Associations between Manual Abilities, Gross Motor Function, Epilepsy, and Mental Capacity in Children with Cerebral Palsy

How to Cite This Article: Gajewska E, Sobieska M, Samborski W. Associations between Manual Abilities, Gross Motor Function, Epilepsy, and Mental Capacity in Children with Cerebral Palsy. Iran J Child Neurol. 2014 Spring 8(2):45-52.ObjectiveThis study aimed to evaluate gross motor function and hand function in children with cerebral palsy to explore their association with epilepsy and mental capacity. Material & MethodsThe research investigating the association between gross and fine motor function and the presence of epilepsy and/or mental impairment was conducted on a group of 83 children (45 girls, 38 boys). Among them, 41 were diagnosedwith quadriplegia, 14 hemiplegia, 18 diplegia, 7 mixed form, and 3 athetosis.A neurologist assessed each child in terms of possible epilepsy and confirmed diagnosis in 35 children. A psychologist assessed the mental level (according toWechsler) and found 13 children within intellectual norm, 3 children with mild mental impairment, 18 with moderate, 27 with severe, and 22 with profound.Children were then classified based on Gross Motor Function Classification System and Manual Ability Classification Scale.ResultsThe gross motor function and manual performance were analysed in relation to mental impairment and the presence of epilepsy. Epilepsy was found to disturb conscious motor functions, but also higher degree of mental impairment wasobserved in children with epilepsy.ConclusionThe occurrence of epilepsy in children with cerebral palsy is associated with worse manual function. The occurrence of epilepsy is associated with limitations in conscious motor functions. 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Analysis of upper and lower limb movement in infants in response to optic flow - preliminary research

Introduction: optic flow is studied in many scientific areas such as automation, robotics, biomechanics and neuropsychology. People who are not visually impaired use this mechanism to move around, usually without realising its complexity. It consists of information provided by the sense of sight and analysed in the central nervous system about the speed and direction of a moving object and the direction and amplitude of the angular and linear components of one's body. However, little is known about how this mechanism develops in the young child. Objective: Observation of upper and lower limb movement in infants between 4 and 12 weeks. of age under the influence of optic flow stimulation as a stimulus. Development of an optimal test protocol and adaptation of the author's research station. Material and method: 16 infants aged from 4 to 12 weeks were initially invited to the study, of which 14 infants were finally included in the study group. The motor response test consisted of two stages. Stage I (static trial): the stimulus was a stationary black and white chessboard pattern; stage II (dynamic trial): the chessboard pattern moved toward the child at a speed of 0.17m/s. Cameras recorded the test in both stages. Results: the children showed increased limb movement under the influence of optical flow (test stage II: dynamic test) compared to stimulation with a fixed pattern (test stage I: static test). Conclusions: a response to dynamic versus static stimuli was observed in 11 of 14 children, but testing in one-month-olds is unreliable due to poor head control

Qualitative assessment in the third month of life allows for a better prognosis of the achievement of motor milestones versus assessment of pathological reflexes- prospective studies on Polish children

IntroductionThe characteristic feature of primitive reflexes is that they occur early in development and must expire at a well-defined age. The study was conducted prospectively on a group of 107 children (74 boys). The study population included 83 infants born on time (weight 3,465 ± 395 g) and 24 born prematurely (weight 2,225 ± 793 g).MethodsAn analysis of motor development at 3 months of age consisting of a qualitative assessment (motor performance) and a check of reflexes was performed; at 9 months, the child was checked for crawling and sitting down, and at 16 months for walking.ResultsThe more abnormal reflexes, the less likely it was to achieve the assessed milestones in time. It is possible to notice that the qualitative assessment is, in each case, a better predictor of the milestones than any of the reflexes, except for walking, where the Babkin reflex was strongly predictive. However, the qualitative assessment sum still occupies the second and third positions in prone and supine positions.DiscussionThe occurrence of Babkin’s reflex at 3 months of age impacts the achievement of sitting down and walking functions. An abnormal Galant reflex was strongly associated with the lack of occurrence of crawling on time. At the same time, a high-quality score at 3 months of age guarantees the development of crawling on time, sitting down, and walking

Influence of Short- and Long-Lasting Blood Pressure Increase on the Acute Phase Proteins Secretion Profile

