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Dyskinetic cerebral palsy: a population‐based study of children born between 1991 and 1998
Author(s) -
Himmelmann K,
Hagberg G,
Wiklund L M,
Eek M N,
Uvebrant P
Publication year - 2007
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2007.00246.x
Subject(s) - cerebral palsy , gross motor function classification system , pediatrics , spasticity , medicine , placental abruption , population , etiology , gestational age , pregnancy , gestation , physical therapy , environmental health , biology , genetics
The aim of this study was to describe the epidemiology, aetiology, and clinical findings in dyskinetic cerebral palsy (CP)in a population‐based follow‐up study of children born between 1991 and 1998. Age range at ascertainment was 4 to 8 years and prevalence was 0.27 per 1000 live‐births. Forty‐eight children were examined (27 males, 21 females; mean age 9y, range 5‐13y). Thirty‐nine had dystonic CP and nine a choreo‐athetotic subtype. Primitive reflexes were present in 43 children and spasticity in 33. Gross Motor Function Classification System levels were: Level IV, n = 10 and Level V, n = 28. The rate of learning disability ( n = 35) and epilepsy ( n = 30) increased with the severity of the motor disability. Thirty‐eight children had anarthria. Peri‐ or neonatal adverse events had been present in 34 of 42 children born at ≥34 weeks’ gestation. Motor impairment was most severe in this group. Placental abruption or uterine rupture had occurred in 8 participants and 19 of the 42 near‐term/term children required assisted ventilation, compared with 1% and 12% respectively in other CP types. Neuroimaging in 39 children born at ≥34 weeks revealed isolated, late third trimester lesions in 24 and a combination of early and late third trimester lesions in seven. Dyskinetic CP is the dominant type of CP found in term‐born, appropriate‐for‐gestational‐age children with severe impairments who have frequently experienced adverse perinatal events.