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Updated: Jul 18, 2026
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Published on: May 18, 2010
Neurological examination at 6 to 9 months in infants with cystic periventricular leukomalacia
1Paediatric Neurology Unit, Catholic University, Rome, Italy. daniricciola@libero.it
Insights
Neurological examination in infants with cystic periventricular leukomalacia (PVL) between 6-9 months can predict motor outcomes. Specific tone patterns and optimality scores help forecast motor sequelae at two years.
Area of Science:
- Neonatal Neurology
- Pediatric Neurology
- Developmental Pediatrics
Background:
- Cystic periventricular leukomalacia (PVL) is a common form of brain injury in preterm infants.
- PVL can lead to significant motor impairments, including cerebral palsy.
- Early identification of neurodevelopmental risks is crucial for timely intervention.
Purpose of the Study:
- To identify neurological abnormality patterns in infants with PVL.
- To determine optimality scores predicting motor sequelae severity.
- To correlate early neurological findings with motor function at two years of age.
Main Methods:
- Hammersmith Infant Neurological Examination administered to 24 infants with PVL (gestational age 26-38 weeks).
- Examinations conducted between 6 and 9.5 months corrected age.
- Motor function (sitting, walking) assessed at 2 years corrected age.
Main Results:
- Increased neck/trunk extensor tone with flexed arms/extended legs predicted inability to sit unsupported at 2 years.
- Truncal hypotonia with extended arms/legs correlated with sitting ability but not walking.
- Optimality scores: 41-60 predicted sitting but not walking; <40 predicted inability to sit independently.
- Scores >60 were associated with the absence of cerebral palsy at 2 years.
Conclusions:
- Neurological examination findings between 6-9 months are predictive of motor impairment in infants with PVL.
- Optimality scores derived from these examinations offer valuable prognostic information.
- Early assessment aids in predicting the severity of motor sequelae in infants with PVL.
Abstract:
The Hammersmith Infant Neurological Examination was performed in 24 infants with cystic periventricular leukomalacia whose gestational age ranged between 26-38 weeks. The infants were examined between 6 and 9.5 months corrected age. The aim of the study was to establish the different patterns of neurological abnormality as well as the optimality scores that predict the severity of motor sequelae at 2 years. Increased neck and trunk extensor tone, and a posture of flexed arms and extended legs between 6 and 9 months were always associated with the inability to sit unsupported at 2 years, whilst truncal hypotonia and extended arms and legs were associated with unsupported sitting but not walking. Optimality scores between 41 and 60 were generally associated with sitting but not walking at 2 years whilst scores below 40 were always associated with the inability to sit independently at 2 years. All infants who did not develop cerebral palsy at 2 years had scores > 60. Our results suggest that the pattern of findings on neurological examination performed between 6 and 9 months as well as the calculated optimality score helps to predict motor impairment in infants with PVL.
