Frontiers in neurology
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Frontiers in neurology · Jan 2014
Measurement of serum melatonin in intensive care unit patients: changes in traumatic brain injury, trauma, and medical conditions.
Melatonin is an endogenous hormone mainly produced by the pineal gland whose dysfunction leads to abnormal sleeping patterns. Changes in melatonin have been reported in acute traumatic brain injury (TBI); however, the impact of environmental conditions typical of the intensive care unit (ICU) has not been assessed. The aim of this study was to compare daily melatonin production in three patient populations treated at the ICU to differentiate the role of TBI versus ICU conditions. ⋯ All of these patient groups demonstrated decreased melatonin concentrations when compared to control patients. This study suggests that TBI as well as ICU conditions, may have a role in the dysfunction of melatonin. Monitoring and possibly substituting melatonin acutely in these settings may assist in ameliorating long-term sleep dysfunction in all of these groups, and possibly contribute to reducing secondary brain injury in severe TBI.
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Frontiers in neurology · Jan 2014
Vestibular migraine in children and adolescents: clinical findings and laboratory tests.
Vestibular migraine (VM) is the most common cause of episodic vertigo in children. We summarize the clinical findings and laboratory test results in a cohort of children and adolescents with VM. We discuss the limitations of current classification criteria for dizzy children. ⋯ Patients with definite, probable, and suspected VM do not differ in the frequency of ocular motor, vestibular, or postural abnormalities. VM is the best explanation for their symptoms. It is essential to establish diagnostic criteria in clinical studies. In clinical practice, however, the most reasonable diagnosis should be made in order to begin treatment. Such a procedure also minimizes the fear of the parents and children, reduces the need to interrupt leisure time and school activities, and prevents the development of SV.