Touwen B C
Abteilung für Neurologie, Universität Groningen.
Monatsschr Kinderheilkd. 1993 Aug;141(8):638-42; quiz 643-4, 675-6.
The normal central nervous system is characterized by both activity and reactivity. Under normal circumstances the former leads the latter. In abnormal conditions reactivity may predominate, usually in the form of reflexes and abnormal postural reactions. Ultrasound registration shows that the first spontaneous motor movements can be seen in the seventh to eighth gestational week. Movement patterns develop fast, and in mid-pregnancy all patterns are observed that can be found in the term newborn baby. During the second half of pregnancy movement patterns are refined: the first differentiation leading to variable and fluent movements. The intrauterine movements are qualitatively more or less similar to those seen in normal preterm babies, the main difference being that the latter as to counteract gravity forces to a greater extent. Qualitative changes of the movement patterns signal deteriorating intrauterine conditions. Stereotyped quality of movement can be a sign of abnormal development. During infancy normal development is characterized by great variability in performance, developmental sequences and relationships. Stereotype performance and strong relationship between the various motor functions, reactions and reflexes should arouse the suspicion that there may be a disturbance in development.
正常的中枢神经系统具有活动性和反应性。在正常情况下，前者主导后者。在异常情况下，反应性可能占主导，通常表现为反射和异常姿势反应。超声记录显示，在妊娠第7至8周可首次观察到自发运动。运动模式发展迅速，在妊娠中期可观察到足月儿所有的运动模式。在妊娠后半期，运动模式得到完善：首次出现分化，导致运动多变且流畅。宫内运动在质量上与正常早产儿的运动或多或少相似，主要区别在于后者能更大程度地对抗重力。运动模式的质量变化表明宫内状况恶化。刻板的运动质量可能是发育异常的迹象。在婴儿期，正常发育的特点是在表现、发育顺序和关系方面存在很大差异。刻板的表现以及各种运动功能、反应和反射之间的强烈关联应引起怀疑，即可能存在发育障碍。
