Serebral palsi tanısıyla izlenen çocukların beyin MRG bulgularının ve klinik bulgularının ilişkilendirilmesi

Amaç: Bu çalışmanın amacı, serebral palsili (SP) çocuklarda hastalığa eşlik eden epilepsi, zeka geriliği, işitme, görme sorunları ile motor kısıtlılık (KMSS seviyesi) gibi bozuklukların hastaların beyin MRG bulgularıyla ilişkisini saptamaktır.Yöntemler: İzmir Dr. Behçet Uz Çocuk Sağlığı ve Hastalıkları Eğitim Araştırma Hastanesi Pediatrik Nöroloji Polikliniğine Ocak 2012 ile Kasım 2013 tarihleri arasında başvurmuş serebral palsi tanılı hastaların kayıtları (yaş, cinsiyet, doğum haftası, doğum ağırlığı, doğum şekli, intrauterin presentasyon, akraba evliliği varlığı, ailede benzer öykü varlığı, beyin MRG bulguları, SP klinik alt tipi, motor kısıtlılık düzeyleri, zeka geriliği, görme bozukluğu, işitme bozukluğu, epilepsi) retrospektif olarak incelendi.Bulgular: Bu çalışmada,73 erkek (%57) ve 55 kız (%43,1) olmak üzere toplam 128 hasta incelendi. Çoğu hastada (n=115, %89,9) kranial MRG bulguları saptanmış olup; 68'inde periventriküler lökomalazi (%53,1), 15'inde serebral malformasyon (%11,7), 15'inde unda gri cevher hastalığı (%11,7), 14'ünde serebrovasküler olay (%10,9), 2'sinde bazal ganglion tutulumu (%1,6), 1'inde (%0,8) tanısal olmayan bulgular saptandı. En sık görülen SP alt tipi kuadriplejik SP idi. SP'ye en sık eşlik eden bozukluklar zeka geriliği (%81,4), epilepsi (%55,5), görme bozukluğu (%29,7) işitme bozukluğu (%8,6) olarak saptandı. Beyin MRG sinde Gri cevher hastalığı (GCH) saptanmasının işitme bozukluğu görülmesi ve motor fonksiyon kısıtlılığı (kmss) ile anlamlı bir ilişkisinin olduğunu saptadık (p

Assosiation between cranial magnetic resonance imaging and clinical findings of children with cerebral palsy

Objective: The aim of this study was to evaluate the association between cranial magnetic resonance imaging (MRI) findings and clinic comorbities of cerebral palsy (CP) like gross motor classification system (GMFCS) level, mental retardation, hearing disabilities, visual disabilities, and epilepsy.Methods: After approval obtained from the Ethics Committee of the Hospital, the medical records (age, gender gestational age, gestational weight, the method of delivery, intrauterine presentation, consanguinity of parents, similar medical history among family members, cranial MRI findigs, clinical subtype of CP, motor impairment level (GMFCS), mental retardation, visual and hearing disabilities, epilepsy) of the patients who applied to the Pediatric Neurology Department of Izmir Dr Behçet Uz Children's Hospital between January 2012 and November 2013 were examined retrospectively.Results: A total of 128 patients (male, n= 73; 57%), and female (n=55; 43%) were included in this study. The most patients (n=115, 89.9%) (89.8%) had documented cranial MRI abnormalities; the most common ones being periventricular white matter injury PVWMI (53.1%), cerebral malformation (11.7%), gray matter injury (11.7%), cerebrovascular event (10.9%), and basal ganglion involvement (n=2; 1.6%). Most frequently seen subtype of CP was quadriplegic CP Also 0.8% of the patients had non-diagnostic findings. The comorbiidities of cerebral palsy were mental retardation (81.4%), epilepsy (55.5%), visual disabilities (27.9%), and hearing (8.6%) disabilities. We found only grey matter injury as a MRI finding was significiantly linked with hearing disability and motor function impairment severity (GMFCS). Conclusion: Although CP is known as a disease more commonly associated with motor disability, secondary problems as mental retardeation, visual, and hearing disabilities are frequently associated with the disease. Early diagnosis and treatment of these comorbidities will affect positively quality of life of these children

Kaynakça

Rosenbaum P, Paneth N, Leviton A, et al. A report: the defi- nition and classification of cerebral palsy April 2006. Dev Med Child Neurol 2007;109:8-14.

