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CPP03 Evaluation of patients with cerebral palsy
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Abstracts: Poster Presentations, the Seventh European Paediatric Neurology Society (EPNS) Congress
Conclusion: Cerebrovascular disorders during prenatal or postnatal period are main causes of spatic hemiparesis in pediatric population as well as cortical dysplasia and perinatal asphixia. CPP03 Evaluation of patients with cerebral palsy A. Tosun *, M. Polat, G. Serdaroglu, H. Tekgul, S. Gokben. Department of Pediatrics, Division of Child Neurology, Ege University Medical School, Izmir, Turkey In this study, 442 patients (260 male) with cerebral palsy between the ages of 1−18 years (mean age 7.05±3.73 year) who were admitted to Ege University Department of Pediatric Neurology between 1995 and 2006 were evaluated. Mean gestation age was 36.45±4.83 (23−43 weeks), 38.1% was preterm, 26.9% and 15.61% had a birth weight of 2500 g and 1500 g respectively. Among the births, 93.9% was in hospital and 42.3% was with ceaserean section. Cerebral palsy was determined in 91.6% of the patients during the first 2 years of life. The etiology was considered as preperinatal in 79.8% and 73% of the patients with 33−37 weeks and 32 weeks gestational age, respectively. Perinatal risk factors were observed mostly in term infants (56.6%) and postnatal factors were detected only in this group (7.7%). Spastic tetraparesis and diparesis were found with similar ratios between 33−37 weeks and 32 weeks (tetraparesis in 39.4%, 37.8%, diparesis in 42.6%, 43.2%, of the patients respectively). Spastic tetraparesis, diparesis and hemiparesis was determined in 32%, 27.6% and 20.6% respectively in the term group. Ataxic type was more common in this group (11%). Compared to our data between 1972 and 1994, preterm infants were folded, spastic diparesis was determined five times more and there was a decrease in tetparesis cases. CPP04 Visual disorders associated with cerebral palsy ¸ cı ¸ 1, H.F. Akkoc¸ 1 , T. Berk1 , T. Hızlı2 , O. El1 , H. Cakmak O. Hudao glu ˘ 1 *. 1 Department of Pediatrics, Division of Child ¨ Neurology, Dokuz Eylul ¨ University, School of Medicine, 2 Beh¸cet Uz Children’s Hospital, I˙zmir, Turkey Purpose: To evaluate the incidence of ocular abnormalities such as strabismus, refractive error, visual acuity, nystagmus associated with cerebral palsy and to correlate the gestational age, birth weight, clinical type, neuroradiologic findings with these abnormalities in children affected by cerebral palsy. Methods: Seventy-one patients with cerebral palsy were included in this prospective study. Visual acuity was assessed by methods suitable for the age and cooperation of the child. Strabismus, nystagmus, refractive error and optic disc morphology were assessed by the detailed anterior segment and fundus examination. The relationship was betvveen ocular findings, gestational age, birth weight, clinical type and the classification rnade by the neuroradiologist according to 61 neuroimages. Results: This report indicated that 83% of the patients had ocular disorders. Strabismus was found in 48% of the children, the ratio of esotropia to exotropia was 2:1. Mean gestational age and birth weight in ortophorias, exotropias, esotropias were 35.8±4.0 months and 2627.1±820.3 grams; 35.7±4.7 months and 2261.8±794.8 grams; 32.3±4.9 months and 1881.3±937.7 grams respectively. There was no significant difference betvveen the severity of periventricular leukomalacia, occipital cortex damage and clinical type compared to those have horizontal deviation. About 90% of the spastic diplegic patients, 83% of hemiplegics and 29% of tetraplegics had a relatively better visual acuity (Snellen equivalent >0.1). The severity of periventricular leukomalacia and occipital cortex damage were not significantly related to the visual acuity. Refractive error was found in 81%, nystagmus in 11% and abnormal optic disc morphology in 65% in patients. Only
42% of the children vvith cerebral palsy had previously had an ophtalmic assessment. Conclusion: There was a significant association between younger gestational age and low birth weight vvith esotropia. Visual acuity vvas better in spastic diplegic group than those vvith tetraplegia and hemiplegia. Despite high incidence of ocular disorders only fevv patients were formerly examined by opthalmologist. These children should have early ophthalmological assessment and care to provide visual stimulation on the motor and mental development. Key Word: Cerebral palsy, periventricular leukomalacia, Snellen equivalent CPP05 Oculomotor function vs. developmental quotient in cerebral palsied children N. Kozeis1,2 *, A. Felekidis1,2 , D. Kokkinou1 , S. Lake2 , E. Aggelidou2 *. 