Department of Pediatrics (Neurology Division), Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
Department of Neurology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
Indian J Pediatr. 2022 Apr;89(4):333-338. doi: 10.1007/s12098-021-03785-7. Epub 2021 Jun 7.
To detail the spectrum of movement disorders (MD) among children with cerebral palsy (CP) and assess impact on functional status.
In this cross-sectional study, children with CP were recruited and examined for various MDs. Tone abnormality was assessed using Hypertonia Assessment Tool (HAT), functional status using Gross Motor Function Classification System Expanded and Revised (GMFCS E&R), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). These scores were classified into mild-moderate (level I-III)/severe (level IV-V) categories.
A total of 113 children (mean age 4.9 ± 3.4 y, 66.4% boys) were enrolled. MDs were noted in 52 (46%) children; the most frequent were dystonia (28%), chorea (14%), choreoathetosis (8%). Of 64 children with quadriparetic CP, 27 (42.2%) demonstrated MDs. Of 19 children with hemiparetic CP, 2 (10.5%) had MDs. Of 16 children with dyskinetic CP, 15 (93%) had MDs. Children with dyskinetic CP had significantly higher frequency of MDs (p = 0.001). There was no difference in occurrence of all MDs or dystonia aloneamongst the two categories (mild-moderate/severe) of GMFCS E&R levels, CFCS levels or MACS levels.
Although diverse MDs occur frequently in CP, these do not correlate with the broad functional status of the child. The study is limited by small sample size.
详细描述脑瘫（CP）患儿运动障碍（MD）的谱，并评估其对功能状态的影响。
在这项横断面研究中，招募了 CP 患儿并对其进行了各种 MD 的检查。使用肌张力评估工具（HAT）评估肌张力异常，使用粗大运动功能分类系统扩展和修订版（GMFCS E&R）、手动能力分类系统（MACS）和沟通功能分类系统（CFCS）评估功能状态。这些评分分为轻度-中度（I-III 级）/重度（IV-V 级）。
共纳入 113 例患儿（平均年龄 4.9±3.4 岁，66.4%为男性）。52 例（46%）患儿存在 MD，最常见的是肌张力障碍（28%）、舞蹈症（14%）、舞蹈手足徐动症（8%）。64 例四肢瘫 CP 患儿中，27 例（42.2%）存在 MD；19 例偏瘫 CP 患儿中，2 例（10.5%）存在 MD；16 例锥体外系 CP 患儿中，15 例（93%）存在 MD。锥体外系 CP 患儿 MD 的发生率明显更高（p=0.001）。在 GMFCS E&R 水平、CFCS 水平或 MACS 水平的轻度-中度/重度两个类别中，所有 MD 或单纯肌张力障碍的发生率均无差异。
尽管 CP 患儿常出现多种 MD，但这些与患儿的广泛功能状态无关。本研究的局限性在于样本量小。
