The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy
The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy
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DOI：
10.1055/s-2002-32368
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发表时间：
2002-04-01
期刊：
影响因子：
1.4
通讯作者：
Prechtl, HFR
中科院分区：
文献类型：
--
作者：
Einspieler, C;Cioni, G;Prechtl, HFR
新生儿和小婴儿自发运动活动的质量异常是后期痉挛性脑瘫的早期预测标志。这项研究的目的是确定哪些运动模式可能是后期运动障碍性脑瘫的特异性。在一项涉及四家欧洲医院的大型前瞻性纵向研究中，我们确定了 12 例患有相对罕见的运动障碍性脑瘫的病例，并将其早期运动发育与 12 例痉挛性脑瘫病例和 12 例对照进行了比较。从出生到产后第五个月，所有婴儿都被反复录像，并评估他们的自发运动模式，包括一般运动。直到产后第二个月，后来出现运动障碍的婴儿表现出较差的一般运动能力，即“手臂绕圈运动”和手指张开。异常的手臂和手指运动持续至少五个月，然后同时缺乏手臂和腿部向中线的运动。后来的运动障碍婴儿与后来的痉挛婴儿一样，都没有烦躁的运动，这是一种自发的运动模式，通常会出现三到五个月。对自发运动模式的定性评估使我们能够识别出生命早期患有运动障碍性脑瘫的高风险婴儿。此外，我们能够将他们与那些以后患痉挛性脑瘫的高风险婴儿区分开来。这是一个具有重要临床意义的问题，因为两种类型的脑瘫需要不同的治疗和早期干预。
Qualitative abnormalities of spontaneous motor activity in new-borns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed longitudinal study involving four European hospitals we identified twelve cases with the relatively rare condition of dyskinetic cerebral palsy and compared their early motor development with twelve spastic cerebral palsy cases and twelve controls. From birth to the fifth month post-term, all infants were repeatedly videoed and their spontaneous motor patterns, including general movements, were assessed. Until the second month post-term, the infants that later became dyskinetic displayed a poor repertoire of general movements, "arm movements in circles" and finger spreading. Abnormal arm and finger movements remained until at least five months and were then concurrent with a lack of arm and leg movements towards the midline. Later dyskinetic infants share with later spastic infants the absence of fidgety movements, a spontaneous movement pattern that is normally present from three to five months. Qualitative assessment of spontaneous motor patterns enabled us to identify infants at high risk for dyskinetic cerebral palsy early in life. Additionally, we were able to discriminate them from those infants at high risk for later spastic cerebral palsy. This is a matter of significant clinical relevance because the two types of cerebral palsy ask for different management and early intervention.