Abstract
Background—To describe the results obtained after treating a non growth hormone-deficient 10-year-old girl who suffered asphyxia during delivery, resulting in important cognitive deficits, with growth hormone (GH) and neurorehabilitation. Methods—GH was administered (mg/day) at doses of 0.5 over three months followed by 0.9, every two weeks over three months, and then alternating 1.2 three days/week and 0.3 two days/week. Neurorehabilitation consisted of daily sessions of neurostimulation, speech therapy, occupational therapy and auditive stimulation. Treatment lasted nine months. Results—Scores obtained in all the areas treated showed that, at discharge, the patient clearly increased her cognitive abilities, memory and language competence index; her intelligence quotient score increased from 51 to 80, and the index of functional independence measure reached a value of 120 over 126 (maximal value). Conclusions—This case suggests that GH administration may play a role in improving cognitive deficits during neurorehabilitation in children with brain damage suffered during delivery. This agrees with the known effects of GH on cognition.
Highlights
Perinatal Asphyxia (PA) or Hypoxia-Ischemia (HI) are a major pediatric issues, usually occurring when delivery is prolonged, with few successful therapies to prevent neuronal damage [1]
Severe asphyxia has been linked to cerebral palsy (CP), mental retardation, and epilepsy [3,4,5], while mild-moderate asphyxia has been associated with cognitive and behavioral alterations, such as hyperactivity, autism [4], attention deficits in children and adolescents [6,7], low intelligence quotient score (IQ) [8], and development of psychotic disorders in adulthood [9]
It is likely that growth hormone (GH) administration played an important role, helping the neurorehabilitation performed, on the positive and quick results obtained in this case, despite the fact that the patient had a normal GH secretion
Summary
Perinatal Asphyxia (PA) or Hypoxia-Ischemia (HI) are a major pediatric issues, usually occurring when delivery is prolonged, with few successful therapies to prevent neuronal damage [1]. PA/HI were previously considered the major cause of CP, a catastrophic acquired disease occurring during the development of the fetal or infant brain. It mainly affects the motor control centers of the developing brain, but can affect cognitive functions, and it is usually accompanied. Conclusions—This case suggests that GH administration may play a role in improving cognitive deficits during neurorehabilitation in children with brain damage suffered during delivery. This agrees with the known effects of GH on cognition
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