Neuropediatrics 2002; 33(5): 242-248
DOI: 10.1055/s-2002-36737
Original Article

Georg Thieme Verlag Stuttgart · New York

Neurological and Perceptual-Motor Outcome at 5 - 6 Years of Age in Children with Neonatal Encephalopathy: Relationship with Neonatal Brain MRI

A. Barnett 1 , E. Mercuri 1 , 2 , M. Rutherford 1 , 3 , L. Haataja 1 , 4 , M. F. Frisone 1 , 2 , S. Henderson 5 , F. Cowan 1 , L. Dubowitz 1
  • 1Department of Paediatrics, Imperial College School of Medicine, Hammersmith Campus, London, United Kingdom
  • 2Department of Paediatric Neurology and Psychiatry, Catholic University, Rome, Italy
  • 3Medical Research Council Clinical Sciences Centre, Imperial College School of Medicine, Hammersmith Campus, London, United Kingdom
  • 4Department of Paediatrics and Child Neurology, Turku University Central Hospital, Turku, Finland
  • 5School of Psychology, Institute of Education, University of London, United Kingdom
Further Information

Publication History

Received: 1 March 2002

Accepted after Revision: 12 June 2002

Publication Date:
21 January 2003 (online)

Abstract

Objective

The aims of this study were 1) to determine the incidence of minor neurological dysfunction and perceptual-motor difficulties in children aged 5œ - 6œ, who had been born full-term but presented with neonatal encephalopathy (NE) and low Apgar scores and 2) to examine the relationships between the presence/absence of these difficulties with neonatal brain MRI.

Participants and Methods

Sixty-eight full-term infants with one minute Apgar scores less than or equal to 5 and neurological abnormalities during the first 48 hours after birth were included in the study. All children had a neonatal MRI brain scan. Surviving infants were assessed between the age of 5 and 6 years using the Touwen Examination, the Movement ABC and the WPPSI-R.

Results

Fifteen of the 68 infants (22 %) died in the neonatal period. Of the 53 surviving infants, 19 (36 %) had cerebral palsy. The remaining 34 were considered normal at 2 years of age but, when assessed at school age, 8 (15 %) had minor neurological dysfunction and/or perceptual-motor difficulties, 1 (2 %) had only cognitive impairment and 25 (47 %) were normal. The outcome largely reflected the pattern of lesions on brain imaging. While 83 % of those with a normal outcome had normal scans or minimal white matter lesions, 80 % of those with minor neurological dysfunction and/or perceptual-motor difficulties had mild or moderate basal ganglia or more marked white matter lesions.

Conclusion

Continued surveillance is recommended for children with apparently normal outcome at two years of age after NE, particularly when abnormalities are detected on brain MRI.

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Eugenio Mercuri

Department of Paediatrics, Hammersmith Hospital

Du Cane Road

London W12 OHN

United Kingdom

Email: e.mercuri@ic.ac.uk