Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway.
Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway; Department of Neurology, Section for Rare Neuromuscular Disorders and EMAN, Oslo University Hospital, Oslo, Norway.
Eur J Paediatr Neurol. 2023 Jul;45:1-6. doi: 10.1016/j.ejpn.2023.05.004. Epub 2023 May 13.
Cognitive and behavioural problems may be predominant in the clinical picture of myotonic dystrophy (DM1) in childhood. This can lead to a diagnostic delay and thus prevent optimal therapeutic measures.
To obtain an overview of children with DM1 in our health region and study their cognitive and behavioural function, quality of life and neurological status.
Patients diagnosed with DM1 were recruited to this cross-sectional study through local habilitation teams of our health region. Neuropsychological testing and physical examination were performed for the majority. For some patients information was retrieved from medical records and through telephone interviews. A questionnaire was administered regarding quality of life.
27 subjects <18 years diagnosed with DM1 were identified, giving a frequency of DM1 of 4.3/100 000 in this age group. Twenty consented to participate. Five had congenital DM1. Most of the participants had only mild neurological deficits. Two with congenital type had hydrocephalus requiring a shunt. Ten, whereof none with congenital DM1, had a cognitive function within normal range. Three were diagnosed with an autism spectrum disorder, and additional three were reported with autistic traits. Many parents reported social and school problems for their child.
Intellectual disability and varying degrees of autistic behaviour were quite common. Motor deficits were most often mild. A strong focus regarding support at school and in social communication is needed for children growing up with DM1.
认知和行为问题可能在儿童型肌强直性营养不良(DM1)的临床表现中占主导地位。这可能导致诊断延迟,从而无法采取最佳治疗措施。
了解我们健康区的 DM1 患儿的概况,并研究他们的认知和行为功能、生活质量和神经状态。
通过我们健康区的当地康复团队招募诊断为 DM1 的患者参与这项横断面研究。大多数患者接受了神经心理学测试和体格检查。对于一些患者,信息是从病历和电话访谈中检索到的。还进行了生活质量问卷调查。
共确定了 27 名<18 岁的 DM1 患者,在该年龄组中 DM1 的发病率为 4.3/100000。有 20 名患者同意参与。其中 5 名患有先天性 DM1。大多数参与者仅有轻度神经功能缺损。有 2 名先天性患者患有需要分流的脑积水。其中 10 名患者的认知功能在正常范围内,无一例为先天性 DM1。有 3 名患者被诊断为自闭症谱系障碍,另外 3 名患者有自闭症特征。许多家长报告他们的孩子存在社交和学校问题。
智力残疾和不同程度的自闭症行为相当常见。运动缺陷大多为轻度。对于患有 DM1 的儿童,需要特别关注他们在学校和社交沟通方面的支持。