Wstęp Powikłania narządowe powstające w przebiegu nadciśnienia tętniczego są między innymi efektem rozwoju zmian zapalnych i miażdżycowych w ścianach naczyń, uwarunkowanych upośledzeniem czynności śródbłonka naczyniowego w następstwie urazu ciśnieniowego. Celem badania było stwierdzenie, czy czynnikiem inicjującym reakcję zapalną jest okresowy wzrost wysokości ciśnienia czy też jego długotrwałe podwyższenie. Materiał i metody Zbadano 44 chorych z pierwotnym nadciśnieniem tętniczym. U 32 z nich pod wpływem silnego stresu emocjonalnego wystąpił wzrost ciśnienia tętniczego. W 19 przypadkach uzyskano normalizację ciśnienia w ciągu 24 h, a w 13 pozostałych - w okresie 6–8 dni. W grupie kontrolnej obserwowano długotrwałą normalizację ciśnienia tętniczego. W 2 i 9 dniu po znaczącym wzroście ciśnienia pobrano próbki krwi, oznaczając stężenie a1-antychymotrypsyny (ACT) i kwaśnej a1-glikoproteiny (AGP) przy użyciu immunoelektroforezy rakietkowej według Laurella oraz wspólczynniki reaktywności za pomocą krzyżowej immunoelektroforezy powinowactwa według BOg-Hansena. Wyniki W ciągu 36 h od wzrostu wysokości ciśnienia tętniczego nastąpiło istotne zwiększenie stężenia obu glikoprotein w surowicy, połączone z równoczesnym wzrostem współczynnika reaktywności. Normalizacja wartości ciśnienia wiązała się z istotnym zmniejszeniem stężenia oraz z normalizacją profilu glikacji obu protein w 9 dniu po epizodzie podwyższenia ciśnienia. Zmiany wykazywały podobną dynamikę w obu grupach chorych, u których doszło do wzrostu ciśnienia tętniczego. Wnioski Obserwowane zmiany profilu uwalniania białek ostrej fazy wskazują na możliwość wywołania ostrej reakcji zapalnej w następstwie gwałtownego i znaczącego podwyższenia wartości ciśnienia tętniczego. Zarówno w przypadku szybkiej normalizacji ciśnienia, jak również w przypadku utrzymywania się stabilnych, podwyższonych wartości ciśnienia obserwuje się normalizację profilu uwalniania białek ostrej fazy.Background The relationship between endothelium function disorder and onset of atherogenic processes in progress of arterial hypertension can be estimated by determination of serum concentration changes of some acute phase proteins. The aim of the study was to determine if the progress of arterial hypertension cause qualitative or/and quantitative changes in secretion profile of acute phase proteins. Material and methods The serum level of a1-antichymotripsin (ACT) and a1-acid glycoprotein (AGP) and the qualitative determination of the glycosylation profile was measured on the 2nd and 9th day after temporary blood pressure increase in 44 patients with essential hypertension. Results During 36 hours, after blood pressure increase, a significant increase of AGP and ACT reactivity coefficients and levels in the serum of blood was observed. The normalization,that occurred on the 9th day, and the persistent constant increase of blood pressure resulted in the significant decrease in the levels of reactivity coefficients as well as blood serum glycoproteins. Conclusions The qualitative and quantitative changes of the secretion profile of examined glycoproteins, in the progress of essential hypertension, indicated conclusive influence of transient blood pressure increase on acute inflammatory process generated in the blood vessels wall. The persistent, constant blood pressure increase and the therapy-dependent or selfdependent normalization of blood pressure caused the rapid decrease of the inflammatory process intensity

Achieving Motor Development Milestones at the Age of Three Months May Determine, but Does Not Guarantee, Proper Further Development

Proper motor performance at 3rd month is necessary for further motor development. The paper aims to demonstrate the reliability, sensitivity, and predictive value of an original motor performance assessment tool in comparison with the neurological assessment at 3, 6, and 9 months. Children (n=123), born at term without pre- or perinatal complications, born at term with pre- or perinatal complications, or born preterm, were assessed at the age of 3, 6, and 9 months, by a neurologist and a physiotherapist. The physiotherapist evaluated 15 qualitative features typical for the age of 3 months in the prone and supine positions. The final neurological assessment determined the degree of developmental disorder. Neurological and global physiotherapeutic assessments showed a statistically significant correlation. Qualitative assessment results were very good in healthy children and decreased with worsening neurological diagnoses. Children diagnosed with cerebral palsy did not show proper qualitative features of 3 months when analyzed at 3, 6, and 9 months. Children with delayed motor development revealed minor qualitative performance impairments as early as 3 months but improved with age. Qualitative assessment at 3 months not only facilitates diagnosis of major developmental disorders but is also a good predictor of delayed motor development in children