1 Pediatric Eye Department Hippokrateion Hospital, 2 3rd Eye University Department AUTH, Thessaloniki, Greece Purpose: To investigate possible relationship between smooth pursuits, gross motor function and brain damage in spastic diplegic (SD) children. Methods: Twenty eight cerebral palsied SD children (2−8 years old) were included in this study. All were classified according to GMFCS system, had a brain MRI and a clinical assessment of smooth pursuits. Results: Brain MRI showed that 8 children appeared with mild periventricular leukomalacia (PVL), 15 with moderate PVL, 2 with severe PVL, none with cortical atrophy, 3 with combined PVL and cortical atrophy and finally, none appeared with parenchymatic atrophy. The GMFCS classification showed 6 children with good kinetic function (1), 11 with mild kinetic problem (2), 9 with moderate kinetic problem (3), 2 with severe disability (4) and none with very severe disability (5). 13 children had normal smooth pursuits, 15 appeared with mildly affected saccadic performance (using head movements), but no child appeared either unable to execute saccades or executing chaotic saccades. The statistical analysis (Kruskal-Wallis test) showed a significant correlation between smooth pursuits, gross motor function and brain damage severity (p < 0.001). Conclusion: Smooth pursuits are mildly affected in SD children, related to their gross motor function and to their severity of brain damage CPP06 Sensory visual function vs. developmental quotient in cerebral palsied children N. Kozeis2 *, D. Kokkinou2 , D. Zafeiriou3 , N. Georgiadis1 . 1 1st Eye University department AUTH, 2 Pediatric Eye Department Hippokrateion Hospital, 3 1st Pediatric University Department AUTH, Thessaloniki, Greece Purpose: To investigate the relationship between the sensorial part of visual function and the psychokinetic development of cerebral palsied (CP) children. Methods: Eighty CP children (2−8 years old) were included in this study. The visual acuity (far & near), the functional visual fields, the color perception and the contrast sensitivity were assessed in all children. Also, the Griffith’s test was performed to evaluate the developmental status (DQ) of each child. For the visual assessments the (VFA-K test) was used. Results: Griffith’s test: 6 children scored (100−80), 12 children scored (80−60), 22 children scored (60−40) and 40 children scored (<40). 50% of the children had reduced best corrected far visual acuity (BCVA), 82.5% had reduced near visual acuity, 65% had a significant refractive error (×>0.50 D), hypermetropia (41.5%), 73.75 had normal functional visual fields, 90% had normal colour perception and 75% had good
Abstracts: Poster Presentations, the Seventh European Paediatric Neurology Society (EPNS) Congress
Conclusion: Cerebrovascular disorders during prenatal or postnatal period are main causes of spatic hemiparesis in pediatric population as well as cortical dysplasia and perinatal asphixia. CPP03 Evaluation of patients with cerebral palsy A. Tosun *, M. Polat, G. Serdaroglu, H. Tekgul, S. Gokben. Department of Pediatrics, Division of Child Neurology, Ege University Medical School, Izmir, Turkey In this study, 442 patients (260 male) with cerebral palsy between the ages of 1−18 years (mean age 7.05±3.73 year) who were admitted to Ege University Department of Pediatric Neurology between 1995 and 2006 were evaluated. Mean gestation age was 36.45±4.83 (23−43 weeks), 38.1% was preterm, 26.9% and 15.61% had a birth weight of 2500 g and 1500 g respectively. Among the births, 93.9% was in hospital and 42.3% was with ceaserean section. Cerebral palsy was determined in 91.6% of the patients during the first 2 years of life. The etiology was considered as preperinatal in 79.8% and 73% of the patients with 33−37 weeks and 32 weeks gestational age, respectively. Perinatal risk factors were observed mostly in term infants (56.6%) and postnatal factors were detected only in this group (7.7%). Spastic tetraparesis and diparesis were found with similar ratios between 33−37 weeks and 32 weeks (tetraparesis in 39.4%, 37.8%, diparesis in 42.6%, 43.2%, of the patients respectively). Spastic tetraparesis, diparesis and hemiparesis was determined in 32%, 27.6% and 20.6% respectively in the term group. Ataxic type was more common in this group (11%). Compared to our data between 1972 and 1994, preterm infants were folded, spastic diparesis was determined five times more and there was a decrease in tetparesis cases. CPP04 Visual disorders associated with cerebral palsy ¸ cı ¸ 1, H.F. Akkoc¸ 1 , T. Berk1 , T. Hızlı2 , O. El1 , H. Cakmak O. Hudao glu ˘ 1 *. 