APLICACIÓN DE ESCALA DE EVALUACIÓN PEDIÁTRICA DEL INVENTARIO DE DISCAPACIDAD-PRUEBA ADAPTATIVA POR COMPUTADORA (PEDI-CAT) EN PACIENTES CON EPILEPSIA.

Introducción: La epilepsia representa una de las principales causas de morbilidad en neuropediatría. El inicio temprano de las crisis epilépticas, se relaciona con menor desempeño intelectual a largo plazo, y alteraciones en las habilidades adaptativas. Objetivo: Aplicar escala de evaluación pediátrica del inventario de discapacidad-prueba adaptativa por computadora (PEDI-CAT) en pacientes pediátricos con epilepsia. Métodos: Se realizó un estudio de nivel descriptivo, tipo observacional, prospectivo, trasversal y analítico, realizado el Departamento de Neurología Pediátrica del Hospital Infantil de México Federico Gómez, en la Ciudad de México. El reclutamiento de los pacientes fue durante abril y diciembre de 2020. Resultados: los pacientes con epilepsia presentaron un percentil <5 en sus habilidades de movilidad 22 (35,4%), actividades diarias 19(30,6%), social-cognitivas 19(30,6%), lo que significa que están por debajo de rango normal comparado con niños de su edad. Conclusiones: los pacientes con epilepsia presentaron un percentil <5 en el dominio de actividades diarias, movilidad y social-cognitiva, lo que significa que están por debajo de rango normal comparado con niños de su edad. Por tanto, la epilepsia debe ser considerado un trastorno que afecta la capacidad adaptativa de los pacientes y no sólo una patología cuya manifestación son las crisis, su detección temprano con el uso de escalas como PEDI-CAT se traduce en la identificación y planificación de estrategias terapéuticas eficaces para mejorar calidad de vida de los pacientes Palabras Clave: Epilepsia, Conducta Adaptativa, Trastornos del Neurodesarrollo. ABSTRACT Introduction: Epilepsy represents one of the main causes of morbidity in pediatric neurology. The early onset of epileptic seizures is related to lower long-term intellectual performance, and alterations in adaptive skills. Objective: To apply the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) report in pediatric patients with epilepsy. Methods: A descriptive, observational, prospective, cross-sectional and analytical study was carried out in the Department of Pediatric Neurology at Hospital Infantil de México Federico Gómez, in Mexico City. Patient recruitment took place between April and December 2020. Results: patients with epilepsy presented a <5 percentile in their mobility skills 22 (35.4%), daily activities19 (30.6%), social-cognitive 19 (30.6%), which means that they are below of normal range compared to children his age. Conclusions: patients with epilepsy presented a <5 percentile in the domain of daily activities, mobility and social-cognitive, which means that they are below the normal range compared to children of their age. Therefore, epilepsy should be considered a disorder that affects the adaptive capacity of patients and not just a pathology whose manifestation is seizures, its early detection with the use of scales such as PEDI-CAT translates into the identification and planning of strategies effective therapeutics to improve the quality of life of patients Keywords: Epilepsy, Adaptation, Psychological, Neurodevelopmental Disorders.

Pediatric neurology and telehealth before and during SARS-CoV-2 pandemic

Telehealth has been known in medicine for over 70 years. Until the year 2020 it has been utilized in a limited setting to provide long-distance care for individuals residing in areas lacking health facilities. SARS-CoV-2 pandemic shifted the priorities of healthcare system towards COVID-19 infections, which resulted in the transition of non-emergency consultations to telemedicine in many countries. Since pediatric neurology requires frequent follow-up and multidisciplinary care, the purpose of our work is to determine the spectrum of use of telehealth in pediatric neurology before and during the pandemic. Secondly, we would like to discuss the differences of focus in tele-neurology for children patients between the pre-pandemic and during pandemic timeframes.Within 171 articles of PubMED database, 36 substantial articles on the introduction of telehealth to pediatric neurology were included in the review. 30.5% of the articles have included the implementation of telemedicine before the pandemic, 69.5% of the articles discussed improvements made after the pandemic started. The spectrum of disorders and interventions considered for telehealth included epilepsy, cerebral palsy, rare diseases, teleneuropsychology and teleneurorehabilitation. Among major differences between pre-pandemic and pandemic research, increase in international cooperation and discussion of not only medical, but also scientific and academic impact of the pandemic could be noted.Telehealth offers sustainable alternatives to many interventions which cannot be performed in-person during public health emergency such as SARS-CoV-2 pandemic. Despite high satisfaction of caregivers and healthcare professionals from the virtual visits, solutions are still far from perfection and need improvements to provide more support for the patients with various disorders, cover the concerns of privacy and confidentiality, as well as support patients from low-income and lack of electronic techology backgrounds.

Migraine Abortive Treatment in Children and Adolescents in Israel

Migraine headaches in children may cause attacks that require abortive treatment. This study evaluated the incidence and efficacy of medications used for relieving migraine headache attacks in the pediatric population in Israel. Children 6–18 years of age who were diagnosed in our pediatric neurology clinic as having migraine headaches were enrolled into the study. Children and their parents recorded the children response to abortive treatment during three consecutive migraine attacks. Fifty children, with 116 migraine attacks, were included in the study (30 females; mean age 12; range 6–18). Forty-seven (94%) reported on abortive treatment on the first migraine attack, 43 (86%) on a second migraine attack and 26 (52%) on a third migraine attack. During the first recorded migraine attack, 41 children (87.5%) reported taking only one type of medication for each headache episode, mainly ibuprofen or acetaminophen; less than a quarter used dipyrone. The improvement rate after two hours was 65.4%±27 for ibuprofen, 59.8±35.3 for acetaminophen and 50.9±27.4 for dipyrone. In conclusion, Children with migraine in Israel mainly use a single medication for each headache episode. Ibuprofen is the most commonly used abortive treatment; however, acetaminophen was associated with a better response.