-A sample of 51 children aged 7 with a history of prematurity was compared to 44 age-matched children who were born at term at the HCPA. The premature children had had gestational ages up to 37 weeks and 6 days and were born weighing less than 2500g. The control group consisted of children born with gestational age between 38 and 42 weeks and weights above 2S00g. The evaluation criteria were clinical examination, neurological examination and the evolutional neurological evaluation (ENE). The results pointed out that impulsiveness, aggressiveness, disorganization and enuresis were prevalent symptoms of developmental disturbances in the sample of prematures. Alterations at neurological examination did not discriminate between the two groups, although cerebral palsy occurred only in the proup of prematures. The ENE functions which differentiated the two groups studied were dynamic balance, appendicular and trunk-limb coordination and motor persistence.KEY WORDS: prematurely born children, development, evolutional neurologic evaluation. Avaliação neurológica evolutiva aos sete anos de idade de crianças nascidas prematurasRESUMO -Para estudar o desenvolvimento neuropsicomotor em amostra de prematuros aos 7 anos de idade, foram avaliadas 51 crianças prematuras e comparadas com 44 a termo. O grupo de prematuros tinha idade gestacional de até 37 semanas e 6 dias e peso de nascimento até 2500g. O grupo controle foi constituído de crianças com idade gestacional entre 38 e 42 semanas e acima de 2500g. Os instrumentos de avaliação utilizados foram os exames clinico, neurológico e neurológico evolutivo (ENE). Os resultados mostraram que impulsividade, agressividade, desorganização e enurese foram sintomas prevalentes nos prematuros. As alterações no exame neurológico não discriminaram os grupos, embora paralisia cerebral só tenha ocorrido nos prematuros. As funções do ENE que distinguiram os grupos foram equilíbrio dinâmico, coordenação tronco-membros e persistência motora, constituindo-se esta no comprometimento dominante nos prematuros e as alterações na coordenação tronco-membros em achado peculiar neste grupo. PALAVRAS-CHAVE: prematuridade, desenvolvimento neuropsicomotor, exame neurológico evolutivo.It has been well established that the development of the central nervous system (CNS) begins at conception and continues to adulthood. Psychomotor development has also been observed during intrauterine life 22 . CNS development is achieved through a series of transformations. An early phase of neuronal proliferation that occurs between the second and fourth month of gestation involves neurons and glial cells derived from the ventricular and sub-ventricular zones. During a second phase of neuronal migration, between the third and fifth month of gestation, millions of neurons move from their original site to their final locations. A third phase involves the organization that begins around the sixth month of gestation and persists for several years. Lastly, the final phase of neuronal maturation is related to the myeli...

Exame físico realizado aos 6 meses de idade revelou relativa obesidade (7600 gramas) para a baixa estatura (64 cm), fácies sindrômica, microcefalia (PO=36cm), orelhas grandes, pescoço curte com pele redundante, fontanela anterior pequena (Fig. 1). O paciente também apresentava discreta hipertonia nos 4 membros e reflexo cutâneo-plantar em extensão. As

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