Kulak Wojciech, Sobaniec Wojciech, Smigielska-Kuzia Joanna, Kubas Bozena, Walecki Jerzy
Department of Pediatric Neurology and Rehabilitation, University of Białystok, Białystok, Poland.
Pediatr Neurol. 2005 May;32(5):311-7. doi: 10.1016/j.pediatrneurol.2005.01.006.
The aim of this study was to compare spastic diplegic and tetraplegic cerebral palsy. Thirty-eight children had spastic diplegic cerebral palsy and 48 spastic tetraplegic cerebral palsy. Risk factors of cerebral palsy, seizures, severity of cerebral palsy, electroencephalogram, and magnetic resonance imaging findings were analyzed. Gestational history, low birth weight, and perinatal pathologies were present in similar percentages in both groups. Lower values of the Apgar score were recorded more often in the tetraplegic cerebral palsy group than the diplegic group. The children with spastic diplegia were classified more frequently into levels I and II of the Gross Motor Function Classification System, but patients with spastic tetraplegia were classified more frequently into levels IV and V. Similarly, mental retardation was observed more frequently in the patients with spastic tetraplegia. In magnetic resonance imaging, periventricular leukomalacia was detected in a higher proportion of children with spastic diplegia than in patients with tetraplegia. Cerebral atrophy occurred more frequently in the tetraplegic group compared with diplegic patients. Twenty-four (50.0%) children with spastic tetraplegia had epilepsy compared with six children with spastic diplegia. The incidence of intractable epilepsy was higher in the tetraplegic patients than in the children with spastic diplegia.
本研究的目的是比较痉挛型双瘫和四肢瘫型脑瘫。38名儿童患有痉挛型双瘫脑瘫,48名患有痉挛型四肢瘫脑瘫。分析了脑瘫的危险因素、癫痫发作情况、脑瘫严重程度、脑电图及磁共振成像结果。两组中妊娠史、低出生体重和围产期病变的出现比例相似。四肢瘫脑瘫组的阿氏评分较低值出现的频率高于双瘫组。痉挛型双瘫儿童更常被归类为粗大运动功能分类系统的I级和II级,但痉挛型四肢瘫患者更常被归类为IV级和V级。同样,痉挛型四肢瘫患者中智力发育迟缓更为常见。在磁共振成像中,痉挛型双瘫儿童中检测到脑室周围白质软化的比例高于四肢瘫患者。与双瘫患者相比,四肢瘫组脑萎缩的发生率更高。24名(50.0%)痉挛型四肢瘫儿童患有癫痫,而痉挛型双瘫儿童有6名。四肢瘫患者中难治性癫痫的发生率高于痉挛型双瘫儿童。