NEUROLOGICAL EXAMINATION AS A PREDICTOR OF ABNORMAL CAT-CLAMS AMONG HYPOXIC ENCEPHALOPATHY INFANTS

Objectives: Objectives: The study aims at 1- Detection of early motor milestones associated with CP at 18 months 2-. The correlation of the early neurological examination at 3, 4 and 5 months to CAT_CLAMS at 18 months among Hypoxic Ischemic Encephalopathy (HIE). 3- Neurodevelopment assessment using CATCLAMS at 18 months.

Methods: Methods: A prospective analytic study of 78 HIE infants (2001–2004). Infants are followed-up at 3, 4 & 5 for neurological examination and 18 months for CAT-CLAMS. Neurological examination and CAT-CLAMS are conducted at each visit. Statistical analysis using Spearman's correlation coefficient test is run to detect possible correlation between neurological examination (categorical) and poor CAT-CLAMS (continuous). Multiple Regression analysis for detecting early motor examination associated with poor outcome.

Results: Results: Abnormal early automated response (EAR): EAR-I: positive support I (46%) and in EAR-II: derotative righting (36%) were the most abnormal neuro exam reported. The lowest CAT-CLAMS DQ at both 3 and 18 months was among HIE stage III, p<.0.005. Abnormal Roll-over (P-S), [r=-.719, p<.001], Galant [r=-.846, p<.003] and derotative righting [r=-.568, p<.04] at the early months of life correlate significantly with the 18 months CAT-CLAM <70. “Abnormal Roll-over P-S” (OR: 0.9, CI: [0.2–5.3]) p<.01 and Obligatory ATNR (OR: 1.5, CI: [0.1–1.4]), p<.003 are associated with CP at 18 months.

Conclusion: Conclusion: Some early simple neurologic, but skillfully performed examination for screening and early suspicion of abnormal outcome is reliable. This is mostly needed in the parts of the world with high incidence of HIE and still developing follow-up clinics.