Etiology of Postneonatally Acquired Cerebral Palsy

Perlstein, Meyer A.; Hood, Philip

doi:10.1001/jama.1964.03060360010002

Cited by 13 publications

(7 citation statements)

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“…This raises the question as to which hemisphere of normal subjects should be used as a control to characterize sensorimotor function reorganization of the intact hemisphere in the patients. As (5,38). We studied only one patient with injury to the right hemisphere.…”

Section: Discussionmentioning

confidence: 99%

Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period.

Cao

Vikingstad

Huttenlocher

et al. 1994

Proc. Natl. Acad. Sci. U.S.A.

128

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Functional magnetic resonance ging was used to map the hand sensorimotor area of hemiparetic adolescents and young adults who had suffered unilateral brain damage in the perinatal period. Unlike normal subjects, who exhibit cortical activation primarily contralateral to voluntary finger movements, the hemaretic patients' intact hemispheres were equally activated by contralateral and ipsilateral finger movements. Our fidings are consistent with previous clinical observations and animal experiments which suggest that the immature brain is able to reorganize in response to focal injury.Many observations suggest that the immature human brain is characterized by "plasticity": i.e., it is capable of major functional reorganization in response to external and internal stimuli. For example, children will recover language skills after sustaining a large insult or even hemispherectomy on the speech-dominant side if the damage occurs before age 7 or 8 (1). Similarly, if a child with strabismus is forced to use the squinting eye by patching of the good eye before about age 7, permanent visual loss in the squinting eye (amblyopia) can be prevented (2, 3). The sensorimotor system also demonstrates plasticity. Children with large unilateral brain lesions can learn to reach out and grasp an object and can walk, although with a limp (4). Movements of the paretic hand in these children are often accompanied by "mirror" movements on the opposite side (5, 6). Such parallel movements are much more prominent when brain injury occurs before 1 year of age (6). These observations suggest that motor function might be represented in the hemisphere ipsilateral to the weak hand if injury is incurred early in life.Similar effects have been found in animal models: e.g., the reaction of the rodent motor system to postnatal hemispherectomy. In this model, it has been shown that the remaining hemisphere develops a new, uncrossed corticospinal tract to the ipsilateral spinal cord in addition to the usual crossed one (7). Huttenlocher et al. (8,9) have succeeded in making separate cortical maps of the neurons forming the aberrant (uncrossed) and normal (crossed) tracts. The neurons which are "recruited" to form the uncrossed tract are found in the same areas as the usual "crossed" neurons, as well as in the adjacent cortex. Thus, these cortical mapping experiments suggest that a limited population of multipotential neurons might be involved in brain plasticity. The mechanisms of neural reorganization in the human brain are not well understood (10) but may involve the unmasking of existing pathways (11, 12), competition for synaptic space (13), or axonal migration and sprouting along chemical gradients (14).Although ample clinical observations (1-7) and animal experiments (8,9,15) suggest that the human brain demonstrates plasticity, there are few studies that provide brain mapping evidence for cortical reorganization after motorcortex lesions. A single case report utilizing magnetoencephalography suggested reorganization in the somatosenso...

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Section: Discussionmentioning

confidence: 99%

Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period.

Cao

Vikingstad

Huttenlocher

et al. 1994

Proc. Natl. Acad. Sci. U.S.A.

128

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“…There is general agreement that this refers to a disorder of movement and posture due to a brain lesion arising after birth and not related to pregnancy or the birth process, but the exact age-limits are controversial. Some workers include only cases arising after the neonatal period, varying from seven days to four weeks (Swinyard et al 1963, Perlstein and Hood 1964, Hagberg et al 1975, Lademan 1978, while others have no lower limit (Arens et al 1978, Blair and Stanley 1982). Upper age-limits range from two years (Hagberg et al 1975, Cussen et al 1978 to an indefinite period in adolescence (Swinyard et al 1963, Perlstein andHood 1964, Holm 1982).…”

Section: D Molten0mentioning

confidence: 99%

“…Some workers include only cases arising after the neonatal period, varying from seven days to four weeks (Swinyard et al 1963, Perlstein and Hood 1964, Hagberg et al 1975, Lademan 1978, while others have no lower limit (Arens et al 1978, Blair and Stanley 1982). Upper age-limits range from two years (Hagberg et al 1975, Cussen et al 1978 to an indefinite period in adolescence (Swinyard et al 1963, Perlstein andHood 1964, Holm 1982). In this study we recognise no lower age-limits and have included children who suffered brain insults in the neonatal period from extraneous causes such as neonatal meningitis or head trauma, providing the child was healthy at birth.…”

