Spasticity and Dystonia are Underidentified in Young Children at High Risk for Cerebral Palsy

2021 ◽  
pp. 088307382110596
Author(s):  
Hanyang Miao ◽  
Amit M. Mathur ◽  
Bhooma R. Aravamuthan
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Young Children ◽  
Diagnostic Workup ◽  
Hypoxic Ischemic Encephalopathy ◽  
Targeted Treatment ◽  
Children With Cerebral Palsy ◽  
Ischemic Encephalopathy

Background Early spasticity and dystonia identification in cerebral palsy is critical for guiding diagnostic workup and prompting targeted treatment early when it is most efficacious. However, differentiating spasticity from dystonia is difficult in young children with cerebral palsy. Methods We sought to determine spasticity and dystonia underidentification rates in children at high risk for cerebral palsy (following neonatal hypoxic-ischemic encephalopathy) by assessing how often child neurologists identified hypertonia alone versus specifying the hypertonia type as spasticity and/or dystonia by age 5 years. Results Of 168 children, 63 developed cerebral palsy and hypertonia but only 19 (30%) had their hypertonia type specified as spasticity and/or dystonia by age 5 years. Conclusions Child neurologists did not specify the type of hypertonia in a majority of children at high risk of cerebral palsy. Because early tone identification critically guides diagnostic workup and treatment of cerebral palsy, these results highlight an important gap in current cerebral palsy care.

scholarly journals Risk factors and the occurrence of cerebral palsy in high risk infants

2018 ◽  
Vol 58 (2) ◽  
pp. 95-100
Author(s):  
Setyo Handryastuti ◽  
Sofyan Ismael ◽  
Sudigdo Sastroasmoro ◽  
Asril Aminulah ◽  
Ferial Hadipoetro Idris ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cerebral Palsy ◽  
High Risk ◽  
Survival Rates ◽  
Significant Risk ◽  
Hypoxic Ischemic Encephalopathy ◽  
First Year ◽  
Factors Associated ◽  
Cerebral Ultrasound ◽  
Ischemic Encephalopathy

Background The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

Determinants of self-care participation of young children with cerebral palsy

2014 ◽  
Vol 17 (6) ◽  
pp. 403-413 ◽  
Author(s):  
Doreen J. Bartlett ◽  
Lisa A. Chiarello ◽  
Sarah Westcott McCoy ◽  
Robert J. Palisano ◽  
Lynn Jeffries ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Young Children ◽  
Self Care ◽  
Children With Cerebral Palsy

scholarly journals Early Development of Locomotor Patterns and Motor Control in Very Young Children at High Risk of Cerebral Palsy, a Longitudinal Case Series

2021 ◽  
Vol 15 ◽  
Author(s):  
Annike Bekius ◽  
Margit M. Bach ◽  
Laura A. van de Pol ◽  
Jaap Harlaar ◽  
Andreas Daffertshofer ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Young Children ◽  
Early Development ◽  
Muscle Activation ◽  
Brain Lesions ◽  
Very Young Children ◽  
Gait Parameters ◽  
Locomotor Patterns ◽  
Over Time

The first years of life might be critical for encouraging independent walking in children with cerebral palsy (CP). We sought to identify mechanisms that may underlie the impaired development of walking in three young children with early brain lesions, at high risk of CP, via comprehensive instrumented longitudinal assessments of locomotor patterns and muscle activation during walking. We followed three children (P1–P3) with early brain lesions, at high risk of CP, during five consecutive gait analysis sessions covering a period of 1 to 2 years, starting before the onset of independent walking, and including the session during the first independent steps. In the course of the study, P1 did not develop CP, P2 was diagnosed with unilateral and P3 with bilateral CP. We monitored the early development of locomotor patterns over time via spatiotemporal gait parameters, intersegmental coordination (estimated via principal component analysis), electromyography activity, and muscle synergies (determined from 11 bilateral muscles via nonnegative matrix factorization). P1 and P2 started to walk independently at the corrected age of 14 and 22 months, respectively. In both of them, spatiotemporal gait parameters, intersegmental coordination, muscle activation patterns, and muscle synergy structure changed from supported to independent walking, although to a lesser extent when unilateral CP was diagnosed (P2), especially for the most affected leg. The child with bilateral CP (P3) did not develop independent walking, and all the parameters did not change over time. Our exploratory longitudinal study revealed differences in maturation of locomotor patterns between children with divergent developmental trajectories. We succeeded in identifying mechanisms that may underlie impaired walking development in very young children at high risk of CP. When verified in larger sample sizes, our approach may be considered a means to improve prognosis and to pinpoint possible targets for early intervention.

Family ecology of young children with cerebral palsy

2013 ◽  
Vol 40 (4) ◽  
pp. 562-571 ◽  
Author(s):  
A. LaForme Fiss ◽  
L. A. Chiarello ◽  
D. Bartlett ◽  
R. J. Palisano ◽  
L. Jeffries ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Young Children ◽  
Family Ecology ◽  
Children With Cerebral Palsy

Variants of the OLIG2 Gene are Associated with Cerebral Palsy in Chinese Han Infants with Hypoxic–Ischemic Encephalopathy

2018 ◽  
Vol 21 (1) ◽  
pp. 75-84 ◽  
Author(s):  
Liya Sun ◽  
Lei Xia ◽  
Mingtai Wang ◽  
Dengna Zhu ◽  
Yangong Wang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Hypoxic Ischemic Encephalopathy ◽  
Chinese Han ◽  
Ischemic Encephalopathy
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