Kabakuş N, Açık Y, Kurt A, Özdiller D, Kurt AN, Aygün AD. Serebral palsili hastalarımızın demografik, etiyolojik ve kli- nik özellikleri. Çocuk Sağlığı ve Hastalıkları Dergisi 2005; 48:125-129.

Surveillance of Cerebral Palsy in Europe. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 2002;44:633-640.

Kuban KC, Leviton A. Cerebral palsy. N Engl J Med 1994; 330:188e95.

Shevell MI, Dagenais L, Hall N. Comorbidities in cerebral palsy and their relationship to neurologic subtype and GMFCS level. Neurology 2009;72:2090-2096. http://dx.doi.org/10.1212/WNL.0b013e3181aa537b

Pschirrer R, Yeomans E. Does asphyxia cause cerebral palsy? Semin Perinatol 2000;24:215-220. http://dx.doi.org/10.1053/sper.2000.7080

Ashwal S, Russman BS, Blasco PA, et al. Quality Standards Subcommittee of the American Academy of Neurology; Practice Committee of the Child Neurology Society. Practise parameter: Diagnostic assesment of child with cerebral palsy-Report of the quality Standards Subcommittee of the American Academy of Neurology and Practice Committee of the Child Neurology Society. Neurology 2004;62:851-863. http://dx.doi.org/10.1212/01.WNL.0000117981.35364.1B

Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in elucidating the pathogenesis of cerebral palsy: a systematic review. Dev Med Child Neurol 2007;49:144-151. http://dx.doi.org/10.1111/j.1469-8749.2007.00144.x

Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of asystem to clas- sify gross motor function in children with cerebral palsy. Dev Med Child Neurol 1997;39:214-223. http://dx.doi.org/10.1111/j.1469-8749.1997.tb07414.x

Surveillence of Cerebral Palsy in Europe: a collaboration of cerebral palsy registers. Surveillence of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol 2000;42:816-824.

Taudorf K, Hansen FJ, Melchior JC, Pedersen H. Spontaneous remission of cerebral palsy. Neuropediatrics 1986;17:19-22. http://dx.doi.org/10.1055/s-2008-1052493

Leviton A, Leviton K. Cerebral palsy. J Medicine Rewiev Article Medical Progress 1995;330:195-198.

Serdaroğlu A, Cansu A, Ozkan S, Tezcan S. Prevelance of cerebral palsy in Turkish children betweeen the ages of 2 and 16 years. Dev Med Child Neurol 2006;48:413-416. http://dx.doi.org/10.1111/j.1469-8749.2006.tb01288.x

Öztürk A, Demirci F, Yavuz T, et al. Antenatal and delivery risk factors and prevalence of cerebral palsy in Düzce. Brain Dev 2007;29:39-42. http://dx.doi.org/10.1016/j.braindev.2006.05.011

Little WJ. On the influence of abnormal parturition, difficult labours, premature birth, and asphyxia neonatorum, on the mental and physical condition of the child, especially in rela- tion to deformities. Trans Obstet Soc Lond 1862;3:293-344.

Thorngren-Jerneck K, Herbst A. Perinatal Factors Associated With Cerebral Palsy in Children Born in Sweden. Obstet Gynecol 2006;108:1499-505. http://dx.doi.org/10.1097/01.AOG.0000247174.27979.6b

Pellegrino L. Cerebral palsy. In: Schwartz W editors. Lippincott Williams and Wilkins. The 5 minute pediatric consult. 2nd ed. Philadelphia: 2000; 236-237.

Tarhan S. Merkezimize başvuran Güneydoğu Anadolu Bölgeli serebral palsili çocukların sosyoekonomik ve demog- rafik özellikleri. Dicle Tıp Dergisi 2005;32:13-19.

Buckley E, Seaber JH. Dyskinetic strabismus as: a sign of cerebral palsy. Am J Ophthalmol 1981;91:652-657. http://dx.doi.org/10.1016/0002-9394(81)90069-6

Erkin G, Delialioğlu S, Ozel S, Culha C, Sirzai H. Risk fac- tors and clinical profiles in Turkish children with cerebral palsy: analysis of 625 cases. Inter J Rehabilitation Research 2008;31:91-89. http://dx.doi.org/10.1097/MRR.0b013e3282f45225

Hamamcı N, Dursun E. Serebral Palsi ve Guillan Barre Rehabilitasyonu. In: Oğuz H. Tıbbi Rehabilitasyon. 1995. p. 663-650.

