Cerebral palsy: A reconceptualization of the spectrum

Shapiro, Bruce K.

doi:10.1016/j.jpeds.2004.05.014

Cited by 70 publications

(79 citation statements)

References 14 publications

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“…Some challenge the existence of CP subtypes categorized by topography because of vagueness in identifying each type [25]. The impairment classification system for CP offered in the 2005 concept/consensus paper, which was re-presented in 2007, recommended simplifying topographic description of CP by removing the term spastic diparesis (and quadriparesis) from the CP lexicon ( [1], [3]), preferring a simple descriptive statement of either 2 or 4 extremity involvement.…”

Section: Discussionmentioning

confidence: 99%

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An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Kuban

Allred

O’Shea

et al. 2008

The Journal of Pediatrics

105

104

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Objective-To develop an algorithm based on data obtained with a reliable, standardized neurological examination, and report the prevalence of cerebral palsy (CP) subtypes (diparesis, hemiparesis, and quadriparesis) in a cohort of 2-year-old children born before 28 weeks gestation.Study design-We compared children with CP subtypes on extent of handicap and frequency of microcephaly, cognitive impairment, and screening positive for autism.Results-Of the 1056 children evaluated, 11.4% (120) were given an algorithm-based classification of CP. Of these children, 31% had diparesis, 17% had hemiparesis, and 52% had quadriparesis. Children with quadriparesis were 9 times more likely than children with diparesis (76% versus 8%) to be more highly impaired and 5 times more likely than children with diparesis to be microcephalic (43% versus 8%). They were more than twice as likely as children with diparesis to have an MDI score below 70 (75% versus 34%), and had the highest rate of MCHAT positivity (76%) compared with children with diparesis (30%) and children without CP (18%).Conclusion-We developed an algorithm that classifies CP subtypes, which should permit comparison among studies. Extent of gross motor dysfunction and rates of co-morbidities are highest among children with quadriparesis and lowest among children with diparesis.

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Section: Discussionmentioning

confidence: 99%

“…Dystonia and spasticity co-occur frequently and the presence of spasticity may make identification of dystonia more difficult ( [25], [26]). The distinction between the two also may be difficult because signs of dystonia may be intermittent and vary with state and level of activity.…”

Section: Algorithm Assumptionsmentioning

confidence: 99%

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Kuban

Allred

O’Shea

et al. 2008

The Journal of Pediatrics

105

104

View full text Add to dashboard Cite

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“…Results were classified as normal when the developmental quotient was 80 or above and as abnormal when it was below 80. CP was diagnosed in the presence of a qualitative motor disorder due to nonprogressive interference with development of the brain occurring before the growth of the central nervous system is complete (38). It was classified according to topography and the nature of the motor disorder (38).…”

Section: Outcome Measuresmentioning

confidence: 99%

“…CP was diagnosed in the presence of a qualitative motor disorder due to nonprogressive interference with development of the brain occurring before the growth of the central nervous system is complete (38). It was classified according to topography and the nature of the motor disorder (38). Neurodevelopmental outcome was classified as favorable in the presence of normal neurological development or mild muscle tone and reflex abnormalities.…”

Section: Outcome Measuresmentioning

confidence: 99%

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

et al. 2012

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Background: seizures are one of the most common symptoms of acute neurological disorders in newborns. This study aimed at evaluating predictors of epilepsy in newborns with neonatal seizures. Methods: We recruited consecutively 85 neonates with repeated neonatal video-electroencephalogram (eeG)-confirmed seizures between January 1999 and December 2004. The relationship between clinical, eeG, and ultrasound (Us) data in the neonatal period and the development of postneonatal epilepsy was investigated at 7 y of age. results: Fifteen patients (17.6%) developed postneonatal epilepsy. Partial or no response to anticonvulsant therapy (odds ratio (OR) 16.7, 95% confidence interval (cI): 1.8-155.8, P = 0.01; OR 47, 95% cI: 5.2-418.1, P < 0.01, respectively), severely abnormal cerebral Us scan findings (OR: 5.4; 95% cI: 1.1-27.4; P < 0.04), severely abnormal eeG background activity (OR: 9.5; 95% cI: 1.6-54.2; P = 0.01), and the presence of status epilepticus (OR: 6.1; 95% cI: 1.8-20.3; P < 0.01) were found to be predictors of epilepsy. however, only the response to therapy seemed to be an independent predictor of postneonatal epilepsy. conclusion: Neonatal seizures seem to be related to postneonatal epilepsy. Recurrent and prolonged neonatal seizures may act on an epileptogenic substrate, causing further damage, which is responsible for the subsequent clinical expression of epilepsy.

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“…4,57 As it was already mentioned, CP describes a group of disorders of the development of movement and posture, causing activity limitations, which are attributed to non-progressive disturbances occurring at the time of fetal brain development. [58][59][60][61] Motor disorders which occur in patients with CP are often accompanied by disturbances of sensation, cognition, communication, perception, behavior, and/or with seizure disorder. [58][59][60][61] "Disturbances" is a term that refers to events or processes that in some way influence the expected pattern of brain maturation.…”

Section: Continuity Of Gms From Prenatal To Postnatal Lifementioning

confidence: 99%

Fetal Neurology—Lesson Learned and Future Challenges

Mišković¹,

Azumendi²,

Kurjak³

et al. 2007

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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Neurological failure is the most apprehension complication of pregnancy, labor and the neonatal period. The origin and outcome correlation is frequently doubtful. The arrival of four-dimensional ultrasonography (4D US) and its function to study fetal behavior patterns have initiated to offer insight into the structural and functional fetal brain development. Although many fetal behavioral studies have been conducted, it is still questionable whether the assessment of continuity from fetal to neonatal behavior could improve our ability of early detection of brain pathology. Neurological assessment of fetus in utero is extremely difficult even having such sophisticated equipment like 4D ultrasound. As it is well known that quantity of GMs is not so informative and predictive for neurological impairment, their quality should be assessed. Gestalt perception of premature GMs we are dealing with in utero and several weeks postnatally are not as predictive for the detection of neurologically abnormal fetuses or newborns as fidgety GMs. Therefore some additional parameters should be added to the prenatal neurological examination in order to improve our ability to make the distinction between normal and abnormal fetuses.

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Cerebral palsy: A reconceptualization of the spectrum

Cited by 70 publications

References 14 publications

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

An Algorithm for Identifying and Classifying Cerebral Palsy in Young Children

Neonatal seizures and postneonatal epilepsy: a 7-y follow-up study

Fetal Neurology—Lesson Learned and Future Challenges

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