Examination of Upper Limb Function and the Relationship with Gross Motor Functional and Structural Parameters in Patients with Spinal Muscular Atrophy

Spinal muscular atrophy (SMA) is an autosomal recessive disorder caused by the deletion or/and mutation in the survival motor neuron 1 (SMN1) gene on chromosome 5. Until now, only a few articles investigating the relationship between upper limb function and the gross motor function in untreated SMA patients have been published. However, there is still a lack of publications including the relationship between structural changes such as cervical rotation, trunk rotation and side trunk shortening, and upper limb function. The aim of the study was to examine the upper limb function in patients with spinal muscular atrophy and the relationship between the upper limb function, gross motor function, and structural parameters. We present an analysis of 25 SMA patients, divided into sitter and walker groups, undergoing pharmacological treatment (nusinersen or risdiplam), examined twice between the initial examination and evaluation after a 12-month period. The participants were tested using validated scales such as the Revised Upper Limb Module (RULM), the Hammersmith Functional Motor Scale—Extended (HFMSE), and the structural parameters. Our results showed that patients demonstrated greater improvement on the RULM scale than on the HFMSE scale. Moreover, persistent structural changes negatively affected both the upper limb function and gross motor skills

The Acute Phase Proteins Reaction in Children Suffering from Pseudocroup

The aim of the study was to evaluate the inflammatory reaction in children with pseudocroup and compare it with other laryngological diseases according to the available literature data. The study group included 51 children hospitalized because of pseudocroup. The measurements of the acute phase proteins (APP), such as C-reactive protein (CRP), alpha-1-antitrypsin (AT), alpha-1-antichymotrypsin (ACT), alpha-1-acid glycoprotein (AGP), ceruloplasmin (Cp), transferrin (Tf), alpha-2-macroglobulin (A2M), and haptoglobin (Hp) were obtained at 3 time points. The glycosylation profiles of AGP, ACT, and Tf were completed. An increased AGP level was observed in girls. The AGP glycosylation revealed the advantage of the W0 variant over the W1 variant. W1 and W2 were decreased in boys. W3 emerged in boys. The Tf concentration and T4 variant were lower compared to the control group. The A2M level was lower after treatment. The Hp and AT levels were decreased a few weeks later. The ACT glycosylation revealed a decrease of the A4 variant in boys. In conclusion, the inflammatory reaction during pseudocroup was of low intensity. The APP glycosylation suggested a chronic process. In a follow-up investigation, no normalization of the parameters was noted, but signs of persistent inflammation were observed

An Evaluation of the Efficacy of Selective Alpha-Blockers in the Treatment of Children with Neurogenic Bladder Dysfunction—Preliminary Findings

The aim of this study was to assess the usefulness of selective α1-blockers in children with neurogenic urinary tract dysfunctions and increased leak point pressure (LPP). 14 children from age 6 to 16 years with neurogenic urinary tract dysfunctions (neurogenic bladder) and LPP > 40 cm H2O were enrolled in the study. All patients received a selective α1-blocker (doxazosin) for 6–8 weeks with an initial dosage of 0.03 mg/kg. During the observation period the continuation of oral anticholinergics, Clean Intermittent Catheterization (CIC), observation of “urinary dryness” and urinary incontinence periods were recommended. Patients were scheduled for a follow-up visit and urodynamic investigation after 6–8 weeks after the doxazosin therapy was started. In 4 patients, urine leakage occurred at lower pressures; in 9 patients, no significant changes in urine leak point pressures were detected; in 3 patients, there was a significant increase in the bladder capacity; in one patient, deterioration in continence was noted. The differences both in LPP and LPV before and after the treatment were not statistically significant. Our observations are consistent with the conclusions from other studies and showed no evident efficacy of doxazosin in children with neurogenic bladder