Aggiornamento monografico
Osservazione del neonato e prognosi neurologica
NEUROLOGICAL ASSESSMENT IN THE FIRST MONTHS OF LIFE BY OBSERVATION OF SPONTANEOUS MOTILITY
1GIOVANNI CIONI, 2FABRIZIO FERRARI
1IRCCS Stella Maris, Istituto di Neuropsichiatria e Psicopedagogia dell’Età Evolutiva, Università di Pisa
2Dipartimento di Scienze Ginecologiche, Ostetriche e Pediatriche, Sezione di Pediatria e Neonatologia, Università di Modena
Dicembre 1997 - pagg. 633 -637
Abstract
Qualitative observation of spontaneous motility,
and particularly of general movements,
is a promising approach to the neurological
assessment of newborns and
young infants. Data on the prognostic value
of abnormal spontaneous movements in the
first months of life for the later development
of neurological handicaps are reported. In
normal awake infants, fidgety movements
(FMs) occur during the age period of 6 to
20 weeks and consist of a sequence of
small and round movements in all parts of
the body. The presence of normal and abnormal
quality of these FMs were studied in
130 infants observed in 5 European Centres
(Graz, Groningen, Heidelberg, Modena
and Pisa) and compared with the neurological
outcome at the age of 2 years. The
results showed that normal FMs lead in
96% of the infants to a normal outcome,
while abnormal quality or total absence of
FMs was followed by neurological abnormalities
in 97% of the infants. The new assessment
technique of spontaneous motor
activity is simple, totally non-intrusive, reliable
and quick. At fidgety age it can identify
those infants who need other exams or
early intervention from those who do not.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
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6. Cioni G, Ferrari F, Einspieler C, Paolicelli PB, Barbani MT, Prechtl HFR: Neurological assessment of preterm infants: comparison between observation of spontaneous movements and neurological examination. J Ped 130, 704-11, 1997.
7. Prechtl HFR, Ferrari F, Cioni G: Predictive value of general movements in asphyxiated fullterm infants. Early Hum Dev 35, 91-120, 1993.
8. Brazelton TB: Neonatal Behavioral Assessment Scale. CDM n. 50. London: Heinemann, 1973.
9. Prechtl HFR: Qualitative changes of spontaneous movements in fetus and preterm infants are a marker of neurological disfunction. Early Hum Dev 23, 151-9, 1990.
10. de Vries JIP, Visser GHA, Prechtl HFR: The emergence of fetal behaviour. Qualitative aspects. Early Hum Dev 7, 301-22, 1982.
11. Cioni G, Prechtl HFR: Preterm and early postterm motor behaviour in low risk premature infants. Early Hum Dev 23, 159-191, 1990.
12. Hopkins B, Prechtl HFR: A qualitative approach to the development of movements during early infancy: HFR Prechtl (ed.), Continuity of Neural Functions from Prenatal to Postnatal Life. Blackwell Scientific Publications, Oxford. Clin Dev Med 94, 179-97, 1984.
13. Hadders-Algra M, Prechtl HFR: Developmental course of general movements in early infancy. I. Descriptive analysis of change in form. Early Hum Dev 28, 201-13, 1982.
14. Prechtl HFR, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D: An early marker for neurological deficits after perinatal brain lesions. Lancet 339, 1361-63, 1997.
15. Einspieler C, Prechtl HFR, Ferrari F, Cioni G, Bos AF: The qualitative assessment of general movements in preterm, term and young infants - a review of its methodology. Early Hum Dev 1997 (in press).
16. Prechtl HFR, Bos FA, Cioni G, Ferrari F, Einspieler C: Spontaneous motor activity as a diagnostic tool. Demonstration video. London: Touch Star, 1997.
17. Albers S, Jorch G: Prognostic significance of spontaneous motility in very immature preterm infant under intensive care treatment. Biol Neonate 66, 182-7, 1994.
18. Geerding JJ, Hopkins B: Qualitative changes in general movements and their prognostic value in preterm infants. Eur J Ped 152, 362-7, 1993.
19. Ferrari F, Prechtl HFR, Cioni G, Roversi MF, Einspieler C, Gallo C, Paolicelli PB, Cavazzuti GB: Posture and spontaneous movements in infants affected by brain malformations. Early Hum Dev 1997 (in press).
20. Bos AF, van Loon AJ, Haddres-Algra M, Martijn A, Okken A, Prechtl HFR: Spontaneous motility in preterm, small for gestational age infants, II. Qualitative aspects. Early Hum Dev 1997 (in press).
