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[Accompanying symptoms in infantile spastic hemiplegia]
Insights
Infantile hemiplegia impacts hand function more severely in right-sided cases. Intelligence and hand function impairment are linked, but speech development is not significantly affected by lesion laterality.
Area of Science:
- Pediatric Neurology
- Developmental Neuroscience
Background:
- Infantile hemiplegia is a common neurological disorder in children.
- Concomitant disorders associated with infantile hemiplegia require thorough evaluation.
Purpose of the Study:
- To evaluate various concomitant disorders in children with infantile hemiplegia.
- To analyze the relationship between hemiplegia laterality and functional impairments.
Main Methods:
- Retrospective analysis of 535 children with infantile hemiplegia.
- Detailed documentation and assessment of hand function, sensory perception, intelligence, speech, and leg length differences in 159 cases.
Main Results:
- Right-sided infantile hemiplegia showed more frequent and severe hand function impairments compared to left-sided.
- Hand function deficits correlated with impaired sensory perception (two-point discrimination, stereognosis).
- Reduced intelligence was observed in 38% of children, with a positive correlation between lower intelligence and hand function severity. Speech development was not influenced by lesion side.
Conclusions:
- Hemiplegia laterality influences the severity of hand function impairment.
- Cognitive function is closely linked to motor deficits in infantile hemiplegia.
- Leg length discrepancies are minimal and stabilize after age eight.
Abstract:
Various concomitant disorders in 535 children with infantile hemiplegia were evaluated; 159 of the cases were particularly well documented. The right/left distribution of the hemiplegia was 56 to 44, the ratio of boys to girls 59 to 41. Severe impairments of hand function (lack of function, first grip) were found more frequently in right hemiplegics than left; the ratio of severe to slight disorders was approx. 3 to 1 in right hemiplegics and 3 to 2 in left hemiplegics. Impairment of hand function was closely related to the quality of sensitivity, the tests of this being based on two-point discrimination and stereognosis. Sixty-two percent of the children were of normal intelligence; of the remainder, approximately equal-sized groups suffered from impairment of the learning faculty or were mentally retarded. There was a positive correlation between reduced intelligence and the severity of impairment of hand function. Impaired speech development was found in 7 percent of the children, right and left hemiplegics being equally affected. Thus, there was no evidence that the brain lesion had any special influence on development of speech. Observations of growth in the legs revealed average differences of length of 2 mm and up to 3.5 cm in isolated cases. After eight year of life there was practically no further increase in the differences in length.