Einspieler Christa, Peharz Robert, Marschik Peter B
Research Unit Interdisciplinary Developmental Neuroscience (iDN), Institute of Physiology, Medical University of Graz, Graz, Austria.
Research Unit Interdisciplinary Developmental Neuroscience (iDN), Institute of Physiology, Medical University of Graz, Graz, Austria.
J Pediatr (Rio J). 2016 May-Jun;92(3 Suppl 1):S64-70. doi: 10.1016/j.jped.2015.12.003. Epub 2016 Mar 17.
To describe fidgety movements (FMs), i.e., the spontaneous movement pattern that typically occurs at 3-5 months after term age, and discuss its clinical relevance.
A comprehensive literature search was performed using the following databases: MEDLINE/PubMed, CINAHL, The Cochrane Library, Science Direct, PsycINFO, and EMBASE. The search strategy included the MeSH terms and search strings ('fidgety movement*') OR [('general movement*') AND ('three month*') OR ('3 month*')], as well as studies published on the General Movements Trust website (www.general-movements-trust.info).
Virtually all infants develop normally if FMs are present and normal, even if their brain ultrasound findings and/or clinical histories indicate a disposition to later neurological deficits. Conversely, almost all infants who never develop FMs have a high risk for neurological deficits such as cerebral palsy, and for genetic disorders with a late onset. If FMs are normal but concurrent postural patterns are not age-adequate or the overall movement character is monotonous, cognitive and/or language skills at school age will be suboptimal. Abnormal FMs are unspecific and have a low predictive power, but occur exceedingly in infants later diagnosed with autism.
Abnormal, absent, or sporadic FMs indicate an increased risk for later neurological dysfunction, whereas normal FMs are highly predictive of normal development, especially if they co-occur with other smooth and fluent movements. Early recognition of neurological signs facilitates early intervention. It is important to re-assure parents of infants with clinical risk factors that the neurological outcome will be adequate if FMs develop normally.
描述不安运动(FMs),即足月年龄后3至5个月通常出现的自发运动模式,并讨论其临床相关性。
使用以下数据库进行了全面的文献检索:MEDLINE/PubMed、CINAHL、Cochrane图书馆、Science Direct、PsycINFO和EMBASE。检索策略包括医学主题词和检索词(“不安运动*”)或[(“一般运动*”)且(“三个月*”)或(“3个月*”)],以及在一般运动信托网站(www.general-movements-trust.info)上发表的研究。
如果不安运动存在且正常,几乎所有婴儿都会正常发育,即使其脑部超声检查结果和/或临床病史表明有日后出现神经功能缺损的倾向。相反,几乎所有从未出现不安运动的婴儿都有患神经功能缺损(如脑瘫)和迟发性遗传疾病的高风险。如果不安运动正常但同时出现的姿势模式不符合年龄特征或整体运动特征单调,则学龄期的认知和/或语言技能将不理想。异常的不安运动不具有特异性,预测能力低,但在后来被诊断为自闭症的婴儿中极为常见。
异常、缺失或零星的不安运动表明日后出现神经功能障碍的风险增加,而正常的不安运动对正常发育具有高度预测性,尤其是当它们与其他平稳流畅的运动同时出现时。早期识别神经学体征有助于早期干预。重要的是要向有临床风险因素的婴儿家长保证,如果不安运动正常发育,神经学结果将是良好的。