Vinte e duas crianças hiperativas, de 7 a 12 anos de idade foram selecionadas dentre 38 matriculadas no Ambulatório de Psiquiatria do Hospital do Servidor Público do Estado de São Paulo. A avaliação psiquiátrica foi negativa, o exame neurológico revelou síndrome psicomotora, a avaliação psicológica evidenciou transtornos relacionados com maturação do Ego em todos os casos. Encaminhadas à psicoterapia, apenas 13 crianças puderam atender a sessões individuais e semanais, por um período ininterrupto de seis meses a um ano. Nem dietas nem medicamentos foram prescritos. Reavaliação feita após seis meses e um ano, revelou redução da hiperatividade, aumento do rendimento escolar e melhor organização psíquica interna. Estes resultados são considerados forte evidência da origem psicodinâmica da síndrome hiperativa em crianças neurologicamente normais.

A group of 22 hyperactive children from 7 to 12 years of age was selected among 38 out-patients registered at Hospital do Servidor Público de São Paulo (Civil Servant Hospital of the State of São Paulo). Their psychiatric evaluation was negative, the neurological examination showed "psychomotor syndrome", and psychological evaluation revealed disorders related with Ego maturation in all cases. Although all children were referred to psychotherapy, only thirteen underwent individual sessions once a week for an uninterrupted period of up to one year. Neither diets nor medicines were prescribed. After six months and one year of treatment, the children were reevaluated. They showed improved school performance, reduced hyperactivity, and better internal psychic organization. These results are considered as undeniable evidence of the psychodynamic origin of hyperactivity syndrome in children, when no definite neurologic or psychiatric diseases are demonstrated.

182 crianças normais de 6 a 14 anos de idade foram neurologicamente examinadas. Os resultados relacionados à dominância lateral revelaram 156 (85,71%) destros, 8 (4,39%) canhotos e 18 (9,89%) com dominância indeterminada. O conceito de ambidestrismo fundamentado na equivalência de competência motora entre os antímeros foi rejeitado. A análise dos resultados leva a fundamentar na interação 'indivíduo-universo', a formação da dominância lateral. Considera-se nesta interação a aquisição de praxias e a criação de estruturas neuronais dinâmicas, em relação e concomitância com o surgimento e o desenvolvimento da ação motora.

182 normal children from 6 to 14 years old presenting learning difficulties were neurologically examined. A 149 items questionaire covering the intrauterine, peri and post partum life were answered by parents and afterwards detailed in interview consultation. Special procedures on motor skill were added to the usual neurological examination, to text motor performance differences between antimeres. Dextrallity appeared in 156 cases (85.71%), sinistrality in 8 (4.39%) and in 18 cases (9.89%) the lateral dominance could not be determined. The concept of ambidextrallity was rejected for the bilateral equivalence in motor competence was not found in the subjects. The results lead to interpret the lateral dominance as a proportional distribution of motor performances in the right and left halves of the body in a process of constant improvement of motor skills which takes place in and belongs to the development of interdependence between the individuals and their environment. It is by way of such interrelationships that the significant motor activity (praxias) is acquired. Lateral dominance is considered a dynamic mechanism resulting from this interactive process which aim is directed together with other mechanisms to provide and improve the human being survival.

Resultados parciais de exame neurológico em 182 crianças normais com idades entre 6 e 14 anos são discutidos quanto ao surgimento das praxias na interação indivíduo-universo em relação com a dominância lateral. Com respeito aos presentes resultados e com referência a dados da literatura é delineada uma hipótese sobre a relação do processo consciente com o ato motor.

The mechanisms and topology of the consciousness phenomenon are briefly presented. The present results and data from literature are used to point out that to localize in one certain part of the cerebrum the conscious process seems untenable. These results derive from the neurological examination on 182 normal children from 6 to 14 years old. The children's motor behaviour during the tests on 'praxia without object' shows the conscious process and attention to be attached to the motor action in the whole extension of its development. Therefore, the consciousness is considered such a process that is present at each moment and locus of the motor action. As pointed out by the present results, it seems that presence or absence of consciouness is regulated by intrapsychic mechanisms.

