Primitive Reflexes Research Articles

Clinical features of vascular cognitive impairment

Vascular cognitive impairment (VCI) can occur in cerebrovascular disease of varying degree of severity, which requires further investigation.Objective: to identify specific features of attention deficit and executive function (EF) impairment in VCI and to determine the relationship between cognitive, neurological and radiological signs of the disease.Material and methods. The study involved 80 patients (51 with VCI – the main group and 29 healthy volunteers – the control group). All participants underwent clinical and neuropsychological examination and MRI of the brain. VCI was diagnosed according to 2014 VASCOG criteria. The neuropsychological examination included an assessment of the general cognitive function (MoCA test, MMSE); general EF (FAB, EXIT-25); episodic memory (12-word memory test and Benton Visual Retention Test); semantic memory (categorical association method); initiation and productivity of cognitive activity (literal associations); attention [TMT-A, Symbol-Digit Modalities Test (SDMT)]; cognitive flexibility (TMT-B); cognitive control (Stroop test).Results. As a result of the study, three subgroups of patients with VCI were identified: 1) predominantly attention deficit (AD); 2) AD and significant decrease in cognitive flexibility (CFD); 3) AD in combination with a significant cognitive control deficiency (CCD). The TMT-A and SDMT tests were significantly worse in all subgroups of VCI compared to the control group, with the worst SDMT score in subgroup 2. Subgroup 2 also had the longest time to complete the TMT-B test. Subgroup 3 was characterized by the worst Stroop test results, and uncontrolled arterial hypertension was more common in this group. Gait disturbances were significantly more frequent in subgroup 2, and increased reflexes of oral automatism and grasp reflex were observed in subgroup 3. White matter hyperintensity (WMH) was more pronounced in subgroup 2, and lacunar infarcts (LI) were more frequent in subgroup 3. Prevalence of LI and severity of WMH were lowest in subgroup 1.Conclusion. The main features of VCI are attention deficit and EF impairment, characteristics of EF disorders depend on the severity and type of vascular lesions of the brain. Progression of WMH is associated with more pronounced CFD and an increase in the number of LI is associated with CCD. There is a correlation between CFD and gait disturbances and between CCD and lack of primitive reflexes inhibition.

Effects of antenatal corticosteroids on outcomes of very premature infants and neurodevelopment during infancy

To explore the effects of antenatal corticosteroids (ACS) on the outcomes of very premature infants (VPIs) and neurodevelopment during infancy. A retrospective study was conducted on 190 VPIs admitted to the Department of Pediatrics of the First Affiliated Hospital of Anhui Medical University from January 2020 to December 2022. The infants were categorized into four groups based on ACS usage and dosage: no ACS group (n=18), single-course group (n=88), multi-course group (n=40), and partial-course group (n=44). The clinical outcomes, Neonatal Behavioral and Neurological Assessment (NBNA) scores at 40 weeks of corrected age, and Gesell Developmental Schedule (Gesell) scores at 1 year of corrected age were compared among the four groups. The impact of timing of ACS use on the Gesell scores of infants at 1 year of corrected age in VPIs with specific gestational ages was analyzed. The incidence rates of neonatal respiratory distress syndrome, bronchopulmonary dysplasia, transient tachypnea of the newborn, and neonatal pneumonia were significantly lower in the partial-course, single-course, and multiple-course groups compared with the no ACS group (P<0.008). However, there was no significant difference among the partial-course, single-course, and multiple-course groups (P>0.008). The NBNA scores (behavioral ability, active muscle tone, primitive reflexes, and general assessment) at 40 weeks of corrected age were significantly higher in the no ACS, partial-course, and single-course groups than in the multiple-course group (P<0.008). The proportion of VPIs with normal neurodevelopment at 1 year of corrected age was significantly higher in the no ACS, partial-course, and single-course groups than in the multiple-course group (P<0.008). The timing of ACS use had no significant effect on neurodevelopment at a corrected age of 1 year in infants with various gestational ages (P>0.05). ACS is crucial for the development of the respiratory system in VPIs, but multiple courses of ACS may cause neurodevelopmental abnormalities. The impact of ACS use on neurodevelopment is independent of gestational age and the timing of ACS use.

