Neuropediatrics 2002; 33(2): 73-78
DOI: 10.1055/s-2002-32368
Original Article

Georg Thieme Verlag Stuttgart · New York

The Early Markers for Later Dyskinetic Cerebral Palsy are Different from Those for Spastic Cerebral Palsy

C. Einspieler1 , G. Cioni2 , P. B. Paolicelli2 , A. F. Bos3 , A. Dressler2 , F. Ferrari4 , M. F. Roversi4 , H. F. R. Prechtl1
  • 1 Department of Physiology, Karl Franzens University, Graz, Austria
  • 2 Division of Child Neurology and Psychiatry, University of Pisa and Stella Maris Scientific Institute, Pisa, Italy
  • 3 Department of Paediatrics, Division of Neonatology, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands
  • 4 Department of Obstetrical, Gynaecological and Paediatric Sciences, Division of Neonatology, University Hospital, Modena, Italy
Further Information

Publication History

Publication Date:
20 June 2002 (online)

Abstract

Qualitative abnormalities of spontaneous motor activity in newborns and young infants are early predictive markers for later spastic cerebral palsy. Aim of this research was to identify which motor patterns may be specific for later dyskinetic cerebral palsy. In a large, prospectively performed longitudinal study involving four European hospitals we identified twelve cases with the relatively rare condition of dyskinetic cerebral palsy and compared their early motor development with twelve spastic cerebral palsy cases and twelve controls. From birth to the fifth month post-term, all infants were repeatedly videoed and their spontaneous motor patterns, including general movements, were assessed. Until the second month post-term, the infants that later became dyskinetic displayed a poor repertoire of general movements, “arm movements in circles” and finger spreading. Abnormal arm and finger movements remained until at least five months and were then concurrent with a lack of arm and leg movements towards the midline. Later dyskinetic infants share with later spastic infants the absence of fidgety movements, a spontaneous movement pattern that is normally present from three to five months. Qualitative assessment of spontaneous motor patterns enabled us to identify infants at high risk for dyskinetic cerebral palsy early in life. Additionally, we were able to discriminate them from those infants at high risk for later spastic cerebral palsy. This is a matter of significant clinical relevance because the two types of cerebral palsy ask for different management and early intervention.

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Prof. M. D., D. Phil. Heinz F. R. Prechtl

Department of Physiology, Karl-Franzens-University of Graz

Harrachgasse 21/5

8010 Graz

Austria

Email: christa.einspieler@kfunigraz.ac.at