Dyskinetic cerebral palsy in Europe: trends in prevalence and severity

Himmelmann, Kate; McManus, Vicki; Hagberg, G; Uvebrant, Paul; Krägeloh-Mann, I.; Cans, Christine

doi:10.1136/adc.2008.144014

Cited by 136 publications

(130 citation statements)

References 25 publications

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“…A recent study, also based on the SCPE common database, reported a significant increase in the prevalence of dyskinetic CP among NBW children for the period 1976-1984, followed by a plateau. [35] Our analysis covered a later period, 1980-1998, and confirmed the leveling off of prevalence of dyskinetic CP.…”

Section: Discussionsupporting

confidence: 74%

Trends in prevalence of cerebral palsy in children born with a birthweight of 2,500 g or over in Europe from 1980 to 1998

et al. 2010

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Section: Discussionsupporting

confidence: 74%

Trends in prevalence of cerebral palsy in children born with a birthweight of 2,500 g or over in Europe from 1980 to 1998

et al. 2010

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“…[13][14][15] Dystonia is more prevalent than the choreoathetotic subtype 19 and commonly manifests as dystonic hyper tonia of the upper extremities, neck, and face with concomitant * The Activa RC neurostimulator system was used in all cases. Lead location was calculated in reference to the midpoint of the anterior commissureposterior commissure (AC-PC) line.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with the more common spastic CP, the dyskinetic forms have greater motor impairment and functional disability, 15 resulting in significant long-term morbidity and caretaker burden. And although this dystonic group has responded only modestly to DBS, 1,16,22,24,27,36 even subtle improvements can significantly impact quality of life and caretaking, 24,27,36 thus underscoring the importance of strict adherence to established classification schemes to identify patients who will benefit most.…”

mentioning

confidence: 99%

“…23 Children with dyskinetic CP, especially those with dystonia, tend to have more severe motor impairment and an increased likelihood of learning disability, epilepsy, and visual and hearing impairments. 15,20 Well-known etiological factors are hypoxic-ischemic encephalopathy (HIE), infection, and hyperbilirubinemia, 15 which preferentially affect the basal ganglia and thalamus. These areas are particularly vulnerable given the high metabolic demands of the peri-and neonatal developmental periods.…”

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confidence: 99%

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Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Keen¹,

Przekop

Olaya

et al. 2014

PED

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Object Deep brain stimulation (DBS) for dystonic cerebral palsy (CP) has rarely been reported, and its efficacy, though modest when compared with that for primary dystonia, remains unclear, especially in the pediatric population. The authors present a small series of children with dystonic CP who underwent bilateral pallidal DBS, to evaluate the treatment's efficacy and safety in the pediatric dystonic CP population. Methods The authors conducted a retrospective review of patients (under the age of 18 years) with dystonic CP who had undergone DBS of the bilateral globus pallidus internus between 2010 and 2012. Two of the authors independently assessed outcomes using the Barry-Albright Dystonia Scale (BADS) and the Burke-Fahn-Marsden Dystonia Rating Scale–movement (BFMDRS-M). Results Five children were diagnosed with dystonic CP due to insults occurring before the age of 1 year. Mean age at surgery was 11 years (range 8–17 years), and the mean follow-up was 26.6 months (range 2–42 months). The mean target position was 20.6 mm lateral to the midcommissural point. The mean preoperative and postoperative BADS scores were 23.8 ± 4.9 (range 18.5–29.0) and 20.0 ± 5.5 (range 14.5–28.0), respectively, with a mean overall percent improvement of 16.0% (p = 0.14). The mean preoperative and postoperative BFMDRS-M scores were 73.3 ± 26.6 (range 38.5–102.0) and 52.4 ± 21.5 (range 34.0–80.0), respectively, with a mean overall percent improvement of 28.5% (p = 0.10). Those stimulated at least 23 months (4 patients) improved 18.3% (p = 0.14) on the BADS and 30.5% (p = 0.07) on the BFMDRS-M. The percentage improvement per body region yielded conflicting results between rating scales; however, BFMDRS-M scores for speech showed some of the greatest improvements. Two patients required hardware removal (1 complete system, 1 unilateral electrode) within 4 months after implantation because of infections that resolved with antibiotics. Conclusions All postoperative dystonia rating scale scores improved with pallidal stimulation, and the greatest improvements occurred in those stimulated the longest. The results were modest but comparable to findings in other similar series. Deep brain stimulation remains a viable treatment option for childhood dystonic CP, although young children may have an increased risk of infection. Of particular note, improvements in the BFMDRS-M subscores for speech were comparable to those for other muscle groups, a finding not previously reported.

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“…The athetotic type of cerebral palsy (known as dyskinetic in Europe) represents 6-15% of all cases of CP, and tends to have a clinically severe prognosis (1)(2)(3). However, a definitive diagnosis of delayed or aberrant motor progress and differentiation between athetosis and spasticity are not always straightforward until children become old enough for a full examination of functional outcomes (3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Anatomical characterization of athetotic and spastic cerebral palsy using an atlas‐based analysis

Yoshida

Faria

Oishi

et al. 2013

Magnetic Resonance Imaging

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Purpose-To analyze diffusion tensor imaging (DTI) in two types of cerebral palsy (CP): the athetotic-type and the spastic-type, using an atlas-based anatomical analysis of the entire brain, and to investigate whether these images have unique anatomical characteristics that can support functional diagnoses.Methods-We retrospectively analyzed the DTI of seven children with athetotic-type, 11 children with spastic-type, and 20 healthy control children, all age-matched. The severity of motor dysfunction was evaluated with the Gross Motor Function Classification System (GMFCS). The images were normalized using a linear transformation, followed by large deformation diffeomorphic metric mapping. For 205 parcellated brain areas, the volume, fractional anisotropy, and mean diffusivity were measured. Principal component analysis (PCA) was performed for the Z scores of these parameters.Result-The GMFCS scores in athetotic-type were significantly higher than those in spastic-type (p<0.001). PCA extracted anatomical components that comprised the two types of CP, as well as the severity of motor dysfunction. In the athetotic group, the abnormalities were more severe than in the spastic group. In the spastic group, significant changes were concentrated in the lateral ventricle and periventricular structures.Conclusion-Our results quantitatively delineated anatomical characteristics that reflected the functional findings in two types of CP.

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Dyskinetic cerebral palsy in Europe: trends in prevalence and severity

Abstract: The prevalence of dyskinetic cerebral palsy appears to have increased in children with a normal birth weight. They have frequently experienced perinatal adverse events. Most children have a severe motor impairment and several accompanying impairments.

Cited by 136 publications

References 25 publications

Trends in prevalence of cerebral palsy in children born with a birthweight of 2,500 g or over in Europe from 1980 to 1998

Trends in prevalence of cerebral palsy in children born with a birthweight of 2,500 g or over in Europe from 1980 to 1998

Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Anatomical characterization of athetotic and spastic cerebral palsy using an atlas‐based analysis

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