Long-term neurodevelopmental outcome with hypoxic-ischemic encephalopathy.

OBJECTIVES: To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits. STUDY DESIGN: Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or mental retardation). Brain injury was scored according to the region and extent of injury. RESULTS: Children without major disability (n = 57) had lower full-scale and performance IQ scores compared with norms (P = .02 and .01, respectively), and the proportion of children with an IQ <85 was higher than expected (P = .04). Motor performance on the Zurich Neuromotor Assessment was affected in the pure motor, adaptive fine motor, and gross motor domains, as well as in the movement quality domain (all P < .001). Watershed injury pattern on neonatal MRI correlated with full-scale and verbal IQ scores (P = .006 and <.001, respectively), but neonatal MRI pattern did not correlate with motor performance in children without major disability. CONCLUSION: Children who sustained neonatal HIE without major disability are at increased risk for long-term intellectual, verbal, and motor deficits. The severity of watershed injury is correlated with later intellectual performance. Long-term follow-up examinations are necessary for early detection of neurodevelopmental impairment and early initiation of adequate therapies.

Escalas de avaliação neuromotora em pré-escolares: revisão bibliográfica / Neuromotor scales for preschool childrren assessment: a review

O sistema nervoso da criança esta em constante transformação e a combinação entre fatores genéticos e ambientais e o que determina o seu desenvolvimento neuropsicomotor. O use de avaliações padronizadas permite identificar se a criança esta apresentando ou não problemas no seudesenvolvimento. O presente estudo tem por finalidade realizar uma revisão bibliográfica sobre as escalas de avaliação do desenvolvimento neuromotor aplicáveis a pré-escolares. Observa-se que as escalas variam quanto ao item analisado, quanto a idade, quanto a forma de interpretação dos resultados entre outros; portanto, o avaliador deve ter em mente o que deseja avaliar para fazer a escolha da escala adequada.(AU)

The child's nervous system is in constant transformation that determines its neurodevelopment and it appears to result from a combination of genetic and environmental factors. The use of standardized scales allows the identification of the neurodevelopmental disorders. This paper aims at establishing a bibliographic review on the neuromotor scales for the neurodevelopment assessment of preschool students. We observed that the scales vary according to the analysed item, the age, the way of interpreting the results, among other factors; therefore, the evaluator must keep in mind what he/she wishes to evaluate to choose the adequate scale.(AU)

Escalas de avaliação neuromotora em pré-escolares: revisão bibliográfica / Neuromotor scales for preschool childrren assessment: a review

O sistema nervoso da criança esta em constante transformação e a combinação entre fatores genéticos e ambientais e o que determina o seu desenvolvimento neuropsicomotor. O use de avaliações padronizadas permite identificar se a criança esta apresentando ou não problemas no seudesenvolvimento. O presente estudo tem por finalidade realizar uma revisão bibliográfica sobre as escalas de avaliação do desenvolvimento neuromotor aplicáveis a pré-escolares. Observa-se que as escalas variam quanto ao item analisado, quanto a idade, quanto a forma de interpretação dos resultados entre outros; portanto, o avaliador deve ter em mente o que deseja avaliar para fazer a escolha da escala adequada.

The child's nervous system is in constant transformation that determines its neurodevelopment and it appears to result from a combination of genetic and environmental factors. The use of standardized scales allows the identification of the neurodevelopmental disorders. This paper aims at establishing a bibliographic review on the neuromotor scales for the neurodevelopment assessment of preschool students. We observed that the scales vary according to the analysed item, the age, the way of interpreting the results, among other factors; therefore, the evaluator must keep in mind what he/she wishes to evaluate to choose the adequate scale.