21. Bos AF, van Asperen RM, de Leeuw DM, Prechtl HFR: The influence of septicaemia on spontaneous motility in preterm infants. Early Hum Dev 1997 (in press).
22. Cioni G, Prechtl HFR, Ferrari F, Paolicelli PB, Einspieler C, Roversi MF: Which better predicts later outcome in fullterm infants: quality of general movements or neurological examination? Early Hum Dev 1997 (in press).
2. Prechtl HFR: The Neurological Examination of the Fullterm Newborn Infant. 2nd Edition. CDM n. 63. London: Heinemann, 1977.
3. Dubowitz LMS, Dubowitz V: The Neurological Assessment of the Preterm and Fullterm Newborn Infant. CDM n. 79. London: Heinemann, 1981.
4. Dubowitz LMS: Clinical assessment of infant nervous system. In: Levene MI, Bennett MJ, Punt J (Eds), Fetal and Neonatal Neurology and Neurosurgery. Edinburgh, Churchill, Livingstone, pp. 33-40, 1988.
5. Ferrari F, Cioni G, Prechtl HFR: Qualitative changes of general movements in preterm infants with brain lesions. Early Hum Dev 23, 193-233, 1990.
6. Cioni G, Ferrari F, Einspieler C, Paolicelli PB, Barbani MT, Prechtl HFR: Neurological assessment of preterm infants: comparison between observation of spontaneous movements and neurological examination. J Ped 130, 704-11, 1997.
7. Prechtl HFR, Ferrari F, Cioni G: Predictive value of general movements in asphyxiated fullterm infants. Early Hum Dev 35, 91-120, 1993.
8. Brazelton TB: Neonatal Behavioral Assessment Scale. CDM n. 50. London: Heinemann, 1973.
9. Prechtl HFR: Qualitative changes of spontaneous movements in fetus and preterm infants are a marker of neurological disfunction. Early Hum Dev 23, 151-9, 1990.
10. de Vries JIP, Visser GHA, Prechtl HFR: The emergence of fetal behaviour. Qualitative aspects. Early Hum Dev 7, 301-22, 1982.
11. Cioni G, Prechtl HFR: Preterm and early postterm motor behaviour in low risk premature infants. Early Hum Dev 23, 159-191, 1990.
12. Hopkins B, Prechtl HFR: A qualitative approach to the development of movements during early infancy: HFR Prechtl (ed.), Continuity of Neural Functions from Prenatal to Postnatal Life. Blackwell Scientific Publications, Oxford. Clin Dev Med 94, 179-97, 1984.
13. Hadders-Algra M, Prechtl HFR: Developmental course of general movements in early infancy. I. Descriptive analysis of change in form. Early Hum Dev 28, 201-13, 1982.
14. Prechtl HFR, Einspieler C, Cioni G, Bos AF, Ferrari F, Sontheimer D: An early marker for neurological deficits after perinatal brain lesions. Lancet 339, 1361-63, 1997.
15. Einspieler C, Prechtl HFR, Ferrari F, Cioni G, Bos AF: The qualitative assessment of general movements in preterm, term and young infants - a review of its methodology. Early Hum Dev 1997 (in press).
16. Prechtl HFR, Bos FA, Cioni G, Ferrari F, Einspieler C: Spontaneous motor activity as a diagnostic tool. Demonstration video. London: Touch Star, 1997.
17. Albers S, Jorch G: Prognostic significance of spontaneous motility in very immature preterm infant under intensive care treatment. Biol Neonate 66, 182-7, 1994.
18. Geerding JJ, Hopkins B: Qualitative changes in general movements and their prognostic value in preterm infants. Eur J Ped 152, 362-7, 1993.
19. Ferrari F, Prechtl HFR, Cioni G, Roversi MF, Einspieler C, Gallo C, Paolicelli PB, Cavazzuti GB: Posture and spontaneous movements in infants affected by brain malformations. Early Hum Dev 1997 (in press).
20. Bos AF, van Loon AJ, Haddres-Algra M, Martijn A, Okken A, Prechtl HFR: Spontaneous motility in preterm, small for gestational age infants, II. Qualitative aspects. Early Hum Dev 1997 (in press).
21. Bos AF, van Asperen RM, de Leeuw DM, Prechtl HFR: The influence of septicaemia on spontaneous motility in preterm infants. Early Hum Dev 1997 (in press).
22. Cioni G, Prechtl HFR, Ferrari F, Paolicelli PB, Einspieler C, Roversi MF: Which better predicts later outcome in fullterm infants: quality of general movements or neurological examination? Early Hum Dev 1997 (in press).