Neurosensorimotor Reflex Integration, Myofascial Release, &amp; Neuro-Developmental Treatment In Children With Cerebral Palsy Athetoid Diplegi: Case Report

Cerebral Palsy (CP) is a disorder caused by brain damage that results in impaired motor and intelligence function. The causes of CP can be divided into three parts: prenatal, natal, and postnatal. The causes of the Prenatal period are maternal infections, hypoxia or ischemia, and placental abnormalities. The causes of the Christmas period are Birth Trauma, Birth Asphyxia, and premature birth. The causes of the postnatal period are neonatal infections, head trauma, and ongoing medical conditions. Measurements were carried out by palpating muscle tone and primitive reflexes with blank gross motor ability reflexes of children with GMFM. The therapy administration for 4 times has not significantly affected muscle tone with muscle palpation at T1, T2, T3, T4 with hypertonic results. Pathological primitive reflexes with reflex blanks on T1, T2, T3, T4 with positive results of ATNR, Cross extensors, graps, Neck righting, Body righting, Optical righting, Labiryn Righting. Gross motor ability with GMFM at T1, T2, T3, T4 with a yield of 34.4%

A Hypertonic Term Newborn with Absent Primitive Reflexes.

A Hypertonic Term Newborn with Absent Primitive Reflexes.

Changes in primitive reflexes in older adults and their relationship to mental health indices: An experimental investigation

The reemergence of primitive reflexes (PRs) in older age is related to cognitive impairment. Currently, there are no means to prevent or slow their reappearance, but research evidence exists for their control in children. Therefore, this experiment investigated whether a 16-week special sensorimotor exercise program could benefit older adults and whether the intervention-induced changes (if any) may be associated with various indices of mental health. Of 115 adults over 60, 95 completed the study (mean age = 76.37 ± SD = 7.04 years, 22 % men). The experimental group (n = 38) showed an almost threefold decline in PRs compared to controls. In contrast, the control group (n = 57) exhibited a nearly threefold increase in PRs compared to the intervention group. Cognitive function increased in the experimental but not in the control group. Changes in PRs over the 16-week intervention were positively related to negative mental health indices (hopelessness and perceived stress) and negatively related to well-being. These findings suggest that the here-presented mild sensorimotor exercises could affect older adults' reemerging PRs and that changes in PRs are associated with mental health benefits. These results may open new research avenues toward preventing cognitive and psychological decline in older adults.

The Assessment of Postural-Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life.

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of passive verticalization, the number of risk factors and the quality of development in the first year of life, and the results of the functional examination of these individuals in adolescence. (2) Methods: Two groups of 60 volunteers, aged 9-14 years, were examined by performing functional tests and the retrospective analysis of their development up to the age of 1 year. The first group consisted of patients diagnosed with postural defects. The control group consisted of healthy people of the same age who volunteered for this study. (3) Results: Statistical analysis showed statistically significant differences between groups in terms of posture (p = 0.001), motor coordination (p = 0.001), and accumulated primitive reflexes (p = 0.001), as well as a high correlation between these disorders and the quality of development in the first year of life. In the first group, for the ages of 3-6 months (r = 0.96; p = 0.001), 6-9 months (r = 0.871; p = 0.001), and 9-12 months (r = 0.806; p = 0.001), no significant correlations were found with the age of 0-3 months. In the second group, the results were as follows: 0-3 months (r = 0.748; p = 0.001), 3-6 months (r = 0.862 p = 0.001), 6-9 months (r = 0.698; p = 0.001), and 9-12 months (r = 0.740; p = 0.001). In the group of adolescents with posture defects, we observed an earlier time of passive verticalization and sitting, as well as more frequent use of loungers, seats, and walkers (p = 0.026). (4) Conclusions: The analysis of this study's data indicates that the development of body posture and motor coordination may be impaired due to accelerated and passive verticalization in the first year of life.

