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DOI: 10.1055/s-2007-984449
© Georg Thieme Verlag KG Stuttgart · New York
Motor Outcome at the Age of One after Perinatal Hypoxic-ischemic Encephalopathy
Publikationsverlauf
received 1.9.2006
accepted 30.5.2007
Publikationsdatum:
22. August 2007 (online)
![](https://www.thieme-connect.de/media/neuropediatrics/200702/lookinside/thumbnails/10.1055-s-2007-984449-1.jpg)
Abstract
Objective: The aim of this report is to describe the motor outcome in one year-old children who were born at full-term with perinatal hypoxic-ischemic encephalopathy (HIE). Relationships between motor ability tests and neurological examination at one year, and between these tests and neonatal brain magnetic resonance imaging (MRI) were investigated.
Participants and Methods: 32 surviving children, born full-term with perinatal HIE, are included in this report. All children had a neonatal MRI. At one year, motor ability was assessed with the Alberta Infant Motor Scale and the Bayley Scales of Infant Development (2nd version). Neurological examinations included the neurological optimality score (NOS).
Results: At one year, 14 children (44%) had normal motor ability, nine (28%) had mildly delayed, and nine had significantly delayed motor ability. The NOS ranged from 14.6-27 points. All children with normal motor ability had (near) optimal NOS, however, not all children with high NOS had normal motor ability. Eleven children (34%) had normal neonatal MRI; at one year, six of them had normal, and five had mildly delayed motor ability. Eight children with normal motor ability showed abnormalities on neonatal MRI.
Conclusion: Neonatal brain MRI does not predict motor outcome at one year. Motor ability tests and neurological examinations should be used in a complementary manner to describe outcome after HIE.
Key words
Motor ability - hypoxic-ischemic encephalopathy - MRI - Alberta Infant Motor Scale - Bayley Scales of Infant Development-II - Neurological Optimality Score
References
- 1 Amess PN. Early brain proton magnetic resonance spectroscopy and neonatal neurology related to neurodevelopmental outcome at 1 year in term infants after presumed hypoxic-ischaemic brain injury. Dev Med Child Neur. 1999; 41 436-445
-
2 Amiel-Tison C, Grenier A.
Neurologic assessment within the first year of life . New York: Oxford University Press 1986 - 3 Barkovich AJ, Hajnal BL, Vigneron D, Sola A, Patridge JC, Allen F. et al . Prediction of neuromotor outcome in perinatal asphyxia: evaluation of MR scoring systems. Am J Neuroradiol. 1998; 19 143-149
- 4 Barnett A, Mercuri E, Rutherford M, Haataja L, Frisone MF, Henderson S. et al . Neurological and perceptual-motor outcome at 5-6 years of age in children with neonatal encephalopathy: relationship with neonatal brain MRI. Neuropediatrics. 2002; 33 242-248
- 5 Battin MR, Dezoete JA, Gunn TR, Gluckman PD, Gunn AJ. Neurodevelopmental outcome of infants treated with head cooling and mild hypothermia after perinatal asphyxia. Pediatrics. 2001; 107 480-484
- 6 Bayley N. Bayley Scales of Infant Development 2nd edn. San Antonio, Texas: The Psychological Corporation 1993
- 7 Brown JK, Purvis RJ, Forfar JO, Cockburn F. Neurological aspects of perinatal asphyxia. Dev Med Child Neurol. 1974; 16 567-580
- 8 Caravale B, Allemand F, Libenson MH. Factors predictive of seizures and neurologic outcome in perinatal depression. Pediatric Neurology. 2003; 29 18-25
- 9 Cowan FM, Vries LS de. The internal capsule in neonatal imaging. Seminar in Fetal & Neonatal Medicine. 2005; 10 461-474
- 10 Darrah J, Piper M, Watt MJ. Assessment of gross motor skills of at-risk infants: predictive validity of the Alberta Infant Motor Scale. Dev Med Child Neurol. 1998; 40 485-491
- 11 Dilenge M, Majnemer A, Shevell MI. Long-term developmental outcome of asphyxiated term neonates. J Child Neurol. 2001; 16 781-792
- 12 Dixon G, Badawi N, Kurinczuk JJ, Keogh JM, Silburn SV, Zubrick SR. et al . Early developmental outcomes after newborn encephalopathy. Pediatrics. 2002; 109 26-33
- 13 Finer N, Robertson C, Richards R, Pinnell LE, Peters KL. Hypoxic-ischemic encephalopathy in term neonates: perinatal factors and outcome. J Pediatr. 1981; 98 112-117
- 14 Frisone MF, Mercuri E, Laroche S, Foglia C, Maalouf EF, Haataja L. et al . Prognostic value of the neurologic optimality score at 9 and 18 months in preterm infants born before 31 weeks gestation. J Pediatr. 2002; 140 57-60
- 15 Gorter JW, Boonacker C, Schie PEM van, Ketelaar M. Reliability of the Gross Motor Function Classification System for children under 2 years of age. Dev Med Child Neurol. 2004; 46 ((Suppl 100)) 16
- 16 Gray PH, Tudehope DI, Masel JP, Burns YR, Mohay HA, O’Callahan MJ. et al . Perinatal hypoxic-ischaemic brain injury: prediction of outcome. Dev Med Child Neurol. 1993; 35 965-973
- 17 Haataja L. Neurologic examination in infants with hypoxic-ischemic encephalopathy at age 9-14 months: use of optimality scores and correlation with magnetic resonance imaging findings. J Pediatr. 2001; 138 332-337
- 18 Jeng SF, Yau KIT, Chen LC, Hsiao SF. Alberta Infant Motor Scale: reliability and validity when used on preterm infants in Taiwan. Phys Ther. 2000; 80 168-178
- 19 Kuenzle C, Baenziger O, Martin E, Thun-Hohenstein L, Steinlin M, Good M. et al . Prognostic value of early MR Imaging in term infants with severe perinatal asphyxia. Neuropediatrics. 1994; 25 191-200
