The influence of head position and head position change on spontaneous body posture and motility in full-term AGA and SGA newborn infants.

No consensus exists concerning the influence of head position and head position change on body posture and motility. Especially the existence of an asymmetric tonic neck reflex (ATNR) in full-term newborns is an issue of discussion. Three-hour video recordings were made of 15 full-term appropriate for gestational age (AGA) and 15 full-term small for gestational age (SGA) infants between the third and eight postnatal day. During a playback of the video recording head position, head position change and several movement patterns of the four limbs were fed into a computer using an event-detecting program. Furthermore, spontaneous head turnings were selected and body posture just before, immediately at and 1 min after the head turning were sketched. The data were analyzed concerning: (1) influence of head position on symmetry of movement of the four limbs; (2) the existence of an ATNR and ATNR-related patterns. In both AGA and SGA infants all movement patterns except hand-face and hand-mouth contact showed a symmetrical distribution, independent of head position. Furthermore, the occurrence of an ATNR following a spontaneous head turning in both AGA and SGA infants was rare. From our results it may be concluded that the ATNR is rare in full-term AGA and SGA newborns. Furthermore, this study demonstrates that head position is not a major factor influencing quantitative aspects of spontaneous motor behaviour. The results are of clinical importance as they imply that in the examination of the neurological condition of the full-term newborn infant by means of observation of spontaneous posture and motility, head position is not of major importance.

Quality of spontaneous general movements in full-term small for gestational age and appropriate for gestational age newborn infants.

Quality of spontaneous movements was studied in 15 healthy full-term appropriate for gestational age (AGA) and in 15 full-term small-for gestational age (SGA) newborn infants. All general movements with a minimal duration of 20 seconds were judged on different aspects of movement quality. From the general movements in each group (AGA: n = 106; SGA: n = 187), dominant patterns were isolated. In the AGA Group 3 dominant patterns of general movements were present. In the SGA Group 5 dominant patterns of general movements were found. Three of those were identical to the movement patterns in the AGA group, the remaining two patterns were unique for the SGA infants. Our results indicate that the three different types of general movements which constitute the major part of the normal repertoire of healthy full-term infants can be used as a reference for normal spontaneous motor behaviour. The two different types of general movements in the SGA infants might be used to discriminate between healthy and neurologically suspect newborn infants. The difference in movement pattern between AGA and SGA infants might be explained by the effect of intrauterine malnutrition on CNS development.

Ambulatory sleep-wake polygraphy in narcolepsy.

We have presented an ambulatory monitoring and off-line data analysis system for sleep-wake polygraphy and have illustrated its use for the diagnosis of narcolepsy. The advantages over conventional polysomnography have been discussed.

An application of mathematical models in posturography.

The measurement of the horizontal displacements (HD) of the centre of mass of the human body when standing still, is often performed by means of a platform. The resulting measured HD as a function of time, both in the left-right or sinister-dexter and the posterior-anterior direction, are known as stabilograms. Such stabilograms are being more widely used to obtain the so called measured statokinesigram, similar to a Lissajous-figure, by eliminating time from the sinister-dexter stabilogram and the posterior-anterior stabilogram. It is shown that in using mathematical models of the standing person to obtained the stabilograms, the resulting statokinesigram is very different from the measured statokinesigram. It is also shown that the quantity line-integral calculated from a statokinesigram is much smaller when determined from a statokinesigram corrected by means of the mathematical models.

Human cerebral potentials evoked by moving dynamic random dot stereograms.

In 11 normal healthy human subjects an evoked potential was elicited by moving dynamic random dot stereograms. The random dots were generated by a minicomputer. An average of each of 8 EEG channels of the subjects tested was made. The maximum of the cerebral evoked potentials thus found was localized in the central and parietal region. No response earlier than 130--150 msec after the stimulus could be proved. The influence of fixation, the number of dots provided, an interocular interstimulus interval in the presentation of the dots, and lense accommodation movements on the evoked stereoptic potentials was investigated and discussed. An interocular interstimulus interval (left eye leading) in the presentation of the dots caused an increase in latency of the response much longer than the imposed interstimulus interval itself. It was shown that no accommodation was needed to perceive the depth impression, and to evoke the cerebral response with random dot stereograms. There are indications of an asymmetry between the two hemispheres in the handling of depth perception after 250 msec. The potential distribution of the evoked potentials strongly suggests that they are not generated in the occipital region.