Developmental medicine and child neurology
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Dev Med Child Neurol · Feb 1992
Case ReportsPositional asphyxia in individuals with severe cerebral palsy.
The authors report the accidental death by positional asphyxia of three individuals with cerebral palsy occurring after they had been placed in bed for the night. During the five-year period between 1984 and 1989, 12 per cent of deaths from positional asphyxia in King County, Washington, involved individuals with cerebral palsy. Such accidents are similar to those occurring among healthy young children, perhaps because both groups have limited motor skills. Further research into accidents among disabled persons may clarify their special risks and possibly lead to modifications in bed design.
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A simplified method of six features for gestational age assessment was modified to include scored measurements for head circumference and mid-arm circumference, in order to improve reliability. The modified model had better correlation with gestational age than the simplified method, comparable accuracy to the Dubowitz system and was also more rapid. Preterm, low-birthweight, appropriate for gestational-age infants and term, low-birthweight, small for gestational-age infants were reliably identified by the model.
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A survey on spinal deformity was conducted by means of a questionnaire mailed to the 350 American families who are members of the International Rett Syndrome Association. 258 questionnaires were completed and further information (medical records and radiographs) was received from treating physicians. Scoliosis was present in 119 patients, whose clinical details are discussed. ⋯ The incidence increases with age, occurring most commonly during the second decade. Bracing to control curve progression has been largely unsuccessful for adolescent patients.
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Dev Med Child Neurol · Feb 1990
Magnetic resonance imaging of inflammatory and demyelinating white-matter diseases of childhood.
Magnetic resonance imaging (MRI) was performed on 36 children and two adults (with clinical presentation during childhood) with white-matter disease of the central nervous system. Abnormalities were readily demonstrated in patients with multiple sclerosis, acute disseminated encephalomyelitis, leucodystrophies and subacute sclerosing panencephalitis: MRI demonstrated the extent and distribution of abnormalities more clearly than computed tomography for all these disorders. ⋯ Children with clinically isolated optic neuritis had a significantly lower frequency of MRI brain-lesions than adults with the same disorder. MRI should be regarded as the radiological investigation of choice when white-matter disease is suspected in children.