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Dyskinetic

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Dyskinetic cerebral palsy in Europe: trends in prevalence and severity.

Himmelmann K, McManus V, Hagberg G, Uvebrant P, Krägeloh-Mann I, Cans C; SCPE collaboration. Archives of disease in childhood. 2009 Dec;94(12):921-6

 

 

Background

Dyskinetic CP is characterized by involuntary changes in muscle tone, and involuntary positions and movements.

What was the aim?

The aim of this study was to describe the trends over time in dyskinetic cerebral palsy (CP) and the clinical picture in children with dyskinetic CP.

How was the work carried out?

Walking ability, cognitive, visual and hearing impairments and the occurrence of epilepsy and signs of adverse events around or during birth (Apgar score at five minutes and convulsions before three days of age) were analysed in children born in 1976-1996. Comparisons with children with bilateral spastic CP, a much more common type of CP, from the same birth years were made

What were the findings?

Of 578 children with dyskinetic CP in the common database of Surveillance of Cerebral Palsy in Europe (SCPE), 70% were born at term. During the studied time period 1976-1996, there was an increase of dyskinetic CP in children with normal birth weight up to 12 children per 100,000 live births, and a contemporary decrease in the neonatal mortality (death during the first month of life). Sixteen per cent of the children walked without aids, 24% walked with aids and 59% needed a wheelchair for ambulation. Severe cognitive impairment was present in 52%, epilepsy in 51%, severe visual impairment in 19% and hearing impairment in 6%. The presence of accompanying impairments increased with severity of the motor impairment.

Adverse events around or during birth were studied in children born in 1991-1996, and an Apgar score of less than 5 at five minutes and convulsions before three days of age had occurred more frequently in children with dyskinetic CP than with bilateral spastic CP. Children with dyskinetic CP also had more severe cognitive and motor impairments than children with bilateral spastic CP.

What does this tell us?

The prevalence of dyskinetic CP appears to increase in children with a normal birth weight. They have frequently experienced adverse events around or during birth. Most children with dyskinetic CP have a severe motor impairment and several accompanying impairments.

Paper

The full results of this study can be found in Archives of disease in childhood. 2009 Dec;94(12):921-6 http://adc.bmj.com/content/94/12/921.full.pdf+html

Pubmed abstract

The summary of this study can be found in Pubmed, a database of citations from biomedical journals. http://www.ncbi.nlm.nih.gov/pubmed/19465585

Authors

Himmelmann K, McManus V, Hagberg G, Uvebrant P, Krägeloh-Mann I, Cans C; SCPE collaboration.