DOI: https://doi.org/10.22141/2224-0713.16.4.2020.207346

Neurophysiological features of spastic syndrome in children with cerebral palsy depending on the severity of motor disorders

I.A. Zorii, V.M. Pashkovskyy, N.V. Vasilieva, O.M. Nika

Abstract


Background. Infantile cerebral palsy is a collective term that combines numerous severe diseases of the nervous system. Eighty percent of children with cerebral palsy suffer from spastic forms, the main symptom of which is an increase in muscle tone — spasticity. Objectification of the state of muscle tone and control over the dynamics of spasticity can be carried out using methods of biomechanics and electroneuromyographic (ENMG) research, which makes it possible to qualitatively and quantitatively study the state of the neuromuscular system. The purpose is to establish the clinical and neurophysiological features of spastic syndrome in children with infantile cerebral palsy, depending on the severity of motor disorders. Materials and methods. We examined 122 children with cerebral palsy (average age 8.8 ± 3.7 years), who were divided into groups according to the values of the Gross Motor Function Classification (GMFCS E&R). All patients underwent a thorough neurological examination and ENMG studies. To assess the suprasegmental (upper motor neuron) and segmental (α-motor neurons of the spinal cord and peripheral nerves) levels of damage, the parameters of the H-reflex and F-wave were analyzed. Results. The majority of the examined children were diagnosed with spastic forms of cerebral palsy: 40 (32.8 %) children — spastic diplegia, 25 (20.5 %) — hemiparetic form, 6 (4.9 %) — spastic triparesis, 34 (27.9 %) — spastic tetraparesis. Children with cerebral palsy with severe motor disorders were significantly more likely to have orthopedic pathology, namely equino-valgus installations and flat-valgus deformities of the feet. Based on ENMG parameters in patients with cerebral palsy, there were recorded suprasegmental violations, manifested in the increase of the amplitude of M-response, especially when testing the tibial nerve, the increased ratio of Hmax/Mmax, increased amplitude of H-reflex and F-wave. Conclusions. With an increase in the severity of motor disorders on the Gross Motor Function Classification Scale (GMFCS E&R) in children with cerebral palsy, neurophysiological changes significantly worsened.

Keywords


cerebral palsy; electroneuromyography; spasticity; Gross Motor Function Classification Scale

References


Abramenko V.V., Kovalenko O.Ie. Risk factors for spastic forms of infantile cerebral palsy depending on the gestational age of the infant. Ukr. nevrol. zhurn, 2017; № 2: 45-49 (Ukrainian).

Alifanova S.V., Kharytonova O.N. Features of observing children born prematurely with very low body weight Zdorove rebenka. 2015; № 7: 37-40 (Ukrainian).

Evtushenko S.K. Etiology and pathogenesis of cerebral palsy in children (a new look at the old problem) (lecture) Mizhnarodnyi nevrolohichnyi zhurnal. 2014; 3 (65): 117-123 (Russian).

Klitochenko G.V., Tonkonozhenko N.L., Krivonozhkina P.S., Malyuzhinskaya N.V. Clinic and diagnosis of cerebral palsy Lekarstvennyiy vestn. 2015; Т.9,№1 (57): 21-25 (Russian).

Kozyavkin V, Kachmar O, Voloshyn T. Gross Motor Function Classification System for Children with Cerebral Palsy. Extended and Revised Version Sotsialna pediatriia ta reabilitolohiia. 2012; №2(3):74-82 (Ukrainian).

Martyniuk V.Iu. Cerebral palsy Sotsialna pediatriia ta reabilitolohiia. 2012; 1: 18-23. (Ukrainian)

Moiseenko R.O., Hoida N.H., Dudina O.O. Childhood disability and issues of building a system of medical and social rehabilitation of children in Ukraine Sotsialna pediatriia ta reabilitolohiia. 2018; 3-4: 10-19 (Ukrainian).

Kholodov S.A. Morphofunctional features of lower limb muscle force disorders in children with cerebral palsy with different locomotor capacity Visn. Cherkas. un-tu. Ser. Biol. nauky. 2015; № 2: 121-127 (Ukrainian).

Iatsenko K.V. Сerebral palsy: etiopathogenesis, clinical neurophysiological aspects and neurological rehabilitation opportunities Ukrainskyi nevrolohichnyi zhurnal. 2015; № 2: 19-24 (Ukrainian).

Freire G., Shevell M., Oskoui M. Cerebral palsy: Phenotypes and risk factors in term singletons born small for gestational age Eur. J. Paediatric Neurol. 2015; Vol. 19, N2: 218-225.

Jones MW, Morgan E, Shelton JE. Primary care of the child with cerebral palsy: a review of system (Part II) J Pediatr Health Care. 2007; 21: 226-237.

Lee HJ, DeLisa JA. Manual of nerve conduction study and surface anatomy for needle electromyography Philadelphia: Lippincott Williams & Wilkins. 2004. 301 p

Liveson J.A., Dong M.M. Laboratory reference for clini cal neurophysiology Philadelphia: F.A. Davis Company. 1992. 514 p.

Mandal A. Cerebral Palsy Prevalence Medical News: Life Sciences and Medicine. 2015. Available from: http://www.news-medical.net/health/Cerebral-Palsy-Prevalence.aspx.

Novak I, Morgan C, Adde L, Blackman J, Boyd RN, et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment JAMA Pediatr. 2017; 171: 897-907,

Spittle AJ, Morgan C, Olsen JE, Novak I, Cheong JLY Early Diagnosis and Treatment of Cerebral Palsy in Children with a History of Preterm Birth Clin Perinatol. 2018; 45: 409-420.

Willerslev-Olsen M, Choe Lund M, Lorentzen J, Barber L, Kofoed-Hansen M, et al. Impaired muscle growth precedes development of increased stiffness of the triceps surae musculotendinous unit in children with cerebral palsy Dev Med Child Neurol. 2018; 60: 672-679.




Copyright (c) 2020 INTERNATIONAL NEUROLOGICAL JOURNAL

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© Publishing House Zaslavsky, 1997-2020

 

   Seo анализ сайта