Jauhari Prashant, Singhi Pratibha, Sankhyan Naveen, Malhi Prahbhjot, Vyas Sameer, Khandelwal Niranjan
1 Pediatric Neurology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
2 Child Psychology Unit, Department of Pediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
J Child Neurol. 2018 Apr;33(5):333-339. doi: 10.1177/0883073817754175. Epub 2018 Feb 21.
This study compared the risk factors and clinical and radiologic profile of children with spastic diplegic cerebral palsy born at term (≥37 weeks) with those born preterm. Children (2-14 years) with cerebral palsy meeting the study criteria for spastic diplegia were enrolled. Antecedent risk factors, clinical profile, and magnetic resonance imaging (MRI) findings were recorded. Spasticity, functional ability, intellectual ability, and social quotient were assessed using standard scales. Ninety-three children met the study inclusion criteria (45 term, 48 preterm). Moderate to severe intellectual disability (53% vs 21%, P = .001) and epilepsy (51% vs 33%) were significantly more common in term-born children, whereas periventricular white matter injury was less common in term-born children (64%vs 89.4%, P = .004). Term spastic diplegia was associated with cortical/subcortical involvement in (11/42 (26%) vs 3/47(6.4%); P = .01). We conclude that term-spastic-diplegia is clinicopathologically different from preterm-spastic-diplegia. Their neuroradiologic pattern also differs with more frequent involvement of cortical/subcortical areas.
本研究比较了足月儿(≥37周)和早产儿痉挛性双瘫型脑瘫患儿的危险因素、临床及影像学特征。纳入符合痉挛性双瘫研究标准的2至14岁脑瘫患儿。记录其既往危险因素、临床特征及磁共振成像(MRI)结果。使用标准量表评估痉挛程度、功能能力、智力能力和社会商数。93名儿童符合研究纳入标准(45名足月儿,48名早产儿)。足月儿中重度智力残疾(53%对21%,P = .001)和癫痫(51%对33%)明显更为常见,而脑室周围白质损伤在足月儿中较少见(64%对89.4%,P = .004)。足月儿痉挛性双瘫与皮质/皮质下受累相关(11/42(26%)对3/47(6.4%);P = .01)。我们得出结论,足月儿痉挛性双瘫在临床病理上与早产儿痉挛性双瘫不同。它们的神经放射学模式也有所不同,皮质/皮质下区域受累更为频繁。