Eletromiograma de superfície foi realizado no crânio e pescoço, durante stress provocado por frio, em 100 pacientes sofrendo cefaléia crônica isolada. Os resultados de diagnóstico obtidos com a eletromiografia revelaram erro de 24% a 32% na avaliação clínica da cefaléia tensional segundo os critérios anamnésicos referendados pelo Comitê de Classificação das Cefaléias, da Sociedade Internacional de Cefaléia (1988). A eletromiografia durante stress é proposta como novo critério de diagnóstico da Cefaléia tensional.

We report the use of surface scalp and neck electromyography during experimental stress state in a series of 100 out-patients suffering from chronic tension headache. Results revealed a 24% to 32% of diagnostic errors in the diagnostic obtained by routine anamnestic procedures and following the criteria recommended by the Headache Classification Commitee of the International Headache Society (1988). The electromyography with stress is proposed as a new diagnostic criterion for tension headache.

Análise de resultados obtidos no estudo de uma série de 100 pacientes com diagnóstico de cefaléia tensional permitem sugerir 5 etapas de um processo fisiopatogênico implicado. Com base nesta sugestão, a indicação para o tratamento e respectiva eficácia, dependerão da etapa patogênica sobre a qual se pretenda fazer incidir a ação terapêutica.

Five steps in the pathogenic process involved in the tension headache pathogenesis are suggested from a 100 patients clinical study. Therapeutic efficacy in the treatment of the tension headache is considered to be linked to the relation between the therapeutic agent and the stage in which it has focused its effect, in the pathogenic process.

A dominância lateral foi verificada pelo eletromiograma de superfície em 100 crianças neurologicamente normais. Foram usados estímulos verbais durante os registros eletromiográficos. Em comparação com o diagnóstico clínico, a eletromiografia se revelou mais precisa, excluindo influências subjetivas nos resultados. Destrismo foi diagnosticado em 90 pacientes, canhotismo em 3 e dominância indefinida em 7. Mecanismos de ordem psicomotora são sugeridos para justificar as respostas motoras provocadas por estímulos verbais com conteúdo afetivo.

Surface electromyography was used to verify the lateral dominance in 100 six to fourteen years old normal children. Electromyographic records were obtained during verbal stimulation. Dexterity was found in 90, sinistrality in 3 and indefinite dominance in 7 patients. Comparing with results from clinical examination, the electromyography seems more accurate and easy to perform. The responses obtained after verbal stimulations were attributed to a psychomotor phenomenon. Mechanisms involved in the production of muscle contractions after verbal stimulation, were not proved. Pharmacologic action of cathecolamines on the central motor neural subsystems is advanced.

Registro de caso de melanoma maligno na região do ângulo ponto-cerebelar em paciente do sexo feminino, com 72 anos de idade, com exame neurológico e tomografia computadorizada sugestivos de neurinoma do acústico, em que o diagnóstico foi estabelecido pelo achado cirúrgico e pelo exame histopatológico. Como não foi achado foco primário no exame clínico e embora não tenha sido feita autopsia, há possibilidade de que o diagnóstico seja de melanoma maligno primário no sistema nervoso central. Esta localização particular desse tipo de tumor é considerada rara, levando em conta os dados da literatura.

A case of malignant melanoma in the cerebello-pontine angle region is presented in a 72 years old female patient, who had neurological examination and CT scan suggestive of acoustic neuroma. The surgical finding and the histological examination provided the diagnosis. As a primary focus was not found on clinical examination and although autopsy was not carried out, there is a possibility of the diagnosis being a primary malignant melanoma in CNS. This specific location for this kind of tumor was found to be rare when literature is looked up.