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Ocular Motor Function in Children with Spastic Hemiplegia Evaluated by the Ocular Motor Score
A Rydberg1,2, J Ygge1,3, M Olsson1,3
1a Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden.
Insights
The Ocular Motor Score (OMS) effectively assesses eye movement disorders in children with spastic hemiplegia. Children with brain malformations showed the highest scores, indicating significant ocular motor dysfunction.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neurorehabilitation
Background:
- Spastic hemiplegia, a common form of cerebral palsy, often presents with associated neurological deficits.
- Ocular motor dysfunction is frequently observed in children with spastic hemiplegia, impacting their visual development and quality of life.
Purpose of the Study:
- To evaluate the utility of the Ocular Motor Score (OMS) in quantifying ocular motor functions in children diagnosed with spastic hemiplegia.
- To identify potential correlations between specific types of brain lesions and the severity of ocular motor impairments.
Main Methods:
- The study included 34 children with spastic hemiplegia (median age 11 years), categorized into three groups based on lesion type: malformations, white matter damage of immaturity (WMDI), and cortical/subcortical lesions.
- The Ocular Motor Score (OMS) protocol, comprising 15 static and dynamic subtests, was administered. Each subtest is scored from 0 (normal) to 1 (maximum disability), yielding a total OMS (tOMS) ranging from 0 to 15.
Main Results:
- The overall median tOMS for children with spastic hemiplegia was 2.5 (range 1.3-5.8).
- Children in the malformation group (group 1) exhibited the highest median tOMS of 5.2, suggesting more severe ocular motor deficits.
- Strabismus was diagnosed in 45% (15/34) of the participants, with no significant difference across the three etiological groups.
Conclusions:
- The Ocular Motor Score (OMS) provides a reliable and clinically feasible method for assessing ocular motor functions in children with spastic hemiplegia.
- Children with underlying brain malformations appear to experience more pronounced ocular motor disturbances.
- The OMS facilitates a rapid clinical overview of ocular motor status, aiding in diagnosis and management planning.
Purpose:
To assess the ocular motor functions in children with spastic hemiplegia by using the Ocular Motor Score (OMS).
Material:
This study included 34 children, median age 11 years. The children were divided into 3 groups according to the underlying brain lesion; group 1 malformations, group 2 white matter damage of immaturity (WMDI), and group 3 cortical/subcortical lesions.
Methods:
The OMS protocol consists of 15 different subtests evaluating ocular motor functions. The OMS is divided into 2 parts, a static and a dynamic. The results from each subtest are scored 0, 0.3, 0.5, or 1, according to the level of disturbance, where 0 corresponds to normal function and 1 represents the maximum disability in the certain subtest. A total OMS (tOMS) between 0 and 15 can be obtained.
Results:
The median tOMS in the whole spastic hemiplegia group was 2.5 (range 1.3-5.8). The highest median tOMS 5.2 was seen in group 1, in the children with malformations. Strabismus was found in 45% (15/34) of the children, with an equal percentage in all 3 groups.
Conclusions:
The children with spastic hemiplegia had a median tOMS of 2.7 and the highest median tOMS was seen in children with malformations. The OMS protocol is easy to use clinically and gives a quick overview of the patient´s ocular motor functions.
