Cerebral Palsy ; complications ; Child ; Child Nutrition Disorders ; complications ; Deglutition Disorders ; Equipment and Supplies ; Esophageal Motility Disorders ; etiology ; therapy ; Humans ; Speech Disorders ; etiology

Autism spectrum disorders (ASD) is a complex neurobehavioral disorder. The etiology of ASD is complex and encompasses the roles of genes, the environment (epigenetics) and the mitochondria. This paper reviewed the current research of the etiology of ASD.

EEGs performed for new-onset seizures show epileptiform discharge in approximately 18% to 56% of children and 12%to 50%of adults. EEG is the most commonly used means of neurological examination for epilepsy. Speciifc EEG abnormalities help characterize the seizure type and epilepsy syndrome, which allows more informed decisions regarding therapy and more accurate prediction of seizure control and ultimate remission. In certain cases, the EEG may detect more subtle seizures, including absence, myoclonic or partial seizures. In the therapy of epilepsy, the effect of different antiepileptic drugs on the inhibition of epileptiform discharges is different. Epileptiform discharges play a very important role in the prediction of recurrence and the decision to remove antiepileptic drugs.

Objective To investigate the clinical features and magnetic resonance imaging (MRI) finding of cerebral palsy in children with bilirubin-encephalopathy. Methods 35 cerebral palsied children with a history of bilirubin-encephalopathy were retrospectively studied. Results 27 cases appeared some early symptoms of the nervous system, including excessive crying without any reason, hypsokinesis, body torquing, opisthotonos, which usually were aggravated by respiratory infection, fever, diarrhea, etc. The marked neuromotor characteristics included the instability and asymmetry of muscle tension and posture, the remaining of some primitive reflexs. According to the Gross Motor Function Classification, there was 1 case with I grade, 3 with II, 4 with III, 5 with IV, and 22 with V (of which 15 cases were younger than 18 months）. 29 cases accepted MRI, and 25 cases appeared abnormal, of which 22 showed typically high T2 signal in the bilateral globus pallidus. Conclusion The clinical and brain MRI findings of dyskinetic cerebral palsy associated with bilirubin-encephalopathy are characteristic and can be recognized easily.

Periventricular leukomalacia (PVL) is the predominant form of brain injury and the main cause of cerebral palsy and cognitive deficits in premature infants. The number of low-birth-weight infants, who survive to demonstrate these neurologic deficits, is increasing. The factors of PVL are ischemia and inflammatory reaction which cause interaction of glutamate and free radicals. Pre-oligodendroglia is highly vulnerable to death caused by their interaction leading to neuropathologic hallmarks of PVL, and resulting in cerebral palsy. It is suggested that the preservation of occurrence and development of PVL is the key for depressing incidence rate of cerebral palsy. Pharmacologic interventions that target these toxic molecules will be useful in diminishing the severity of PVL accordingly to decreasing or lessening cerebral palsy in premature infants..

Magnetic resonance imaging (MRI) is now an important diagnostic technology in determining brain structure injury. It has important meaning for determining the pathological type of CP, MRI findings in CP showed a good correlation with CP type, gestational age, etiology and injury time. In this article, the authors reviewed the advance in research on relationship between changes in MRI and gestational age, etiology and injury time.

Dysarthria ; etiology ; Encephalitis, Viral ; complications ; Facial Paralysis ; etiology ; Humans ; Syndrome

Cerebral Palsy ; diagnosis ; etiology ; therapy ; Humans ; Magnetic Resonance Imaging ; Prognosis

Objective: To evaluate the value of contrast-enhanced magnetic resonance angiography (CE-MRA) in the diagnosis of vertebral stenosis. Methods: A total of 108 patients (216 vertebral arteries) with clinical ischemic symptoms were examined by CE-MRA, then they were examined with digital subtraction angiography (DSA) within one week after CE-MRA examination. Using DSA as a standard, the accuracy of CE-MRA in the diagnosis of vertebral arteries was evaluated. Results: Circled digit oneOf the 216 vertebral arteries, 188 (87.0%) were consistent with the results of CE-MRA and DSA. The stenosis degree of 24 arteries (11.1%) determined by CE-MRA was higher than those determined by DSA. The stenosis degree of 4 arteries (1.9%) determined by CE-MRA was lower than those determined by DSA. Spearman rank correlation coefficient of the 2 kinds of examination was rs = 0.785 (P <0.001). Circled digit twoIn 168 normal vertebral arteries examined by CE-MRA, 2 were mild stenosis (stenosis rate ≤49%) and 2 were moderate to severe stenosis (stenosis rate 50-99%) examined by DSA. Of the 8 arteries with mild stenosis diagnosed by CE-MRA, DSA confirmed that 6 arteries were normal; of the 30 arteries with moderate to severe Stenosis diagnosed by CE-MRA, DSA confirmed that 10 were mild stenosis and 8 were normal. CE-MRA examination showed that the 10 occluded arteries were all confirmed by DSA. Circled digit threeUsing DSA as the gold standard, the sensitivity, specificity, false positive rate, false negative rate, positive predictive value, negative predictive value, and diagnostic consistent of CE-MRA rate were 89.5% (34/38), 92.1% (164/178), 7.9% (14/178), 10.5% (4/38), 70.8% (34/48), 97.6% (164/168), and 91.7% (198/216) , respectively. The Youden index was Y = 0.816. Conclusion: CE-MRA has high sensitivity in the diagnosis of vertebral artery ostial stenosis, it can be used as a screening means for detection. However, if we want to accurately evaluate the stenotic degree of vertebral artery, a variety of examination methods are needed.

Objective To investigate the symptom characteristis as well as the clinical assessment methods of dysphagia and oral motor function in children with cerebral palsy(CP).Methods A total of 116 children with CP,aged 18 months to 96 months(66 boys and 50 girls),treated in Qingdao Rehabilitation Center for Disabled Children from June 2009 to September 2010,were included in the study.Diagnosis and subtype of CP were determined by neuropaediatrician,the dysphagia disorders survey(DDS)as well as oral motor assessment were conducted by the speech therapists.Results Of the 116 cases,22.4％ of the cases were with mild dysphagia and 34.5％ with moderate to severe dysphagia,resulting in a prevalence of dysphagia of 56.9％.The main problems of these cases occurred during oral phase and pharyngeal phase,including inadequate feeding skills(involving sucking,biting,chewing or/and swallowing),coughing,vomiting and choking during feeding,cry/overextension of neck and head during feeding,drooling,hypertonic tongue and inadequate tongue lateralization.The severe dysphagia was encountered frequently in children with spastic quadriplegic,dyskinetic or mixed type CP children.Of the 116 cases,90 cases(77.59％)were with oral motor dysfunction(including all spastic quadriplegic,dyskinetic or mixed type children).The oral motor scores of CP children were significantly lower than those of the controls(P ＜ 0.01).Conclusions Oral phase dysphagia and oral motor disorder might be considered as the common clinical problems among the patients with CP,and could be assessed by using DDS combined with oral motor assessment,but for dysphagia during pharyngeal or esophagus phase,the videofluoroscopic modified barium swallow should be used for further evaluation.