Brosig Cheryl L, Siegel Dawn H, Haggstrom Anita N, Frieden Ilona J, Drolet Beth A
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
Pediatr Dermatol. 2016 Jul;33(4):415-23. doi: 10.1111/pde.12870. Epub 2016 Jun 13.
Practitioners who work with children with posterior fossa, facial hemangiomas, arterial anomalies, cardiovascular anomalies, and abnormalities of the eye (PHACE) syndrome need information about neurodevelopmental outcomes to provide appropriate anticipatory guidance and education for parents. This study aimed to determine the neurodevelopmental outcomes in children with PHACE syndrome and identify which children may be at greatest risk for delays.
Children with a diagnosis of PHACE syndrome (ages 4-18 yrs) were recruited from the PHACE Syndrome International Clinical Registry and Genetic Repository. Participants (n = 25) underwent a neurodevelopmental evaluation at a children's hospital tertiary care referral center between 2009 and 2013. Children completed standardized neurocognitive tests assessing multiple domains. Parents completed standardized questionnaires assessing behavioral and emotional functioning.
Results were analyzed according to cohort and individual subject. Mean scores for the cohort did not differ significantly from test norms in most domains. The only subtest that the cohort scored lower on than test norms was Word Structure, a language task. Forty-four percent of the sample scored within the normal range in all domains, 28% had one score in the at-risk range (1-2 standard deviations [SDs] below the mean), 12% had two or more scores in the at-risk range, and 16% had at least one score in the impaired range (>2 SDs below the mean).
Although most children in this cohort of patients with PHACE syndrome did not have significant neurodevelopmental deficits, a subset of patients had delays in multiple areas. Practitioners who work with these children should routinely ask about neurocognitive and developmental skills. Children with more severe phenotypes should be referred for appropriate evaluations and intervention services.
从事小儿后颅窝、面部血管瘤、动脉异常、心血管异常及眼部异常(PHACE)综合征治疗的医生需要了解神经发育结果,以便为家长提供适当的预期指导和教育。本研究旨在确定PHACE综合征患儿的神经发育结果,并确定哪些患儿延迟风险最高。
从PHACE综合征国际临床登记处和基因库招募诊断为PHACE综合征的儿童(4至18岁)。2009年至2013年期间,25名参与者在一家儿童医院三级医疗转诊中心接受了神经发育评估。儿童完成了评估多个领域的标准化神经认知测试。家长完成了评估行为和情绪功能的标准化问卷。
根据队列和个体受试者分析结果。该队列在大多数领域的平均得分与测试常模无显著差异。该队列得分低于测试常模的唯一子测试是语言任务“单词结构”。44%的样本在所有领域得分均在正常范围内,28%有一个得分处于风险范围(低于平均值1至2个标准差[SD]),12%有两个或更多得分处于风险范围,16%至少有一个得分处于受损范围(低于平均值>2个标准差)。
虽然该队列中大多数PHACE综合征患儿没有明显的神经发育缺陷,但有一部分患儿在多个领域存在延迟。治疗这些患儿的医生应常规询问神经认知和发育技能。具有更严重表型的患儿应转诊接受适当的评估和干预服务。