Background: While the predictive value of general movements for later cerebralpalsy is well known, its value to predict minor neurological and developmental impairments is less clear. AIM: To analyze the results of the assessment of general movements in relation to the developmental outcome measured by the Bayley scales of infant development in a group of preterm infants. Methods: Twenty-six preterm infants (gestational age from 23 weeks to36 weeks) were included. The results of the assessment of general movements at term age and at 3 months corrected age were compared to the results of the mental and psychomotor developmental index of the Bayley scales assessed between two and three years of chronological age. Results: Infants with normal writhing general movements achieved the highest scores on the mental and psychomotor developmental index, and those with cramped-synchronized general movements had the lowest scores. Infants with normal general movementsduring the fidgety period achieved the highest scores on both scales;those with an absence of fidgety movements achieved the lowest scores. We found the sensitivity of general movements to predict cognitive impairmentsto be 1.00 during the writhing period and 0.83 during the fidgety period; and 0.85 and 0.54, respectively, to predict motor impairments. The differences in the mental developmental index score between the groups with different qualities of general movements were significant in the writhing period and approached significance in the fidgety period, while for the psychomotor developmental index the differences between the groups with different qualities of general movements were not significant. Conclusion: Thequality of general movements may be predictive of later development.
COBISS.SI-ID: 26436313
Aim To study the correlations between neurological signs and developmental performance, and to analyze the value of neurological signs in identification of developmental disabilities. Methods A group of 26 preterm infants (gestational age from 23 weeks to 36 weeks) was studied. The neurological assessment described by Amiel-Tison and Gosselin was performed at term age andrepeated every 3 months up to the age of 2, when the sum of all adverse findings was categorized. According to the nature and associations of neurological and cranial signs, patients were divided into 5 categories: 1) cerebral palsy; 2) minimal cerebral palsy; 3) Amiel-Tison triad; 4) intermediate; and 5) normal. Developmental assessment using the Bayley Scales of Infant Development, second edition, was performed between the age of 2 and 3, and the Mental and Psychomotor Developmental Index was determined. Results The developmental performance was highest in the group of children without neurological signs and lowest in the group with cerebral palsy. There was a strong correlation between neurological signs and mental developmental performance (Spearman fÏ = 0.71), while the correlation between neurological signs and psychomotor developmental performance was weaker (Spearman Ï = 0.54). Conclusion Categorization of neurological assessment and identificationof 3 minor neurological signs may be a valuable tool for early detection of children with developmental disabilities.
COBISS.SI-ID: 26200281
Background: During early development severe epilepsies may appear, some with well established occurrence. Benign non-epileptic and epileptic paroxysmal syndromes with excellent prognosis occur in the same period. There are no exact data on their occurrence. Aim We have reviewed medical histories of children with benign non-epileptic or benign epileptic events: benign myoclonus of early infancy, benign neonatal sleep myoclonus, benign sleep myoclonus in infancy, benign partial epilepsy in infancy (BPEI) and benign infantile familial convulsions (BIFC) were established. The occurrence, clinical characteristics and prognosis of these syndromes were evaluated. Methods: Inclusion criteria were met in 31 children. Research included retrospective analysis of clinical characteristics, laboratory values, neuroimaging and neurophysiological assessments, followed by evaluation of psychosocial development with the use of the Strengths and Difficulties Questionnaire (SDQ), fulfilled by parents. Results: In our group the incidenceof benign non-epileptic convulsions was 6.69 per 10 000 live births and the incidence of benign epileptic convulsions was 1.35 per 10 000. Male/female ratio in the group of children with non-epileptic events was 2.1:1. Among non-epileptic group 5 out of 23 children and among epileptic group 3 out of 8 children had minimal, mild or moderate abnormalities at neurological assessment at the time of the first clinical examination. Nonspecific changes in laboratory values were seen in 6 out of 23 in the non-epileptic and in 1 out of 8 children in the epileptic group. Neurophysiological assessments showed subtle changes in 4/23 in the non-epileptic and 6/8 in the epileptic group. Neuroimaging was not optimal in 5/23 with non-epileptic and 3/8 with epileptic events. Analysis of SDQ did notshow significant deviations in psyhosocial development. Statistically significant deviation was observed only in relations with peers (p = 0.009). Conclusions: Benign neonatal and infantile convulsions are more frequent than severe epilepsies of the same age period. Results show higher proportion of males with benign non-epileptic conditions. No deviations in further development was found. Laboratory values, neuroimaging and neurophysiological assessments were normal or nonspecifically changed.
Background: Pineal cysts are benign glial uniloculated or multiloculated fluid-filled sacs located in the pineal gland region. Small pineal cysts are often found incidentally in healthy adults in 1.5-10.8%. Large cysts may causeneurological problems due to pressure exertion on adjacent structures. Methods: We have used prospective, observational study of an inception cohort of 16 adolescents of mean age 21.69 years (SD= 0.87) with mild (68.7%) to moderate (31.3%) HIE: 7 girls (43.8%) and 9 (56.3%) boys, born with mean gestational age of 35.75 weeks (SD= 3.80) and mean birthweight of 2 644 g (SD=815). HIE was confirmed by presence of abnormal CTG and/or meconium and/orApgar scores less than 7 at 5 minutes and/or need for resuscitation and/or cord pH less than 7.2 and /or BE more than -15. The clinical assessmentof HIE was done according to the Sarnat-Sarnat scoring. Neonatal data, including EEG and imaging data, were collected. Adolescents were scannedwith 3T Magnetom Trio Tim, Siemens, head coil 12 channels, regular sequences and sagittal 3D magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequence with voxel size 1 mm3. Neurological outcome was determined. Results: In 1 patient we found cortical dysplasia and 1 had a panic attack hence their data were omitted. In the group of 14 we have incidentally found in 5 patients a larger, asymptomatic pineal cysts with the overall incidence of 36%. Other MR findings in the group were in 50% white matter injury, in 50% thinner corpus callosum. No statistically significant difference between neonatal cUS and late follow-up MRI (p=0.881) was found. Correlation was not significant with Spearman correlation koefficient 0.201. Presence of pineal cysts was linked to thinner corpus callosum (p=0.005). Conclusions: We propose that larger pineal cyst, in the absence of other imaging findings except for thinner corpus callosum, is a benign consequence of mild hypoxia in a near-term brain.
COBISS.SI-ID: 29350105
We evaluated the functional outcome in a cohort of 22 children with mitochondrial diseases. The Pediatric Evaluation of Disability Inventory was administered and scaled scores determined. A large variability in functional skills was seen in all 3 assessed domains: Self-Care (46.4 +/- 25.6 S.D.; median 42.4; range 11.8-100), Mobility (47.1 +/- 30.4 S.D.; median 46.7; range6.1-100), and Social Function (49.7 +/- 22.3 S.D.; median 45.6; range 21.6-100). There was also a large variability in caregiver assistance, rangingfrom independent functioning to total dependence on assistance for the following: Self-Care (29.0 +/- 33.7 S.D.; median 10.1; range 0-100), Mobility (36.6 +/- 38.5 S.D.; median 26.1; range 0-100), and Social Function (42.9 +/- 32.4 S.D.; median 44.4; range 0-100). The Pediatric Evaluation of Disability Inventory scores describe in depth different, but strongly related, aspects of everyday functioning in children with mitochondrial diseases. The importance of caregiver assistance in helping these children should not be underestimated. The use of assistive devices was estimated, which were found to be used by few patients.
COBISS.SI-ID: 28533977