NEURAL TUBE CLOSURE ANOMALIES: EPIDEMIOLOGICAL STUDIES AND RISK FACTORS AT THE NEONATAL AND NEONATAL RESUSCITATION DEPARTMENT OF MOHAMMED VI UNIVERSITY HOSPITAL, OUJDA

Objective:This studyaims to identify the sociodemographic, maternal, and obstetricriskfactorsassociatedwith neural tube defects (NTDs) and determinetheirprevalenceamongnewbornshospitalized in the neonatology and neonatal intensive care unit at CHU Mohamed VI Oujda. Methods:Weconducted a descriptive retrospectivestudy over an 18-month period, including all newbornshospitalizedwithisolated or associatedNTDs. Incomplete records wereexcludedfrom the analysis. Results:Out of 797 hospitalizednewborns, 66 hadcongenital malformations, including 10 cases of NTDs (1.25%). The types of NTDsidentifiedwereanencephaly (1 case), spina bifida (6 cases), and encephalocele (3 cases). The majority of mothers had an average age of 34.3 years, with 80% coming from a low socioeconomic status and 60% having a history of consanguineous marriages. Additionally, fenugreek consumption during the first trimester of pregnancy was reported in 70% of cases, while only 20% of mothers had taken folic acid.Regarding the newborns, 70% presented with hypotonia, and 60% exhibited weak or absent primitive reflexes. The short-term postoperative mortality rate was 30%. Discussion:The prevalence of neural tube defects (NTDs) observed in this study is significantly higher than the global average, which may be explained by unfavorable socioeconomic conditions and maternal nutritional deficiencies. Fenugreek consumption and low folic acid supplementation were identified as significant risk factors. Conclusion:To reduce the incidence of NTDs, itis essential to Strengthening prenatal care, encouraging folic acid supplementation, and advising against the consumption of fenugreek during pregnancy are essential. A preventive strategy tailored to local specificities could significantly improve newborn health and reduce complications associated with neural tube defects (NTDs).

Towards novel classification of infants’ movement patterns supported by computerized video analysis

BackgroundPositional preferences, asymmetry of body position and movements potentially indicate abnormal clinical conditions in infants. However, a lack of standardized nomenclature hinders accurate assessment and documentation of these preferences over time. Video tools offer a safe and reproducible method to analyze and describe infant movement patterns, aiding in physiotherapy management and goal planning. The study aimed to develop an objective classification system for infant movement patterns with particular emphasis on the specific distribution of muscle tension, using methods of computer analysis of video recordings to enhance accuracy and reproducibility in assessments.MethodsThe study involved the recording of videos of 51 infants between 6 and 15 weeks of age, born at term, with an Apgar score of at least 8 points. Based on observations of a recording of infant spontaneous movements in the supine position, experts identified postural-motor patterns: symmetry and typical asymmetry linked to the asymmetrical tonic neck reflex. Deviations from the typical postural-motor system were indicated, and subcategories of atypical patterns were distinguished. A computer-based inference system was developed to automatically classify individual patterns.ResultsThe following division of motor patterns was used: (1) normal patterns, including (a) typical (symmetrical, asymmetrical: variants 1 and 2); and (b) atypical (variants: 1 to 4), (2) positional preference, and (3) abnormal patterns. The proposed automatic classification method achieved an expert decision mapping accuracy of 84%. For atypical patterns, the high reproducibility of the system’s results was confirmed. Lower reproducibility, not exceeding 70%, was achieved with typical patterns.ConclusionsBased on the observation of infant spontaneous movements, it is possible to identify movement patterns divided into typical and atypical patterns. Computer-based analysis of infant movement patterns makes it possible to objectify and satisfactorily reproduce diagnostic decisions.

