Cameron Nathan A, Gormley Mark E, Deshpande Supreet
Gillette Children's Specialty Healthcare, St. Paul, MN, USA.
Gillette Children's Specialty Healthcare, St. Paul, MN, USA Deptartment of Physical Medicine and Rehabilitation, University of Minnesota School of Medicine, Minneapolis, MN, USA.
J Pediatr Rehabil Med. 2013 Jan 1;6(4):239-42. doi: 10.3233/PRM-140258.
Cytomegalovirus (CMV) is a leading cause of congenital encephalopathy and cerebral palsy (CP). In this study we report the severity of disability in individuals who developed CP secondary to symptomatic congenital CMV encephalopathy.
The medical records of patients with CP secondary to symptomatic congenital CMV encephalopathy diagnosed from 1995 to 2011 were retrospectively reviewed. Gross Motor Functional Classification Scale (GMFCS) level, language function, and swallowing function were collected.
Twenty-three patients were found. Of those 23 patients, 83% (19/23) were at a GMFCS level IV or V, 9% (2/23) each GMFCS level II or III and none (0%) at GMFCS I. Eighteen patients were non-verbal, 3 had minimal to moderate verbal skills and 2 had no verbal impairment. Eighteen patients also had severe dysphagia requiring gastrostomy tube (GT) feedings, and 5 ate orally. There was a strong correlation between the severity of GMFCS and having a gastrostomy tube (p< 0.0006) and GMFCS and verbal skills (p< 0.0023).
This study shows that patients with CP secondary to symptomatic congenital cytomegalovirus encephalopathy have a very high risk of having severe physical and cognitive disabilities. This information can help healthcare providers and caregivers plan for the potential long-term medical, rehabilitation, and financial needs of this group of patients.
巨细胞病毒（CMV）是先天性脑病和脑瘫（CP）的主要病因。在本研究中，我们报告了因有症状的先天性CMV脑病继发脑瘫的个体的残疾严重程度。
回顾性分析1995年至2011年诊断为有症状的先天性CMV脑病继发脑瘫患者的病历。收集粗大运动功能分类量表（GMFCS）水平、语言功能和吞咽功能。
共发现23例患者。在这23例患者中，83%（19/23）处于GMFCS IV级或V级，9%（2/23）处于GMFCS II级或III级，无（0%）处于GMFCS I级。18例患者无言语能力，3例有轻度至中度言语能力，2例无言语障碍。18例患者还患有严重吞咽困难，需要胃造瘘管（GT）喂养，5例经口进食。GMFCS严重程度与胃造瘘管使用情况（p<0.0006）以及GMFCS与言语能力之间存在强相关性（p<0.0023）。
本研究表明，有症状的先天性巨细胞病毒脑病继发脑瘫的患者有非常高的严重身体和认知残疾风险。这些信息有助于医疗服务提供者和护理人员规划这组患者潜在的长期医疗、康复和经济需求。
