Neurological signs in infancy

At early age, it is important to determine which children are at high risk of a neurodevelopmental disorder. This makes it possible to start early intervention; a definite diagnosis is not necessary. It is well known that neurological signs may assist early prediction, but knowledge on the contribution of specific signs is limited. This thesis addresses the prevalence and possible underlying mechanisms of specific neurological signs in infancy. We studied two groups of children. The first group comprised low-risk infants from the general Dutch population; the second group consisted of children at very high risk of neurodevelopmental disorders, in particular cerebral palsy (CP). In the low-risk group we found a high, yet with age decreasing prevalence of a prevailing head position to one side during the first 6 months of life. From 4 months onwards a prevailing head position was associated with perinatal risk factors and suboptimal development. Atypical muscle tone in 1 or 2 body parts was common with limited clinical significance, whereas atypical muscle tone in 3 or 4 body parts was clinically relevant. The very high-risk children virtually always presented with atypical muscle tone in early infancy. From 7 months of age onwards, specific atypical tone patterns were associated with CP. Besides, in the very high-risk group, the presence of a tonic knee jerk response during infancy assisted prediction of CP, and infant motor development assisted prediction of developmental outcome at school-age.

Dissertation: http://hdl.handle.net/11370/2dbb8124-cc62-4e5b-90b0-ef4384f36f92