Naslov
Dykinetic cerebral palsy in asphyxiated term neonates – the challenge to identify mild lesions

Autori
Mejaški Bošnjak, Vlatka ; Krägeloh-Mann, Ingeborg ; Đaković, Ivana ; Marjanović, Josip ; Grmoja, Tonći

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
41. simpozij Hrvatskog društva za dječju neurologiju s međunarodnim sudjelovanjem, Hrvatski liječnički zbor, Zagreb, 8. prosinac 2012. Zbornik radova. / Gojmerac, Tomislav - Zagreb, 2012, 43-43

Skup
41. simpozij Hrvatskog društva za dječju neurologiju s međunarodnim sudjelovanjem, Hrvatski liječnički zbor, Zagreb, 8. prosinac 2012.

Mjesto i datum
Zagreb, Hrvatska, 08.12.2012

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
dykinetic cerebral palsy; asphyxia; term neonates; brain lesions

Sažetak
Scientific background: Dyskinetic CP is rare (7% of total CP), but typically caused by hypoxic lesions of thalami and basal ganglia in term aspyxiated neonates. Aims: This study illustrates the importance of good neuroimaging in dyskinetic cerebral palsy (CP) following asphyxia on example of two term born boys. Methods and subjects: The first boy was born with Apgar scores 1/5 and resuscitated. Motor development was delayed, but intellectual functions near normal. Communications problems occurred due to orofacial dyskinesia. The second boy suffered severe intrapartal asphyxia, caused by placental abruption and ruptured uterus, with Apgar score 1/3, resuscitated. His motor milestones were markedly delayed, while intellectual development was normal. His school performance was disturbed by severe dysarthria. Both children, assessed at age of 15 years, were diagnosed as dysknetic CP, using Surveillance of Cerebral Palsy (SCPE) functional classification: Patient 1, GMFCS 2, BFMCS 3b ; Patient 2, GMFCS 5, BMFM 5, with accompanying impairments of epilepsy and communications problems (Viking Speech Scale, 2010, level 3) in both patients. Results and discussion: In both children brain MRI, performed at the age of 15 years (1.5 Tesla), revealed mild but typical bilateral deep grey matter lesions involving the ventrolateral thalamus (Patient 1, 2) and posterior putamen (Patient 2) best seen on T2 w and Flair images. Both children were term born with clear signs of asphyxia and hypoxic-ischemic encephalopathy and then developed dyskinetic CP with severe communication problems but near normal intellectual functions. Brain MRI of both children illustrated mild but bilateral lesions in thalami and in putamen (Patient 2). In cases of asphyxiated neonates developing dyskinetic CP, MRI of good quality is an important diagnostic step. Lesions although small but in strategic domains can cause severe motor impairment, but may be overlooked.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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