jurkiewicz, Ari Leon;Zeigelboim, Bianca Simone;L?hr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2008, DOI: 10.1590/S1676-26492008000400004
Abstract: introduction: the relationship between epilepsy and sleep has been recognized many years. sleep disturbances and epilepsy are pathological conditions of raise prevalence in the general population, particularly in infancy, childhood and adolescence. the aim of this study was to compare the sleep behavior in children from seven to 15 years-old with controlled epilepsy and refractory epilepsy. methods: the scale "sleep behavior questionnaire", translated and validated for portuguese language, was applied to all patients with controlled epilepsy and refractory epilepsy who attended the pediatric neurology department of hospital pequeno príncipe between april and september 2007. results: the 46 patients were divided into 2 groups, which consisted of 24 with controlled epilepsy (group 1) and 22 with refractory epilepsy (group 2). mann-whitney statistical test was applied and a significant statistical difference (p=0,000) was evidenced between the index of sleep behavior of the two groups, the equality of sleep being considered worse in the patients with refractory epilepsy. conclusion: the data showed the children from seven to 15 years-old with refractory epilepsy have worse quality of sleep than children with controlled epilepsy.
Clinical, laboratory and neuroimage findings in juvenile systemic lupus erythematosus presenting involvement of the nervous system
Spinosa, M?nica Jaques;Bandeira, Márcia;Liberalesso, Paulo Breno Noronha;Vieira, Simone Carreiro;Janz Jr, Loris Lady;Sá, Eliane Gomes de;L?hr Jr, Alfredo;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000300013
Abstract: objective: to characterize neurological involvement in juvenile systemic lupus erythe-matosus. method: the charts of all patients with the diagnosis of systemic lupus erythematosus before the age of 16 years, followed at the rheumatology unit of pequeno príncipe hospital, from january 1992 to january 2006, were retrospectively reviewed, highlighting neuropsychiatric aspects. results: forty-seven patients were included. neuropsychiatric syndromes were found 29 (61.7%): seizures (17 / 36.2%), intractable headache (7 / 14.9%), mood disorders (5 / 10.6%), cerebrovascular disease (4 / 8.5%), acute confusional state (3 / 6.4%), aseptic meningitis (3 / 6.4%), psychosis (3 / 6.4%), chorea (3 / 6.4%), guillain-barré syndrome (2 / 4.3%) and cranial neuropathy (1 / 2.1%). morbidity indexes (sledai and slicc) were higher among patients with neuropsychiatric manifestations (p<0.05). conclusion: neuropsychiatric syndromes are frequent, and add significant morbidity to juvenile systemic lupus erythematosus.
Etiologia e a morbi-letalidade do coma agudo em crian?as
L?hr Junior, Alfredo;Liberalesso, Paulo Breno Noronha;Luzzi, Gisele Claudino Reck;Faria, Antonio Carlos de;Bugallo, Maria Julia Cami?a;Santos, Mara Lucia Schmit Ferreira;
Arquivos de Neuro-Psiquiatria , 2003, DOI: 10.1590/S0004-282X2003000400018
Abstract: objective: an analysis was conducted on the etiology and the morbi-mortality of pediatric patients in acute coma, hospitalized at the intensive care unit of hospital infantil pequeno príncipe (uti-hipp). method: one hundred and four control sheets of children hospitalized at the uti-hipp and diagnosed as being in acute coma were analyzed. the glasgow coma scale duly modified for children was used, with a score count equal to or lower than 8 points. the observation period was from march/98 to january/2001. all the supplementary exams as well as the neurological conditions of the patients when discharged were analyzed. results: the study comprised 104 children whose ages varied from 2 months to 13 years, with 57 (54.8%) of them being males. hospital - stay time varied from 1 to 114 days, plus 3 cases in a persistent vegetative condition. as regards to etiology, 31 (29.8%) of the cases were due to meningo-encephalitis, 24 (23.1%) to an epileptic condition, 19 (18.3%) were toxic-metabolic, 16 (15.4%) to intra-cranial hypertension, 7 (6.7%) to shock/anoxia, 4 (3.8%) to an indeterminate etiology and 3(2.9%) were miscellaneous. insofar as the clinical evolution of the children is concerned, 23 (22.1%) died, 32 (30.8%) evolved without any sequelae, 39 (37.5%) were discharged with neurological sequelae and for 10 (9.6%), no information is available. conclusion: according to this study, one third of the children has died, one third presented neurological sequelae, and one third presented no further complications.
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