Neuropediatrics 2006; 37(4): 247-252
DOI: 10.1055/s-2006-924581
Original Article

Georg Thieme Verlag KG Stuttgart · New York

Neurological Examination at 6 to 9 Months in Infants with Cystic Periventricular Leukomalacia

D. Ricci1 , F. Cowan,2 , M. Pane1 , F. Gallini,3 , L. Haataja2 , 4 , R. Luciano,3 , L. Cesarini1 , D. Leone,1 , V. Donvito1 , G. Baranello,1 , M. Rutherford2 , C. Romagnoli,3 , L. Dubowitz2 , E. Mercuri1 , 2
  • 1Paediatric Neurology Unit, Catholic University, Rome, Italy
  • 2Department of Pediatrics, Hammersmith Hospital, Imperial College, London, UK
  • 3Neonatal Unit, Catholic University, Rome, Italy
  • 4Department of Paediatric Neurology, Turku University Hospital, Turku, Finland
Further Information

Publication History

Received: March 17, 2006

Accepted after Revision: August 9, 2006

Publication Date:
20 December 2006 (online)

Abstract

The Hammersmith Infant Neurological Examination was performed in 24 infants with cystic periventricular leukomalacia whose gestational age ranged between 26 - 38 weeks. The infants were examined between 6 and 9.5 months corrected age. The aim of the study was to establish the different patterns of neurological abnormality as well as the optimality scores that predict the severity of motor sequelae at 2 years. Increased neck and trunk extensor tone, and a posture of flexed arms and extended legs between 6 and 9 months were always associated with the inability to sit unsupported at 2 years, whilst truncal hypotonia and extended arms and legs were associated with unsupported sitting but not walking. Optimality scores between 41 and 60 were generally associated with sitting but not walking at 2 years whilst scores below 40 were always associated with the inability to sit independently at 2 years. All infants who did not develop cerebral palsy at 2 years had scores > 60. Our results suggest that the pattern of findings on neurological examination performed between 6 and 9 months as well as the calculated optimality score helps to predict motor impairment in infants with PVL.

References

Dr. Daniela Ricci

Pediatric Neurology
Catholic University

Largo Gemelli, 8

00168 Rome

Italy

Email: daniricciola@libero.it