Is the assessment of general movements helpful for the prediction of the neurodevelopmental outcome in a child with symptomatic congenital CMV infection?

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Background: Cytomegalovirus infection is the most frequent intrauterine viral infection and occurs in one of 100 liveborns. Every tenth infection is symptomatic at birth with a variety in clinical features, whereby neurological signs are less common. The neurodevelopmental outcome is uncertain, but can also be normal. Aim: to determine neurological deficits early in development with means of general movement assessment according to Prechtl (GMs). Patient: Male, born at term with peripartal asphyxia. Other clinical manifestations are ventriculomegaly with cystic formations, intracranial calcifications, clonic seizures, chorioretinitis and hepatosplenomegaly. Antiviral therapy resulted in a normalisation of the ventricular size as well as a normalisation of the hearing abilities.. Methods: GMs were recorded for 10 minutes at 7 and 12 weeks. Follow-up at 4, 9 and 12 months with a developmental test, named Muenchner Entwicklungsdiagnostik, (MFED) and the neurological examination according to Touwen. Results: poor repertoire GMs at 7 weeks, no fidgety movements at 12 weeks. First signs of abnormal leg movement at 4 months, developmental delay of 2 to 3 months at 9 and also at 12 months. Conclusion: It was possible to detect neurodevelopmental abnormalities as early as 7 weeks. Especially the absence of fidgety movements is a marker for the neurodevelopmental deficit.