Group A Streptococcus can induce autoimmune disease in humans with particular involvement of the heart, joints, and brain. The spectrum of post-streptococcal disease of the central nervous system (CNS) has been widened recently and includes movement disorders (chorea, tics, dystonia, and Parkinsonism), psychiatric disorders (particularly emotional disorders), and associated sleep disorders. Neuroimaging and pathological studies indicate that the most vulnerable brain region is the basal ganglia. The immunopathogenesis of the disease is incompletely defined, and although there is some support for autoantibody-mediated disease, several conflicting studies cast doubt on the autoantibody hypothesis. It has been speculated that post-streptococcal autoimmunity has a role in common neuropsychiatric disease but the evidence is conflicting and routine screening of patients with Tourette syndrome and obsessive–compulsive disorder for post-streptococcal autoimmune abnormalities is not be recommended at present. However, post-streptococcal disorders of the CNS remain a useful model of neuropsychiatric disease, which may improve our understanding of abnormal movements and behaviours in children.

We present a systematic review on the effect of early intervention, starting between birth and a corrected age of 18 months, on motor development in infants at high risk for, or with, developmental motor disorders. Thirty-four studies fulfilled the selection criteria. Seventeen studies were performed within the neonatal intensive care unit (NICU) environment. Eight studies had a high methodological quality. They evaluated various forms of intervention. Results indicated that the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) intervention might have a temporary positive effect on motor development. Twelve of the 17 post-NICU studies had a high methodological quality. They addressed the effect of neurodevelopmental treatment (NDT) and specific or general developmental programmes. The results showed that intervention in accordance with the principles of NDT does not have a beneficial effect on motor development. They also indicated that specific or general developmental programmes can have a positive effect on motor outcome. We concluded that the type of intervention that might be beneficial for infants at preterm age differs from the type that is effective in infants who have reached at least term age. Preterm infants seem to benefit most from intervention that aims at mimicking the intrauterine environment, such as NIDCAP intervention. After term age, intervention by means of specific or general developmental programmes has a positive effect on motor development.

The notion of talent is an elusive concept but there appears to be sound evidence that both savants and experts share important qualities. Brief descriptive accounts of the talents displayed by savants are presented, along with a discussion of intelligence, implicit learning, and the organization of knowledge. Cognitive theories helpful in understanding exceptional abilities in people with autism are also discussed. It is concluded that a certain cognitive style, i.e. weak coherence, may predispose individuals to develop their talents. Although it would be interesting to speculate that some great artists and mathematicians show a similar degree of obsessive preoccupation and a cognitive style reminiscent of autistic spectrum disorder, presumably as a strategic mechanism, there is, as yet, little research on the subject.

magnetic resonance imaging (mri) of a 5-day-old female born at term with congenital leftsided hemiplegia revealed t2 shortening and t2* signal dropout lining the lateral wall of a focally enlarged right lateral ventricle, reflecting the deposition of haemosiderin or ferritin derived from periventricular venous infarction in utero. this observation strengthens the hypothesis that congenital hemiplegia in children born at term can result from a clinically silent periventricular venous infarction in utero. the loss of shortening of t2 in the right posterior limb of the internal capsule at birth was followed by prolongation of t2 at 1 year. it is important to evaluate the asymmetry of the posterior limb shown by mri to predict future hemiplegia and enable early therapy.

Virtual reality (VR) therapy is a new, neurorehabilitation intervention aimed at enhancing motor performance in children with hemiparetic cerebral palsy (CP). This case report investigated the effects of VR therapy on cortical reorganization and associated motor function in an 8-year-old male with hemiparetic CP. Cortical activation and associated motor development were measured before and after VR therapy using functional magnetic resonance imaging (fMRI) and standardized motor tests. Before VR therapy, the bilateral primary sensorimotor cortices (SMCs) and ipsilateral supplementary motor area (SMA) were predominantly activated during affected elbow movement. After VR therapy, the altered activations disappeared and the contralateral SMC was activated. This neuroplastic change was associated with enhanced functional motor skills including reaching, self-feeding, and dressing. These functions were not possible before the intervention. To our knowledge, this is the first fMRI study in the literature that provides evidence for neuroplasticity after VR therapy in a child with hemiparetic CP.

In two males, 11 and 12 years of age, referred for attention-deficit–hyperactivity disorder (ADHD), 47,XYY syndrome was diagnosed. A team that included a neuropsychologist, a physiotherapist, and a physician examined them. Stature (patients were above 97.5% height for age), muscle consistency, and tremor indicated chromosome analysis. Psychological tests results did not fully fit the ADHD diagnosis. On the basis of our clinical observation we felt that stimulant medication was indicated. Administration of methylphenidate led to improved motor and cognitive functions as well as social adaptation in both patients. We suggest that this treatment might well be considered in clinically similar patients with XYY sex chromosomes; we further suggest that learning problems in such individuals may be related to ADHD.

This review aimed to synthesize current research evidence to determine the effectiveness of conservative interventions for infants with positional plagiocephaly. A systematic review was conducted, where papers were sourced from 13 library and internet databases. Research was included if published in English between 1983 and 2003. Level of evidence and quality of each paper was assessed to determine studies' magnitude of inherent bias. Results were synthesized in a narrative format and were considered with respect to homogeneity of participants, response rate, and outcome measures. Sixteen papers met inclusion criteria: 12 were case series and four were comparative studies. The methodological quality of the studies was moderate to poor, thus their results should be interpreted with caution. A consistent finding was that counterpositioning±physiotherapy or helmet therapy may reduce skull deformity; however, it was not possible to draw conclusions regarding the relative effectiveness of these interventions. Further investigation is required to compare the effect of helmet therapy with counterpositioning alone or when combined with physiotherapy. First, there is a need to develop an outcome measurement battery which incorporates psychometrically-sound measures from the perspectives of clinicians and patients.

botulinum toxin a (btx-a) is increasingly being used in early management of spasticity in ambulant children with cerebral palsy (cp), with the aim of improving function, promoting muscle growth, and delaying the need for surgical intervention. however, there is a lack of evidence about the long-term outcome of btx-a injections. the focus on spasticity as the predominant problem in younger children with spastic cp may not fully consider the associated muscle weakness. it also raises concern that although btx-a may improve function in the short term, it has the potential to affect muscle growth and function adversely in the long term. a cautious approach to the early use of btx-a, with the use of objective outcome measures within a specialized multidisciplinary setting, is recommended, particularly in ambulant children with spastic diplegic cp, until further evidence is available on the long-term outcome of early btx-a injections in children with cp.