Neonatal Neurosonographic Findings, Cerebral Doppler and Electrophysiological Findings in Infants with Motor Idsturbance

Kim, Jae Kwahg; Park, Kook In; Park, Chang Il; Park, Min Soo; Park, Moon Sugn; Namgung, Ran; Lee, Chul; Han, Dong Kwan

Abstract

PURPOSE: Neurosonography, cerebral doppler and electrophysiological study are valuable in predicting neurodevelopmental outcome. The purpose of this study was to analyze characteristics of neonatal neurosonographic findigs, cerebral doppler and electrophysiological findings in infants withmotor disturbance.
METHODS
The subjects were 33 infants hospitalized at Yonsei Severance Medical Center NICU from January, 1990 to December, 1992. 19 of these patients underwent neonatal cranial ultrasonogram and cerebral doppler and were diagnosed with cerebral palsy(CP) after Vojta treatment. 14 patients alose received Vojta treatment after discharge but showed only delayed development(DD). The cases were studied retrospectively and color doppler sonograpy was performed within 3 days of birth, 5-7 days after birth and weekly thereafter, and the cerebral blood flow velocity of the anterior cerebral artery was measured and comparison between normal pre-term and full-term infants done. Electroencephalogeraphy(EEG) and brainstem auditory evoked potential(BSAEP) were performed before discharge, with follow-up studies done only in cases showing abnormal findings, whereas visual evoked potential(VEP) was performed after discharge interhemispheric fissure was seen in 7 cases of CP and 1 cases of DD, showing a singnificatn frequency in CP, whereas there was no difference in the linear echogenecity of the basal ganglia. 4) Abnormal EEG was seen in 12 cases(63%) of CP group and 4 cses(29%) of DD group. The follow up EEG was normalized in all DD patients but CP patients conhtinues to show significant EEG abnormalities (7 cases out of 9). BSAEP and VEP abnormalities showed no significant difference between the 2 groups. 5) There was no significant difference in the average resistance index(RI) which was calculated from the cerebral blood flow velocity measured by cerebral doppler among normal newborns, CP and DD patents group. But average RI of CP patients was significantly lower than that of normal newborns, indicating an increase in cerebral blood flow in early life with severe neurologic sequelae.
CONCLUSIONS
Neurosogography, cerebral doppler and electrophysiological studies performed in the perinatal period of children with motor disturbance show characteristic abnormal finding, with significant differences among childrem diagnosed with CP and DDD.