-
20 Levene MI. The asphyxiated newborn infant. In: Levene MI, Lilford RJ, editors.
Fetal and neonatal neurology and neurosurgery . Edinburgh: Churchill Livingstone 1995: 405-425 - 21 Low JA, Galbraith RS, Muir DW, Killen HL, Patre EA, Karchmar EJ. Factors associated with motor and cognitive deficits in children after intrapartum fetal hypoxia. Am J Obstet Gynecol. 1984; 48 533-539
- 22 Low JA, Galbraith RS, Muir DW, Killen HL, Pater EA, Karchmar EJ. Motor and cognitive deficits after intrapartum asphyxia in the mature fetus. Am J Obstet Gynecol. 1988; 158 356-361
- 23 Mercuri E, Guzzetta A, Haataja L, Cowan F, Rutherford M, Counsell S. et al . Neonatal neurological examination in infants with hypoxic ischaemic encephalopathy: correlation with MRI findings. Neuropediatrics. 1999; 30 83-89
- 24 Mercuri E, Rutherford M, Cowan F, Pennock J, Counsell S, Papadimitriou M. et al . Early prognostic indicators of outcome in infants with neonatal cerebral infarction: a clinical, electrocephalogram, and magnetic resonance imaging study. Pediatrics. 1999; 103 39-46
- 25 Miller SP, Latal B, Clark H, Barnwell A, Glidden D, Barkovich AJ. et al . Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy. Am J Obstet Gynecol. 2004; 190 93-99
- 26 Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997; 39 214-223
- 27 Palisano RJ, Hanna SE, Rosenbaum PL, Russell DJ, Walter SD, Wood EP. et al . Validation of a model of gross motor function for children with cerebral palsy. Phys Ther. 2000; 80 974-985
- 28 Piper MC, Pinnell LE, Darrah J, Maguire T, Byrne PJ. et al . Construction and validation of the Alberta Infant Motor Scale (AIMS). Can J Public Health. 1992; 83 S46-S50
-
29 Piper MC, Darrah J.
Motor Assessment of the Developing Infant . Philadelphia, Pa: WB Saunders Co. 1994 - 30 Prechtl HFR. The optimality concept. Early Hum Dev. 1980; 4 201-205
- 31 Rosenbaum PL, Walter SD, Hanna SE, Palisano RJ, Russell DJ, Raina P. et al . Prognosis for gross motor function in cerebral palsy: creation of motor development curves. JAMA. 2002; 288 1357-1363
- 32 Russell DJ, Rosenbaum PL, Cadman DT, Gowland C, Hardy S, Jarvis S. The gross motor function measure: a means to evaluate the effects of physical therapy. Dev Med Child Neurol. 1989; 31 341-352
- 33 Russell DJ, Rosenbaum PL, Avery LM, Lane M. Gross Motor Function Measure (GMFM-66 & GMFM-88) User's manual. Clinics in Developmental Medicine no. 159 Mac Keith Press 2002
- 34 Rutherford MA, Pennock J, Counsell S, Mercuri M, Cowan FM, Dubowitz LMS. et al . Abnormal magnetic resonance signal in the internal capsule predicts poor neurodevelopmental outcome in infants with hypoxic-ischaemic encephalopathy. Pediatrics. 1998; 102 323-328
- 35 Sarnat HB, Sarnat MS. Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. Arch Neurol. 1976; 33 696-705
- 36 Thornberg E, Thiringer K, Odeback A, Milsom I. Birth asphyxia: indicence, clinical course and outcome in a Swedish population. Acta Paediatr. 1995; 84 927-932
- 37 Meulen BF Van der, Ruiter SAJ, Lutje Spelberg HC, Smrkovsky M. Dutch version of the BSID-II. Swets Test Publishers, Lisse 2002 (in Dutch)
-
38 Volpe JJ. Hypoxic-ischaemic encephalopathy. In: Volpe JJ, (ed).
Neurology of the newborn . Philadelphia: WB Saunders Co 1995;: 314-369 - 39 Wood E, Rosenbaum P. The gross motor function classification system for cerebral palsy: a study of reliability and stability over time. Dev Med Child Neurol. 2000; 42 292-296
- 40 World Health Organization .International classification of functioning, disability and health. Geneva: WHO 2001
Correspondence
P. E. M. van SchieMSc, PT
Department of Rehabilitation Medicine
VU University Medical Center
P.O. Box 7057
1007 MB Amsterdam
The Netherlands
Telefon: +31/20/444 01 61
Fax: +31/20/444 07 87
eMail: pem.vanschie@vumc.nl