Neonatal sepsis-a peek into our findings in Northwest Nigeria: a prospective study

BackgroundNeonatal sepsis is still a global health concern as it contributes to a high burden of neonatal morbidity and mortality especially in developing countries. The aim of the study is to give an insight into neonatal sepsis: risk factors, sepsis types, clinical features, pathogen burden with their antibiotic sensitivities, and outcome of admission in our facility. The study was a prospective hospital-based study conducted over 10 months, October 2018–July 2019.ResultOf the 248 term neonates with features of sepsis enrolled in the study 94 (37.9%) were confirmed to have sepsis. Late-onset sepsis LOS (68%) was found to be the most common, and most of the neonates were delivered elsewhere. Clinical features were non-specific for both early-onset (EOS) and LOS and include fever, jaundice, poor suck, and depressed primitive reflexes. Infections were mostly caused by gram-negative bacteria, and while Staphylococcus aureus was the single most common isolate for both EOS and LOS. Antibiotic sensitivity was highest with ciprofloxacin for both EOS and LOS. Mortality was high at 14.9% and was mostly contributed to by Staphylococcus aureus infection.ConclusionNeonatal sepsis is still a burden with mostly non-specific clinical features. The local prevalent organisms were Staphylococcus aureus, Enterobacter agglomerans and Klebsiella pneumonia with good antibiotic susceptibility to ciprofloxacin. Most presented with late-onset sepsis and therefore infection is likely to be community-acquired which to a great extent can be prevented with robust public health interventions.

Persistence and activity levels of primitive reflexes in young high-level football players.

Primitive reflexes (PR) induce involuntary automatic movements in response to specific stimuli. This study aimed to determine the prevalence of active PR in young high-level football players. Sixty-nine national-level football players from a French academy were tested (17.0 ± 1.4 years; 69.6 ± 8.0 kg; 178.9 ± 6.9 cm) to evaluate the persistence of PR, following the methodology of the Institute for Neuro-Physiological Psychology (INPP) and the classification by a global score (GS). Based on the sum of seven tests, each was rated between 0 = null and 4 = max. The GS is classified into five categories from no activity to maximal (0-1 = no activity, 2-7 = low, 8-13 = medium, 14-21 = high, and 22-28 = maximal). Around two-thirds (68.1%) of players presented active PR at different activity levels. Among them, a small proportion (7.2%) had medium GS, while 60.9% had a low GS. The GS was not dependent on field position or the age of the players (p > 0.05). However, playing football in an age category higher than their own was associated with significantly more active primitive reflexes (PR) compared to being in their age category (p < 0.01). The results showed that 72.7% of "upgraded" football players had low GS and 18.2% had medium GS, compared to 55.3% and 2.1% in the non-upgraded group. The findings of the current study demonstrate that PR could still be active in a healthy population of high-level football players. Practicing a single sport for years and upgrading players could create a negative environment that can ultimately lead to the activation of otherwise integrated PR.

Children with Attention Deficit and Hyperactivity Disorder: Persistence of Primitive Reflexes and Related Motor Activity Issues

To identify which primitive reflex is higher and its associated problem with motor performance in children with ADHD.14 children with ADHD (4–6 years old) from pediatric clinic of Surat were checked for the presence of the asymmetric tonic neck reflex, symmetric tonic neck reflex, tonic labyrinthine reflex, Palmer, Galant, and Moro reflex test method given by sally Goddard. Motor skills were checked with the motor proficiency test (MOT 4–6 test) in those18 tasks. A child with ADHD has reflex activity in the following areas: ATNR right (42.9%), Galan right (21.4%), STNR extension (28.6%), and Moro (35.7%). Motor skills are inversely related to retained permeative reflex. ADHD Children with increased reflex activity facing difficulty on the MOT test. This study shows that ADHD symptoms are closely linked with persistence of primitive reflexes. The association between persisting primitive reflexes and motor skills suggests that ADHD symptoms may represent a compensation for unfinished developmental phases related to declining reflexes.

Prediction of Cerebral Palsy and Other Motor Developmental Trajectories in High-Risk Neonate Using the Rapid Neurodevelopmental Assessment (RNDA)

