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