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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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CHILDREN WITH DYSKINETIC CEREBRAL PALSY BORN IN 2001-2004, FROM THE PORTUGUESE NATIONAL SURVEILLANCE

Daniel Virella1, Rosa Gouveia2, Maria da Graça Andrada2, Teresa Folha3, Ana Cadete4, José Joaquim Alvarelhão5, Eulália Calado6

 

1- Unidade de Cuidados Intensivos Neonatais, Hospital Dona Estefânia, Centro Hospitalar Lisboa Central, EPE, Lisboa;
2- Programa de Vigilância Nacional da Paralisia Cerebral, Lisboa;
3- Centro de Reabilitação de Paralisia Cerebral Calouste Gulbenkian, Lisboa;
4-
Serviço de Medicina Física e de Reabilitação, Hospital Fernando Fonseca, EPE, Amadora;
5- Escola Superior de Saúde de Aveiro;
6-
Serviço de Neurologia Pediátrica, Hospital Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa

- 26th Annual Meeting of the European Academy of Childhood Disability, 3-5 Julho 2014 – Vienna, Áustria (poster)
- 15º Congresso Nacional de Pediatria, 16-18 Outubro de 2014, Albufeira

Introduction: The Portuguese Surveillance of Cerebral Palsy at 5 years of age is a national registry. We compare functional characteristics, comorbidity and risk factors in children with predominantly dyskinetic cerebral palsy (DCP) and non-dyskinetic CP (NDCP).

Participants and methods: The Portuguese Surveillance shares definitions, classifications and tools with SCPE. Survivors at five years age born 2001-2004, living in Portugal were selected. Apgar score 5 or Apgar score 6-7 with early neonatal seizures (<72h) were considered criteria of asphyxia.

Results: 646/724children from the index birth-cohorts were selected. 72 children were classified as DCP (11.1%), 51 dystonic (70.8%), 18 choreo-athetotic (25%), 3 unclassified (4.2%). Annual range of DCP cases w as 15-21 (9.2-13.5%). The proportion of DCP children at GMFCS and BFMF levels IV-V (71.8% and 79.2%) was significantly higher that among NDCP (38.0% vs. 33.4%). Similar patterns were seen for verbal expression, feeding ability and drooling control. Cognitive impairment (IQ <70) had significantly higher prevalence among DCP children (68.1% vs. 56.9%). Visual impairment was significantly less frequent among DCP children (38.5% vs. 52.7%). Epilepsy prevalence was similar (37.5% vs. 43.2%). Hip luxation/subluxation prevalence was significantly lower in DCP children (10.9% vs. 21.6%). Non-inclusion in preschool was significantly more frequent among DCP children (31.0% vs. 14.8%). The main adjusted odds for having DCP among children with CP were being born at term (OR 2.85; 95%CI 1.5-5.4) and having criteria of asphyxia (OR 3.0; 95%CI 3.0-5.45).

Conclusion: The functional outcomes and morbidity of children with DCP are severe and frequently more severe than in children with NDCP.

Palavras Chave: Paralisia Cerebral discinética, vigilância