Clinical patterns of dystonia and choreoathetosis in participants with dyskinetic cerebral palsy

Abstract

Dystonia and choreoathetosis increase during activity. However, dystonia predominates and seems to have a larger impact on functional abilities. Our findings further suggest that choreoathetosis seems to be more linked to pure thalamus and basal ganglia lesions than dystonia.

Translation, cross-cultural adaptation and validation of the ABILHAND-Kids for the Brazilian Portuguese

“…The questionnaire was developed in French and has been used in several clinical studies. It is a useful tool for assessing the relationship between manual ability and dystonia and choreoathetosis 11 , for identifying factors that might influence children's manual function in long term 12 , and for identifying children's upper limb impairments 13 . Moreover, ABILHAND-Kids questionnaire has been used as an outcome measure in several interventional studies [14][15][16][17][18] and in other clinical conditions such as radial deficiency 19 , obstetric brachial plexus injury 20 and paediatric ischaemic stroke 21 .…”

Deep brain stimulation in cerebral palsy: Challenges and opportunities

“…Patients often present with a mixed movement disorder comprising dystonia and choreoathetosis, axial hypotonia, and sometimes coexisting spasticity leading to severe impairment in activities of daily living. 4,5 Etiology of CP is broad ranging from perinatal asphyxia, metabolic brain injury, kernicterus, vascular events, to trauma. There is hardly any high quality evidence on oral pharmacotherapy and recommendations are mostly based on personal clinical experience and transferred results from trials on adult patients.…”

“…28 In patients with dyskinetic CP the sole use of dystonia rating scales does not necessarily capture what matters most to children with dystonia, as many of these patients suffer of a complex, mixed movement disorder with additional symptoms such as choreoathetosis or spasticity. 5,18,29 Non-motor symptoms, e.g. quality of life and pain perception or participation and function in activities of daily living, have hardly been systematically assessed in paediatric patients undergoing DBS so far (unpublished data, Koy et al, submitted to EJPN).…”

The quest for patterns in dyskinetic cerebral palsy

“…[1][2][3] The DIS may be helpful in discriminating the different features of dyskinetic CP in a structured way, increasing our knowledge, which in turn may have implications for future research and hopefully resulting in more appropriate interventions for people with dyskinetic CP. However, the nature of the movement pattern needs to be linked to the consequences for function, activities, and participation.…”

“…However, the nature of the movement pattern needs to be linked to the consequences for function, activities, and participation. The majority of individuals with dyskinetic CP have dystonia 1,4 which involves getting into involuntary postures that are probably painful at times, thus impeding activities and reducing quality of life.…”