A systematic review of tests to predict cerebral palsy in young children.
Margot Bosanquet,Margot Bosanquet,Margot Bosanquet,Lisa Copeland,Robert S. Ware,Robert S. Ware,Roslyn N. Boyd,Roslyn N. Boyd +7 more
TLDR
This systematic review evaluates the accuracy of predictive assessments and investigations used to assist in the diagnosis of cerebral palsy in preschool‐age children (<5y).Abstract:
Aim
This systematic review evaluates the accuracy of predictive assessments and investigations used to assist in the diagnosis of cerebral palsy (CP) in preschool-age children (<5y).
Method
Six databases were searched for studies that included a diagnosis of CP validated after 2 years of age. The validity of the studies meeting the criteria was evaluated using the Standards for Reporting Diagnostic Accuracy criteria. Where possible, results were pooled and a meta-analysis was undertaken.
Results
Nineteen out of 351 studies met the full inclusion criteria, including studies of general movements assessment (GMA), cranial ultrasound, brain magnetic resonance imaging (MRI), and neurological examination. All studies assessed high-risk populations including preterm (gestational range 23–41wks) and low-birthweight infants (range 500–4350g). Summary estimates of sensitivity and specificity of GMA were 98% (95% confidence interval [CI] 74–100%) and 91% (95% CI 83–93%) respectively; of cranial ultrasound 74% (95% CI 63–83%) and 92% (95% CI 81–96%) respectively; and of neurological examination 88% (95% CI 55–97%) and 87% (95% CI 57–97%) respectively. MRI performed at term corrected age (in preterm infants) appeared to be a strong predictor of CP, with sensitivity ranging in individual studies from 86 to 100% and specificity ranging from 89 to 97% There was inadequate evidence for the use of other predictive tools.
Summary
This review found that the assessment with the best evidence and strength for predictive accuracy is the GMA. MRI has a good predictive value when performed at term-corrected age. Cranial ultrasound is as specific as MRI and has the advantage of being readily available at the bedside. Studies to date have focused on high-risk infants. The accuracy of these tests in low-risk infants remains unclear and requires further research.read more
Citations
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Journal ArticleDOI
Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment
Iona Novak,Catherine Morgan,Lars Adde,James A Blackman,Roslyn N. Boyd,Janice E. Brunstrom-Hernandez,Giovanni Cioni,Diane L. Damiano,Johanna Darrah,Ann-Christin Eliasson,Linda S. de Vries,Christa Einspieler,Michael T. Fahey,Darcy Fehlings,Donna M. Ferriero,Linda Fetters,Simona Fiori,Hans Forssberg,Andrew M. Gordon,Susan Greaves,Andrea Guzzetta,Mijna Hadders-Algra,Regina T. Harbourne,Angelina Kakooza-Mwesige,Petra Karlsson,Lena Krumlinde-Sundholm,Beatrice Latal,Alison Loughran-Fowlds,Nathalie L. Maitre,Sarah McIntyre,Garey Noritz,Lindsay Pennington,Domenico M. Romeo,Roberta B. Shepherd,Alicia J Spittle,Marelle Thornton,Jane Valentine,Karen Walker,Robert White,Nadia Badawi +39 more
TL;DR: Best available evidence about cerebral palsy–specific early intervention that should follow early diagnosis to optimize neuroplasticity and function is summarized.
Journal ArticleDOI
Evidence-based Diagnosis, Health Care, and Rehabilitation for Children With Cerebral Palsy
TL;DR: The aims were to survey the questions parents asked neurologists and provide evidence-based answers, using knowledge translation techniques, to provide an overview of the most up-to-date diagnostic practices and evidence- based intervention options for cerebral palsy.
Journal ArticleDOI
Fidgety movements - tiny in appearance, but huge in impact.
TL;DR: Abnormal, absent, or sporadic FMs indicate an increased risk for later neurological dysfunction, whereas normal FMs are highly predictive of normal development, especially if they co-occur with other smooth and fluent movements.
Journal ArticleDOI
Early Diagnosis and Early Intervention in Cerebral Palsy
TL;DR: The opportunities and challenges for early diagnosis and early intervention in cerebral palsy, a group of disorders of the development of movement and posture, suggest that programs that stimulate all aspects of infant development by means of family coaching are most promising.
Journal ArticleDOI
Cerebral Palsy: Current Opinions on Definition, Epidemiology, Risk Factors, Classification and Treatment Options.
TL;DR: Current views on definitions, risk factors, diagnostics and treatment of CP as well as comorbid problems, eg, drug-resistant epilepsy are presented.
References
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Journal ArticleDOI
Hand movements at 3 months predict later hemiplegia in term infants with neonatal cerebral infarction.
Andrea Guzzetta,Alessandra Pizzardi,Vittorio Belmonti,Antonio Boldrini,Marco Carotenuto,Giulia D’Acunto,Fabrizio Ferrari,Simona Fiori,C Gallo,Paolo Ghirri,Eugenio Mercuri,Domenico M. Romeo,Maria Federica Roversi,Giovanni Cioni +13 more
TL;DR: This study explored the predictive value of quantitative assessment of hand movements in 3‐month‐old infants after neonatal stroke and found it to be predictive of future stroke recurrence.
Journal ArticleDOI
Early recognition of infants at high risk for cerebral palsy: examination at age four months.
TL;DR: Observations from the examination at four months were investigated as predictors of cerebral palsy, and the most reliable individual sign was increased muscle tone in neck, arms, legs or trunk.
Clinical and MRI Correlates of Cerebral Palsy
TL;DR: MRI findings suggest that obstetric mishaps might have oc- curred in a small proportion of children with CP, and a systematic approach to identifying and treating maternal infections needs to be developed.
Journal ArticleDOI
Magnetic Resonance Imaging Regional T1 Abnormalities at Term Accurately Predict Motor Outcome in Preterm Infants
Yukiko Nanba,Kiyoshi Matsui,Noriko Aida,Yoshiaki Sato,Katsuaki Toyoshima,Motoyoshi Kawataki,Rikuo Hoshino,Makiko Ohyama,Yasufumi Itani,Akiko Goto,Akira Oka +10 more
TL;DR: Lesions in the corona radiata above the posterior limb of the internal capsule on a coronal view by term MRI were useful for predicting motor prognosis in preterm infants with periventricular leukomalacia.
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