Background: Cerebral Palsy (CP) is a prevalent motor disability affecting children globally, emphasizing the need for early identification and intervention. The Rapid Neurodevelopmental Assessment (RNDA) offers a comprehensive approach to predict CP and other motor developmental trajectories in high-risk neonates. Objective: This longitudinal cohort study aims to evaluate the effectiveness of RNDA in predicting CP and motor developmental trajectories. Method: Seventy term neonates from Dhaka Shishu (Children) Hospital were included, with neurodevelopmental assessments conducted using RNDA. Assessments were performed at 3 months and 6-9 months, with CP evaluation at 12 months using clinical examinations. Results: Prolonged labor (44.3%) and delayed cry after birth (31.4%) were common among the study patients (n=70), with varying modes of delivery including normal vaginal delivery (50.0%), vaginal delivery with complications (12.9%), and lower uterine cesarean section (37.1%). Muscle tone, primitive reflexes, gross and fine motor skills, epilepsy, and microcephaly were evaluated across visits to identify impending CP. Significant associations were found between hypertonicity, primitive reflex impairment, gross motor impairment, and fine motor impairment with impending CP across visits, particularly in the 3rd visit (p&lt;0.05). Sensitivity, specificity, accuracy, and predictive values varied across parameters and visits, with fine motor skills and gross motor skills showing the highest sensitivity in the 3rd visit (86.4% and 100.0%, respectively). Additionally, abnormal EEG, USG of the brain, and MRI findings were significantly associated with impending CP, with USG of the brain demonstrating the highest sensitivity (93.3%) and MRI showing the highest specificity (70.0%). Conclusion: RNDA emerges as a valuable tool for early prediction of CP and motor developmental trajectories in high-risk neonates. Early identification through RNDA facilitates timely interventions, optimizing long-term neurodevelopmental outcomes.

The Effect of Therapeutic Hypothermia on Serum Carboxy-Terminal Hydrolase L1 and Amplitude EEG Changes in Hypoxic-Ischemic Neonates

Abstract Background Hypoxia-ischemic encephalopathy (HIE) is one of the most important complications of the newborn period. It is the result of depriving nerve tissue of oxygen and glucose, which may be the result of either hypoxia or ischemia. Objective To assess effect of therapeutic hypothermia (TH) on EEG changes and Carboxy-terminal hydrolase L1level in neonatal HIE at Al-Zahraa university and El Haram hospitals. Patients and Methods This was a prospective comparative study that was conducted at the NICU unit Al ZahraaUniversity and El Haram hospitals for a period from (May 2020 till June 2022). This study included 50 full term newborns (37 to 40 weeks of gestational age) with clinical and laboratory evidence of HIE II–III, They were divided into two groups: Group 1: 25 HIE neonates who were treated with therapeutic hypothermia and group 2: 25 HIE neonates who weren’t received therapeutic hypothermia. Newborns with congenital anomalies, intracranial lesion, epileptic seizure, spinal cord injury or cardiac arrest were excluded from the study. We record EEG changes during 72 hrs by an electroencephalogram with a bioelectric amplifier (Deltamed, Bourgogne), (Philips) Screen. Blood samples were analyzed for UCH-L1 levels by (SEG945Mi). The neonates involved in cooling group were placed over a cooling blanket (Blanketrol III), for 72 hours. Results The results showed there was statistically significant relation between high UCH-L1 level and higher grades of the Sarnat score and primitive reflexes of both the cooling group and non cooling group. The results also showed that there were lower levels of UCH-L1 in cooling group compared to non cooling group of the studied neonates Also there was significant negative correlation found between UCH-L1 level and PH, and HCO3 values. This study showed that there was statistically significant relation found between UCH-L1 level and EEG recording on the 3rd day of both the studied groups. This study showed that (84%) of the non cooling group had EEG abnormalities compared to (68%) of the cooling group. Among both groups of the studied neonates, 76% had EEG abnormalities in form of (34%) had suppression EEG, (16%) were occipito-temporal, (20%) fronto-temporal and (6%) centro-parital. Regarding the site of EEG abnormality (18%) were right sided, (24%) were left sided. The study showed that 72% of cooling group were discharged compared to 48% of non cooling group. Conclusion From our study we concluded significant improvement in EEG records in ischemic neonates who were treated with therapeutic hypothermia. UCH- L1 is a good early neuronal injury biomarker for detecting severity of HIE P value &amp;lt; 0.001 and is a good predictor of hypoxia with specificity 92% and ppv 86.7% and NPV 65.7%. Therapeutic hypothermia has been noted to reduce severe disability among survivors.

