Neuropediatrics 2000; 31(5): 240-251
DOI: 10.1055/s-2000-9233
Original Article

Georg Thieme Verlag Stuttgart · New York

Early Neurological Signs in Preterm Infants with Unilateral Intraparenchymal Echodensity

G. Cioni1 , A. F. Bos2 , Christa Einspieler3 , F. Ferrari4 , A. Martijn5 , Paola B. Paolicelli1 , G. Rapisardi6 , M. Federica Roversi4 , H. F. R. Prechtl3
  • 1 Division of Child Neurology and Psychiatry, University of Pisa and Stella Maris Foundation, Pisa, Italy
  • 2 Department of Paediatrics, Division of Neonatology, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands
  • 3 Department of Physiology, Karl-Franzens-University, Graz, Austria
  • 4 Department of Obstetrics and Paediatrics, Division of Neonatology, University Hospital, Modena, Italy
  • 5 Department of Radiology, Beatrix Children's Hospital, University Hospital, Groningen, The Netherlands
  • 6 Department of Paediatrics, Neonatal Intensive Care Unit, Anna Meyer Hospital, Florence, Italy
Further Information

Publication History

Publication Date:
31 December 2000 (online)

The aim of the study was to document the early developmental course of neurological signs in a group of preterm infants at risk for hemiplegia due to unilateral intraparenchymal echodensity (UIPE). Sixteen preterm infants with UIPE and sixteen controls were given serial neurological examinations, according to the protocols currently adopted in the different NICUs of the project. Moreover, the quality assessment of their general movements (GMs) was assessed subsequently from videotapes, from birth until around four months postterm. At two years, 12 of the UIPE infants showed hemiplegia and one suffered from asymmetrical diplegia. The findings of the traditional neurological examination were abnormal for the large majority of the UIPE infants, although normal findings were also recorded in some cases, especially during the preterm period. Asymmetries were found after term age in nine UIPE and in two control infants. From the first observation onwards, all infants with UIPE showed bilaterally abnormal GMs and in those with unfavourable outcome fidgety movements (FMs) were absent. At the FMs period (9 - 16 weeks postterm), all infants with subsequent hemiplegia showed asymmetry of distal segmental movements which were reduced or absent on the side contralateral to the lesion.

Conclusions: Unilateral brain lesions induce clear neurological signs and abnormal GMs in particular, although these abnormalities are not initially asymmetrical. A reduction of segmental movements on one side of the body during the third month postterm is highly predictive of hemiplegia.

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M. D. Giovanni Cioni

Division Child Neurology and Psychiatry University of Pisa and Stella Maris Foundation

Via dei Giacinti 2

56018 Calambrone (Pisa)

Italy

Email: E-mail: cioni@inpe.unipi.it

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