engleski

Dyskinetic cerebral palsy in term asphyxiated neonates - clinical features and brain magnetic resonance imaging

Dyskinetic cerebral palsy is rare, occurs in about 14 per 100, 000 live births, constituting about 7% of all cerebral palsy cases, but represents one of the most disabling forms of cerebral palsy. Increasing use of magnetic resonance imaging gives us opportunity to visualize brain lesions in cerebral palsy which is in dyskinetic cerebral palsy typically caused by hypoxic lesions of thalami, basal ganglia and parasagittal region and hippocampus in term asphyxiated neonates. Moreover, degrees of magnetic resonance imaging lesions patterns could be defined, which correlate with severity of motor impairment and accompanying neurodevelopmental disorders. The aim of this study was to describe 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 thalami, basal ganglia and central regions or hippocampus which are classified as mild (Patient 2 and 4) or severe (Patient 1 and 3). Neurodevelopmental outcome was poor in three of four children. Three of them have severe dyskinetic cerebral palsy of choreo-athetotic subtype, whereas fourth patient has less severe dyskinetic cerebral palsy. Accompanying impairments were in all four patients related to severe speech disturbance, epilepsy have Patent 1 and 4, while cognitive development was normal or mildly affected. Severity of dyskinetic cerebral palsy and accompanying disorders correlated with severity of hypoxic lesions in strategical domain i.e. thalamus, n. lenticularis, central regions and hippocampus.

dyskinetic cerebral palsy; perinatal asphyxia; term neonate; hypoxic brain lesion; thalamus; basal ganglia; parasagittal lesion; hippocampus

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