1 Department of Pediatrics, Division of Child ¨ Neurology, Dokuz Eylul ¨ University, School of Medicine, 2 Beh¸cet Uz Children’s Hospital, I˙zmir, Turkey Purpose: To evaluate the incidence of ocular abnormalities such as strabismus, refractive error, visual acuity, nystagmus associated with cerebral palsy and to correlate the gestational age, birth weight, clinical type, neuroradiologic findings with these abnormalities in children affected by cerebral palsy. Methods: Seventy-one patients with cerebral palsy were included in this prospective study. Visual acuity was assessed by methods suitable for the age and cooperation of the child. Strabismus, nystagmus, refractive error and optic disc morphology were assessed by the detailed anterior segment and fundus examination. The relationship was betvveen ocular findings, gestational age, birth weight, clinical type and the classification rnade by the neuroradiologist according to 61 neuroimages. Results: This report indicated that 83% of the patients had ocular disorders. Strabismus was found in 48% of the children, the ratio of esotropia to exotropia was 2:1. Mean gestational age and birth weight in ortophorias, exotropias, esotropias were 35.8±4.0 months and 2627.1±820.3 grams; 35.7±4.7 months and 2261.8±794.8 grams; 32.3±4.9 months and 1881.3±937.7 grams respectively. There was no significant difference betvveen the severity of periventricular leukomalacia, occipital cortex damage and clinical type compared to those have horizontal deviation. About 90% of the spastic diplegic patients, 83% of hemiplegics and 29% of tetraplegics had a relatively better visual acuity (Snellen equivalent >0.1). The severity of periventricular leukomalacia and occipital cortex damage were not significantly related to the visual acuity. Refractive error was found in 81%, nystagmus in 11% and abnormal optic disc morphology in 65% in patients. Only
42% of the children vvith cerebral palsy had previously had an ophtalmic assessment. Conclusion: There was a significant association between younger gestational age and low birth weight vvith esotropia. Visual acuity vvas better in spastic diplegic group than those vvith tetraplegia and hemiplegia. Despite high incidence of ocular disorders only fevv patients were formerly examined by opthalmologist. These children should have early ophthalmological assessment and care to provide visual stimulation on the motor and mental development. Key Word: Cerebral palsy, periventricular leukomalacia, Snellen equivalent CPP05 Oculomotor function vs. developmental quotient in cerebral palsied children N. Kozeis1,2 *, A. Felekidis1,2 , D. Kokkinou1 , S. Lake2 , E. Aggelidou2 *. 1 Pediatric Eye Department Hippokrateion Hospital, 2 3rd Eye University Department AUTH, Thessaloniki, Greece Purpose: To investigate possible relationship between smooth pursuits, gross motor function and brain damage in spastic diplegic (SD) children. Methods: Twenty eight cerebral palsied SD children (2−8 years old) were included in this study. All were classified according to GMFCS system, had a brain MRI and a clinical assessment of smooth pursuits. Results: Brain MRI showed that 8 children appeared with mild periventricular leukomalacia (PVL), 15 with moderate PVL, 2 with severe PVL, none with cortical atrophy, 3 with combined PVL and cortical atrophy and finally, none appeared with parenchymatic atrophy. The GMFCS classification showed 6 children with good kinetic function (1), 11 with mild kinetic problem (2), 9 with moderate kinetic problem (3), 2 with severe disability (4) and none with very severe disability (5). 13 children had normal smooth pursuits, 15 appeared with mildly affected saccadic performance (using head movements), but no child appeared either unable to execute saccades or executing chaotic saccades. The statistical analysis (Kruskal-Wallis test) showed a significant correlation between smooth pursuits, gross motor function and brain damage severity (p < 0.001). Conclusion: Smooth pursuits are mildly affected in SD children, related to their gross motor function and to their severity of brain damage CPP06 Sensory visual function vs. developmental quotient in cerebral palsied children N. Kozeis2 *, D. Kokkinou2 , D. Zafeiriou3 , N. Georgiadis1 . 1 1st Eye University department AUTH, 2 Pediatric Eye Department Hippokrateion Hospital, 3 1st Pediatric University Department AUTH, Thessaloniki, Greece Purpose: To investigate the relationship between the sensorial part of visual function and the psychokinetic development of cerebral palsied (CP) children. Methods: Eighty CP children (2−8 years old) were included in this study. The visual acuity (far & near), the functional visual fields, the color perception and the contrast sensitivity were assessed in all children. Also, the Griffith’s test was performed to evaluate the developmental status (DQ) of each child. For the visual assessments the (VFA-K test) was used. Results: Griffith’s test: 6 children scored (100−80), 12 children scored (80−60), 22 children scored (60−40) and 40 children scored (<40). 50% of the children had reduced best corrected far visual acuity (BCVA), 82.5% had reduced near visual acuity, 65% had a significant refractive error (×>0.50 D), hypermetropia (41.5%), 73.75 had normal functional visual fields, 90% had normal colour perception and 75% had good