Babinski reflex evaluation in term neonates with hypoxic ischemic encephalopathy: Across-sectional observational study

Background: Assessment of primitive reflexes is one of the earliest, easiest and most frequently used method among health care workers for newborns and young infants. Babinski reflex is one of the infantile reflexes. Our aim was to study Babinski reflex in a term neonates with hypoxic ischemic encephalopathy (HIE). The incidence of HIE in developed countries is estimated to be 1.5 per 1,000 live births. Estimates in developing countries range from 2.3-26.5 per 1,000 live births. Methods: This study is a cross-sectional observational study. 70 consecutive neonates fulfilling criteria of HIE according to Sarnat and Sarnat classification, admitted in our neonatal intensive care unit (NICU) were included. It was elicited from 12 hours after birth to 72 hours of birth. Babinski response was assessed using thumb nail drag method. Results: 83% babies are born to 18-35 years and 17% to elderly gravid. 55% are delivered through normal vaginal delivery and 45% to LSCS. 52% neonates belong to HIE stage I, 30% and 18% neonates belong to HIE stage II and III respectively. In HIE stage I, planter grasp was elicitable in 89%. It remains non-elicitable in 44% and 91% in HIE stages II and III respectively. Conclusions: Absence of Babinski reflex can be correlated with the increase in severity of HIE. It is important to include the assessment of Babinski reflex along with other primitive reflexes in the newborn generally and especially in HIE.

Early Play Behaviors of Infants at Elevated Likelihood for Autism Spectrum Disorder.

Although research has examined early identification of autism spectrum disorder (ASD), few studies have found behavioral markers during midinfancy associated with later ASD diagnosis. To examine infants' play behaviors and atypical positions at age 6 mo and later outcome classification among infants at elevated likelihood (EL) and typical likelihood (TL) for ASD. Atypical positions refer to movement patterns indicative of motor delays or deviations, including atypical extension and flexion, poor weight shift and rotation, hypertonicity or hypotonicity, and the presence of primitive reflex patterns. Observational cohort longitudinal design using blinded video analysis. Fifty-eight infants (41 EL infants and 17 TL infants) 6 mo of age. Infants later diagnosed with ASD needed more support to engage in play at age 6 mo compared with infants who did not receive an ASD diagnosis (U = 130, z = -2.29, p < .05, r = .31). Atypical positions at 6 mo of age were not associated with a later diagnosis of ASD. Play behaviors may be early indicators of developmental differences for infants later diagnosed with ASD. The results of this pilot study suggest the need to observe the quality of interaction with a caregiver and objects during early play, which may serve as potential early indicators of ASD. Plain-Language Summary: Few studies have found behavioral markers during midinfancy that are associated with a later diagnosis of autism spectrum disorder (ASD). The results of this study showed that infants who were later diagnosed with ASD were found to have differences in play behaviors compared to infants who were not later diagnosed with ASD. Thus, early play behaviors may be an early indicator of developmental differences for infants who are later diagnosed with ASD.

Plantar Grasp Sign as a Screening Tool for Orthostatic Tremor (OT)

Plantar Grasp Sign as a Screening Tool for Orthostatic Tremor (OT)

Guiding Parents of Children With Persistent Primitive Reflexes

Strong primitive reflexes in infants suggest proper development of the central nervous system. However, if not naturally integrated in the first year of life, these persistent primitive reflexes may interfere with further motor and cognitive development as well as emotional regulation. When nurse practitioners diagnose persistent primitive reflexes, parents are often eager to know what can be done at home. Described here is a program evaluation completed on a series of movement-to-music videos called Rockin’ Reflex that provide parents with inexpensive, easy-to-follow videos that they can do at home to help their children integrate these reflexes.

