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在一项基于人群的研究中,三分之一学龄期脑瘫儿童存在神经精神障碍。

One-third of school-aged children with cerebral palsy have neuropsychiatric impairments in a population-based study.

机构信息

Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.

出版信息

Acta Paediatr. 2019 Nov;108(11):2048-2055. doi: 10.1111/apa.14844. Epub 2019 Jun 13.

Abstract

AIM

To describe motor function and associated impairments, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), in school-aged children with cerebral palsy (CP).

METHODS

Population-based study of all children with CP born 1999-2006 from the county of Västra Götaland, Sweden; 264 children (141 males, 123 females). Information was obtained from the CP Register of western Sweden (data collected at 4-8 years of age) and all medical records at 10-17 years of age.

RESULTS

Cerebral palsy was spastic in 76%, dyskinetic in 17% and ataxic in 7% of all children. Sixty-three per cent were independent walkers. Associated impairments were present in 75%. Vision was impaired in 19%, hearing in 8% and speech in 54%. Intellectual disability (ID) was present in 53% and epilepsy in 41%. ID had increased from 42% to 53% since preschool-age. Neuropsychiatric impairments were present in 32% of the children; ASD in 18%; and ADHD in 21%. All impairments, except for ASD and ADHD, increased with more severe motor impairment.

CONCLUSION

Three in four school-aged children with CP have associated impairments, underscoring the need to broadly assess every child. The high rate of ASD and ADHD points to the importance of in-depth studies of such impairments in CP.

摘要

目的

描述学龄期脑瘫儿童的运动功能及相关障碍,尤其是自闭症谱系障碍(ASD)和注意缺陷多动障碍(ADHD)。

方法

这是一项基于人群的研究,纳入了瑞典西约塔兰省 1999 年至 2006 年间出生的所有脑瘫患儿;共纳入 264 名儿童(男 141 名,女 123 名)。信息来自瑞典西部脑瘫登记处(在 4-8 岁时收集数据)和所有 10-17 岁时的医疗记录。

结果

所有儿童中痉挛型脑瘫占 76%,运动障碍型占 17%,共济失调型占 7%。63%的患儿能够独立行走。75%的患儿存在相关障碍。19%的患儿视力受损,8%的患儿听力受损,54%的患儿存在言语障碍。53%的患儿存在智力障碍(ID),41%的患儿存在癫痫。自学龄前以来,ID 的比例从 42%增加到 53%。32%的患儿存在神经精神障碍,18%的患儿存在 ASD,21%的患儿存在 ADHD。除 ASD 和 ADHD 外,所有的障碍都随着运动功能障碍的加重而增加。

结论

四分之三的学龄期脑瘫患儿存在相关障碍,这突显了广泛评估每个患儿的必要性。ASD 和 ADHD 的高发生率表明,需要对脑瘫患儿的这些障碍进行深入研究。

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