Children with dyskinetic cerebral palsy are severely affected as compared to bilateral spastic cerebral palsy

Abstract

Aim: We aimed at describing clinical findings in children with dyskinetic as compared to bilateral spastic cerebral palsy (CP).Methods: Data were extracted from the Danish nationwide CP register. Participants were born in 1999-2007 and were 5-6 years at ascertainment. Results:The total number of CP cases was 1165 of which 92 had dyskinetic and 540 bilateral spastic CP. Prevalence of dyskinetic CP was 0.16 per 1000 live births. In participants with dyskinetic compared to bilateral spastic CP, there was more frequently an Apgar level less than five at five minutes (22.7% vs. 11.2%) and neonatal seizures (43.5% vs. 28.5%), but less respiratory deficiency, hyperbilirubinaemia and sepsis. Impairment based on gross motor function classification was more severe in dyskinetic CP (level III-V 90.0% vs. 66.0%). In dyskinetic CP, there was a high rate of reduced developmental quotient (68.1%), visual impairment (39.3%) and epilepsy (51.6%). Basal ganglia lesions were more prevalent in dyskinetic compared to bilateral spastic CP (27.7% vs. 12.8%).Conclusion: Cases of dyskinetic CP had overlapping clinical features with cases of bilateral spastic CP, but differed significantly in several perinatal risk factors. The children with dyskinetic CP had experienced more peri-or neonatal adverse events, and neurodevelopmental impairment was severe.

Instrumented assessment of motor function in dyskinetic cerebral palsy: a systematic review

“…The majority of the reviewed methods have in common that they assessed muscle function and movement during tasks that require some level of understanding of a task instruction, manual ability and/or ambulation. However, it is known that in dyskinetic CP a high percentage of children has severe intellectual disability (about 70%), severe visual impairments (about 40%), and 70-80% are non-ambulatory (GMFCS IV-V) and have a severely impaired manual ability (MACS IV-V) [8,9]. Therefore for a large group of children and young adults with dyskinetic CP, only few instrumented methods are available.…”

“…non-ambulatory) and the Manual Ability Classification System (MACS) [7] level IV-V (i.e. severely impaired manual ability) [8,9].…”

Neuroimaging of Basal Ganglia in Neurometabolic Diseases in Children

“…Cerebral palsy (CP) is associated with a profound hypoxic insult. Approximately 70% of patients with extrapyramidal dystonic cerebral palsy present with changes in the basal ganglia or/and the thalamus [45][46][47]. For instance, the globus pallidus is the most vulnerable part of the basal ganglia in neonates with kernicterus.…”

“…For instance, the globus pallidus is the most vulnerable part of the basal ganglia in neonates with kernicterus. Approximately 15-20% of patients with dystonic CP present with the damage to the lentiform nuclei, followed by putamen injury [45][46][47].…”

Efficacy of axial TheraTogs on gait pattern in children with dyskinetic cerebral palsy: a randomized controlled trial

“…The most common manifestations are athetosis, chorea, and dystonia [7]. These involuntary movements can cause discomfort, interfere with voluntary movements, and limit or even impede upper and lower limb functions [8,9].…”