Prediction of Cerebral Palsy and Other Motor Developmental Trajectories in High-Risk Neonate Using the Rapid Neurodevelopmental Assessment (RNDA) and Prechtl’s Method of Qualitative Assessment of General Movement (GMsA)

Background: The integration of the RNDA and Prechtl's Method offers a promising approach to identify high-risk neonates and predict their motor developmental trajectories. This early identification can guide clinicians in providing timely interventions, improving the long-term outcomes and quality of life for infants affected by CP and other motor disorders. Objective: The study investigates the predictive potential of the Rapid Neurodevelopmental Assessment (RNDA) and Prechtl’s Method of Qualitative Assessment of General Movement (GMsA) in high-risk neonates. Method: This longitudinal cohort study at Dhaka Shishu Hospital (January 2016-December 2017) enrolled 16 high-risk neonates. GMsA and RNDA were conducted from birth to 20 weeks post-term age. Muscle tone, primitive reflexes, gross and fine motor skills were evaluated. Impending CP diagnosis was at 1 year. Statistical analysis was performed using SPSS 23.0. Results: The study investigates the association between various developmental markers and the risk of cerebral palsy (CP) in infants. Results reveal a higher prevalence of muscle tone impairment in impending CP cases across preterm, term, and post term ages. Sensitivity, specificity, and predictive values for CP prediction based on muscle tone are presented, showing significant associations. Primitive reflexes also demonstrate higher impairment rates in impending CP cases across different age points, with corresponding sensitivity, specificity, and predictive values. Gross motor and fine motor impairments exhibit significant associations with impending CP, along with predictive values. The distribution of categorical scores for GMsA and RNDA across various age points emphasizes the prevalence of impairments in impending CP cases. Findings indicate a strong association between GMsA scores and CP risk, with significant predictive capabilities across different visits. Overall, the study highlights the utility of these developmental markers in predicting CP ....

Early Intervention Guided by the General Movements Examination at Term Corrected Age-Short Term Outcomes.

The early identification of the former premature neonates at risk of neurologic sequelae could lead to early intervention and a better prognosis. This pilot study aimed to investigate whether the General Movement patterns observed at term-equivalent age in former premature infants could serve as predictors for guiding early intervention and improving prognosis. In a population of 44 premature neonates (mean gestational age 33.59 weeks (+2.43 weeks)) examined at term-equivalent age, 10 neonates with a cramped-synchronized General Movements motor pattern were identified. These neonates were included in an early intervention program consisting of physiotherapy executed both by the therapist and by the parents at home. They were again examined at a corrected age of 12 weeks. The presence or absence of fidgety movements and the MOS-R (motor optimality score revised) was noted. The examinations were performed by certified specialists. Normal fidgety movements and a MOS-R of 20-24 were presented in 9/10 of the former premature infants, with normal foot to foot contact present in 7/10, and normal hand to hand contact present in 5/10. The atypical patterns noted were side to side movements of the head in 5/10, a non-centered head in 9/10, asymmetric tonic neck reflex in 9/10 and jerky movements in 10/10. One patient presented with no fidgety movements and a MOS-R score of 9. Early intervention in our group of patients allowed for an improvement in the neurologic status, demonstrated by the presence of fidgety movements. We suggest that early intervention should be indicated in all premature infants that present with a cramped-synchronized GM pattern during examination at term-equivalent age. However, due to the small sample size, the absence of statistical analysis and a control group, and the limited follow-up period, the conclusions must be approached with caution.

Bell's palsy in a seven-month-old twin infant: a case report

Idiopathic peripheral facial paralysis is a rare condition in the pediatric population under one year of age, characterized by paralysis of the structures innervated by the facial nerve. This report describes the first infant in Brazil to be diagnosed with this clinical condition. A 7-months-old twin infant presented with altered left oromotor control and a discrete incomplete closure of the left eyelid when blinking, although with normal tear production. Her primitive reflexes were present and the spontaneous movements of the four limbs were normal. An investigation for infectious etiology and a magnetic resonance imaging of the brain were performed and did not show any alterations. Thus, the diagnosis of Bell's palsy was assumed, and oral prednisone was prescribed for five days. The patient evolved with total resolution of the facial paralysis during the first two weeks after discharge. Most cases of peripheral facial paralysis in children are idiopathic, while the others are associated with infectious and/or traumatic etiologies. There are still no consistent data proving the benefit of the use of corticoid alone or in combination with antiviral drugs for the treatment of children under one year of age.