P181 – 2393: Specific features of infantile cerebral palsy development in small premature infants with extremely low birth weight and very low birth weight

Abstract

Objective Study of specific features of infantile cerebral palsy development in small premature infants. Methods Complex clinical and paraclinical (neurosonography, brain MRI, encephalography – EEG) examination of psychoneurological development was performed in 312 disabled children due to infantile cerebral palsy (ICP): 98 infants with extremely low birth weight (ELBW), 109 infants with very low birth weight (VLBW), and 105 mature infants. Results ICP rate achieved in 29%, 23%, and 11% of infants with ELBW, VLBW, and mature infants correspondingly to the 2–3 years old: 7%, 5%, and 3% – as spastic tetrapalsy, or tetraparesis, 12%, 9%, and 5% – lower paraparesis, 9%, 6%, and 2% – hemiparesis, 4%, 3%, and 1% – atonic-astatic and hyperkinetic form. Severe irreversible ischemic-hemorrhagic lesions (subependymal posthemorrhagic pseudocysts, cystic encephalomalacia, progressing hydrocephalia) were visualized in MRI. Symptomatic epilepsy developed in 25% of children with ELBW, 21% – with VLBW, and 14% of mature children in 3–5 years old: 48%, 39%, and 30% – generalized forms, 52%, 61%, and 70% correspondingly – focal forms. Children suffered from resistant epilepsy forms were born mainly at 22–27 weeks of gestation. Spastic tetraparesis, hard atonic-astatic, and psychoverbal disorders were found in majority of them. Low-amplitude slow waves were registered in 98% of children with ELBW, 83% – with VLBW, and 72% of mature children at EEG; in 54%, 37%, and 25% of them correspondingly – in combination with pathologic patterns including epileptiform ones. Conclusion Perinatal cerebral pathology is evidently more frequently responsible for development of hard cerebral disorders forming the most severe forms of IPC as one of the main reasons of early persistent disability in small premature infants.