Paediatria Croatica, Vol. 57 No. 2, 2013.
Professional paper
DYSKINETIC CEREBRAL PALSY IN TERM ASPHYXIATED NEONATES – CLINICAL FEATURES AND BRAIN MAGNETIC RESONANCE IMAGING
Vlatka Mejaški Bošnjak
orcid.org/0000-0002-1068-5037
; Department of Pediatrics, Children's Hospital Zagreb, Klaićeva 16, Zagreb
Ivana Đaković
; Department of Pediatrics, Children's Hospital Zagreb, Klaićeva 16, Zagreb
Josip Marjanović
; Children's Hospital Zagreb, Klaićeva 16, Zagreb
Tonći Grmoja
; Children's Hospital Zagreb, Klaićeva 16, Zagreb
Abstract
Dyskinetic cerebral palsy is rare, occurring in about 14 per 100 000 live births and accounting for about 7% of all cerebral palsy cases, but represents one of the most disabling forms of cerebral palsy. Increasing use of magnetic resonance imaging offers an opportunity to visualize brain lesions in cerebral palsy, which is in dyskinetic cerebral palsy typically caused by hypoxic lesions of the thalami, basal ganglia and parasagittal region and hippocampus in term asphyxiated neonates. Moreover, degrees of magnetic resonance imaging lesion patterns can be defined, which correlate with the severity of motor impairment and accompanying neurodevelopmental disorders. The aim of this study was to describe the profile of motor disability and accompanying impairments in children with dyskinetic cerebral palsy in four term asphyxiated infants as well as their magnetic resonance imaging lesion patterns. All four term children had severe perinatal asphyxia according to data at birth, followed by moderate to severe hypoxic-ischemic encephalopathy in three of them. Subsequent magnetic resonance imaging showed hypoxic lesions of the thalami, basal ganglia and central regions or hippocampus, classified as mild (Patients 2 and 4) or severe (Patients 1 and 3). Neurodevelopmental outcome was poor in three of the four children. Three of them had severe dyskinetic cerebral palsy of choreoathetoid subtype, whereas the fourth patient had less severe dyskinetic cerebral palsy. Accompanying impairments were in all four patients related to severe speech disturbance, epilepsy in Patients 1 and 4, while cognitive development was normal or mildly affected. The severity of dyskinetic cerebral palsy and accompanying disorders correlated with the severity of hypoxic lesions in the strategic domain, i.e. thalamus, n. lenticularis, central regions and hippocampus.
Keywords
cerebral palsy; asphyxia; infant, newborn; thalamus; basal ganglia; hippocampus; magnetic resonance imaging
Hrčak ID:
105047
URI
Publication date:
25.6.2013.
Visits: 2.130 *