Cramped synchronized general movements in preterm infants as an early marker for cerebral palsy
Cramped synchronized general movements in preterm infants as an early marker for cerebral palsy
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DOI：
10.1001/archpedi.156.5.460
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发表时间：
2002-05-01
影响因子：
--
通讯作者：
Prechtl, HFR
中科院分区：
文献类型：
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作者：
Ferrari, F;Cioni, G;Prechtl, HFR
目的：为了确定是否有特定的异常（即痉挛性同步一般运动[GM]）可以预测脑性瘫痪和受脑损伤影响的早产儿后期运动障碍的严重程度。设计：对84例超声异常的早产儿从出生至经后56~60周进行常规神经系统检查，并对GM进行连续录像和盲法观察，GM异常的发展过程进行了比较，脑超声结果单独和神经系统检查的结果，在病人的结果在2至3 years. Results：婴儿一致或占主导地位（33例）痉挛同步GM开发脑瘫。痉挛性同步GM越早被观察到，神经学结果越差。暂时性痉挛性同步字符GMs（8例），其次是轻度脑瘫（坐立不安的运动）或正常发育（坐立不安的运动存在）。13例正常肌球蛋白和30例肌球蛋白表达差的患儿，要么预后正常（84%），要么脑瘫伴轻度运动障碍（16%）。GMs的观察是100%的敏感性，和特异性的痉挛同步GMs为92.5%至100%，在整个年龄范围内，这是远远高于神经系统examination.Conclusions的特异性：一致的和占主导地位的痉挛同步GMs具体预测脑瘫。这种特征出现得越早，后期的损害就越严重。
Objective: To ascertain whether specific abnormalities (ie, cramped synchronized general movements [GMs]) can predict cerebral palsy and the severity of later motor impairment in preterm infants affected by brain lesions.Design: Traditional neurological examination was performed, and GMs were serially videotaped and blindly observed for 84 preterm infants with ultrasound abnormalities from birth until 56 to 60 weeks' postmenstrual age, The developmental course of GM abnormalities was compared with brain ultrasound findings alone and with findings from neurological examination, in relation to the patient's outcome at age 2 to 3 years.Results: Infants with consistent or predominant (33 cases) cramped synchronized GMs developed cerebral palsy. The earlier cramped synchronized GMs were observed, the worse was the neurological outcome. Transient cramped synchronized character GMs (8 cases) were followed by mild cerebral palsy (fidgety movements were absent) or normal development (fidgety movements were present). Consistently normal GMs (13 cases) and poor repertoire GMs (30 cases) either lead to normal outcomes (84%) or cerebral palsy with mild motor impairment (16%). Observation of GMs was 100% Sensitive, and the specificity of the cramped synchronized GMs was 92.5% to 100% throughout the age range, which is much higher than the specificity of neurological examination.Conclusions: Consistent and predominant cramped synchronized GMs specifically predict cerebral palsy. The earlier this characteristic appears, the worse is the later impairment.