Using postural reactions as a screening test to identify high-risk infants for cerebral palsy: a prospective study
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Published on: December 11, 2013
D I Zafeiriou1, I G Tsikoulas, G M Kremenopoulos
11st Pediatric Clinic, Aristotle University of Thessaloniki, Greece. jeff@med.auth.gr
Insights
Early detection of cerebral palsy (CP) is possible using postural reactions (PR). Abnormalities in five or more PR within the first month predict CP, while fewer abnormalities indicate normal development.
Area of Science:
- Pediatrics
- Neurology
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) diagnosis relies on early identification of developmental abnormalities.
- Postural reactions (PR) are key indicators of neurological development in infants.
- Predictive value of PR for CP diagnosis needs further clarification.
Purpose of the Study:
- To assess the predictive accuracy of seven common postural reactions (PR) for diagnosing cerebral palsy (CP) in high-risk infants.
- To correlate patterns of abnormal PR in the first year of life with specific CP subtypes and developmental outcomes at three years.
Main Methods:
- Prospective study of 204 high-risk infants followed until three years of age.
- Systematic assessment of seven commonly used PR from the first month of life.
- Correlation analysis between PR abnormalities and diagnoses of CP, developmental retardation (DR), or normal outcome.
Main Results:
- Five or more abnormal PR from the first month correlated with spastic CP.
- Three or fewer abnormal PR predicted a normal outcome.
- Specific PR abnormalities identified early in infancy were linked to spastic CP, athetoid CP, developmental retardation, and ataxic CP.
Conclusions:
- Examination of PR provides a valuable quantitative and qualitative screening tool for high-risk infants.
- Early assessment of PR from the first month of life can aid in the early diagnosis of cerebral palsy and other developmental disorders.
Abstract:
To clarify the predictive value of the seven more commonly used postural reactions (PR) in the 1st year of life regarding the diagnosis of cerebral palsy (CP), we prospectively examined 204 high-risk infants of whom 58 developed CP, 22 had developmental retardation (DR) and 124 were normal at follow-up at 3 years of age. Abnormalities of five or more PR from the 1st month of life were correlated with spastic CP, while five or six abnormal PR were also correlated with athetoid CP. Three or less abnormal PR correlated with a normal outcome. All seven PR tested were significantly abnormal in children with spastic CP from the 1st month compared to normal children. Athetoid children demonstrated abnormalities of the Peiper-Isbert (P-I) reaction and Vojta reaction from the 1st month and of the vertical, horizontal and Collis vertical suspension from the 3rd month. Children with DR had significantly abnormal Collis horizontal and Collis vertical suspension, Vojta reaction and traction response from the 1st month and Peiper-Isbert reaction from the 3rd month. Ataxic children demonstrated significantly abnormal traction response from the 1st month, Collis horizontal reaction from the 7th month and Peiper-Isbert reaction from the 11th month. We conclude that the examination of PR is a useful quantitative and qualitative diagnostic screening tool for high-risk infants from the 1st month of life.