Hagberg B, Hagberg G, Beckung E, Uvebrant P. Changing panorama of cerebral palsy in Sweden. VIII. Prevalence and origin in the birth year period 1991-94. Acta Paediatrica 2001;90:271-277. http://dx.doi.org/10.1080/080352501300067532

Blair E & Stanley F. Issues in the classification and epidemi- ology of cerebral palsy. Mental Retardation and Develop- mental Disabilities Research Reviews 2002;3:184-193. http://dx.doi.org/10.1002/(SICI)1098-2779(1997)3:2_____184::AID- MRDD10>3.0.CO;2-R

Mert GG, Incecik F, Altunbasak S, et al. Factors affecting epilepsy development and epilepsy prognosis in cerebral palsy. Pediatr Neurol 2011;45:89-94. http://dx.doi.org/10.1016/j.pediatrneurol.2011.03.001

İpek B, Ecevit Ç, İpek I, Kocabaş Ö, Kavaklı T, Öztürk A. The Evaluation of 371 cases with Cerebral Palsy between January 1984 and December 2004. Journal of Neurological Sciences 2007;24:270-279.

Zelnik N, Kompnicki M, Bennett-Back O, Castel-Deutsch T, Tirosh E. Risk factors for epilepsy in children with cerebral palsy. Eur J PAediatr Neurol 2010;14:67-72. http://dx.doi.org/10.1016/j.ejpn.2009.06.002

Singhi P, Jagirdar S, Khandelwal N, Malhi P. Epilepsy in children with cerebral palsy. J Child Neurol 2003;18:174- 179. http://dx.doi.org/10.1177/08830738030180030601

Tosun A, Gökben S, Serdaroğlu G, Polat M, Tekgül H Changing views of cerebral palsy over 35 years: the experi- ence of a center. Turk J Pediatr 2013;55:8-15.

Scrutton D. The classification of cerebral palsies. Dev Med Child Neurol 1992;34:833-837.

Chen YH: Correlations between computerized tomography of the head and motor developmental disturbances of child- ren with cerebral palsy. Nippon Seikeigeka Gakkai Zasshi 1981;55:85-99.

Molteni B, Oleari G, Fedrizzi E, Bracchi M. Relation betwe- en CT patterns, clinical findings and etiological factors in children born at term, affected by congenital hemiparesis. Neuropediatrics 1987;18:75-80. http://dx.doi.org/10.1055/s-2008-1052456

Andersen GL, Irgens LM, Haagaas I, Scranes JS, Meberg AE. Cerebral palsy in Norway: prevelance, subtypes and severity. Eur J Pediatr Neurol 2008;12:13-14. http://dx.doi.org/10.1016/j.ejpn.2007.05.001

Crothers B, Paine RS. The natural history of cerebral palsy. Cambridge: Harvard University Press 1959.

Grether JK, Cumminis SK, Nelson KB. The California cereb- ral palsy project. Pediatr Perinat Epidemiol 1992;6:339-351. http://dx.doi.org/10.1111/j.1365-3016.1992.tb00774.x

Duman Ö, İmad FM, Kızılay F, Yücel İ, Balkan S, Haspolat Ş. Serebral palsili hastaların işlevsel kapasitelerine göre görme sorunlarının değerlendirilmesi. Çocuk Sağlığı ve Hastalıkları Dergisi 2005;48:130-135.

Cumurcu T, Cumurcu HB, Erkorkmaz Ü, Yardım H. Serebral Palsili Çocuklarda Göz Bulguları. Fırat Tıp Dergisi 2007;12:48-52.

Stiers P, Vanderkelen R, Vanneste G, Coene S, De Ramelaere M, Vandenbussche E. Visual-perceptual impairment in a ran- dom sample of children with cerebral palsy. Dev Med Child Neurol 2002;44:370-382. http://dx.doi.org/10.1111/j.1469-8749.2002.tb00831.x

Aksu F. Nature and prognosis of seizures in patients with cerebral palsy. Dev Med Child Neurol 1990;32:661-668. http://dx.doi.org/10.1111/j.1469-8749.1990.tb08426.x

Von Wendt L, Rantakallio P, Saukkonen AL, Tuisku M, Makinen H. Cerebral palsy and additional handicaps in a 1-year birth cohort from northern Finland--a prospective follow-up study to the age of 14 years. Ann Clin Res 1985;17:156-161.

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