Section: D Molten0mentioning

confidence: 99%

“…Despite this low prevalence rate, the rate of acquired cerebral palsy in the black group is still marginally higher than in the coloured group and markedly higher than in the white group. Table V shows the percentages of postnatally-acquired cerebral palsy given in three previous studies (Swinyard et al 1963, Perlstein and Hood 1964, Blair and Stanley 1982, together with an additional seven studies dealing with the epidemiology of cerebral palsy in general (d'Avignon 1963 and Lademan 1978 did not report incidence figures). Our earlier article (Arens et al 1978) dealt with cerebral palsy among white and coloured children from a wider geographical area than in the present study.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

“…The reports from New York (Swinyard et al 1963), Ireland (Cussen et al 1978), Seattle (Holme 1982) and Western Australia (Blair and Stanley 1982) show remarkably similar rates of 10 to 11 per cent, despite a 20-year timespan. The Perlstein and Hood (1964) Chicago study, with a 14 per cent prevalence, was of a very mixed population with regard to both socio-economic conditions and ethnic groupings. The low figure in Sweden (Hagberg et al 1976) is probably attributable to excellent Swedish health services, but it should also be noted that Hagberg and colleagues' upper agelimit was two years.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

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A Comparative Study of Postnatally‐acquired Cerebral Palsy in Cape Town

Arens

Molteno

1989

Develop Med Child Neuro

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SUMMARY The importance of socio‐economic conditions in the causation of postnatally‐acquired cerebral palsy has not been stressed in previous studies. A comparative survey was undertaken in Cape Town, South Africa. Three ethnic groups were compared—white, coloured (mixed ancestry) and black. The percentage of postnatally‐acquired cerebral palsy in these groups was 13·2, 24·0 and 36·1 per cent, respectively. These figures can be explained by the differing socio‐economic conditions of each group, the white group belonging to the highest socio‐economic stratum and the black group to the lowest. The main causes of postnatally‐acquired cerebral palsy were cerebral infections (particularly meningitis), cerebral trauma and cerebrovascular accidents. The proportion in each group, the main causal factors, age at onset, types of cerebral palsy and intellectual status are similar to those of most previous studies. RÉSUMÉ Etude comparative de l'IMC d'origine post‐natale au Cap L'importance des conditions socio‐économiques dans les IMC d'origine postnatale n'a pas été soulignée au cours d'études précédentes. Une recherche comparative a été entreprise au Cap, en Union Sud‐Africaine. Trois groupes ethniques ont été compareés, blanc, métis et noir. Le pourcentage d'IMC par cause post‐natale dans les trois groupes a été respectivement de 13·2, 24·0 et 36·1. Ces écarts peuvent être expliqués par les conditions socio‐économiques propres à chaque groupe, le status socio‐économique des blancs étant le plus élevé, celui des noirs le plus bas. Les principales causes des IMC d'origine post‐natales étaient: l'infection cérébrale (en particulier, meningite), les traumatismes cérébraux et les accidents cérébrovasculaires. La proportion dans chaque groupe, les principaux facteurs responsables, l'âge de début, les types d'IMC et l'état intellectuel sont apparus identiques à ceux de la plupart des études antérieures. ZUSAMMENFASSUNG Eine Vergleichsstudie über postnatal erworbene Cerebralparese in Kapstadt Die Bedeutung der sozio‐ökonomischen Bedingung als Ursache der postnatal erworbenen Cerebralparese ist in früheren Studien nicht erwähnt worden. In Kapstadt, Südafrika, wurde eine Vergleichsstudie durchgeführt. Es wurden drei ethnische Gruppen verglichen—weiß, farbig (gemischete Vorfahren) und schwarz. Der Prozentsatz der erworbenen Cerebralparese in diesen Gruppen betrug 13·2, 24·0 und 36·1. Diese Zahlen können durch die Unterschiede der sozio‐ökonischen Bedingungen für die einzelnen Gruppen erklärt werden, die weiße Gruppe gehört zu der höchsten sozio‐ökonomischen Schicht und die schwarze zur niedrigsten. Die Hauptursachen für die postnatal erworbene Cerebralparese waren: Hirninfektionen (insbesondere Meningitis), Hirntrauma und cerebrovaskuläre Unfälle. Das Verhältnis in jeder Gruppe, die Hauptursachen, Alter bei Beginn, Art der Cerebralparese und intellektueller Stand ähneln den Angaben der meisten früheren Untersuchungen. RESUMEN Estudio comparativo de la parálisis cerebral adquirida postnatalmente en la Ciudad del Cabo La importancia d...

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Infantile Zerebralparese

Döderlein¹

2015

Infantile Zerebralparese

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Etiology of Postneonatally Acquired Cerebral Palsy

Cited by 13 publications

References 5 publications

Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period.

Functional magnetic resonance studies of the reorganization of the human hand sensorimotor area after unilateral brain injury in the perinatal period.

A Comparative Study of Postnatally‐acquired Cerebral Palsy in Cape Town

Infantile Zerebralparese

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