title: Cramped synchronized general movements in preterm infants as an early marker for cerebral palsy.
abstract: OBJECTIVE
  To ascertain whether specific abnormalities (ie, cramped synchronized general movements [GMs]) can predict cerebral palsy and the severity of later motor impairment in preterm infants affected by brain lesions.
  
  
  METHODS
  Traditional neurological examination was performed, and GMs were serially videotaped and blindly observed for 84 preterm infants with ultrasound abnormalities from birth until 56 to 60 weeks' postmenstrual age. The developmental course of GM abnormalities was compared with brain ultrasound findings alone and with findings from neurological examination, in relation to the patient's outcome at age 2 to 3 years.
  
  
  RESULTS
  Infants with consistent or predominant (33 cases) cramped synchronized GMs developed cerebral palsy. The earlier cramped synchronized GMs were observed, the worse was the neurological outcome. Transient cramped synchronized character GMs (8 cases) were followed by mild cerebral palsy (fidgety movements were absent) or normal development (fidgety movements were present). Consistently normal GMs (13 cases) and poor repertoire GMs (30 cases) either lead to normal outcomes (84%) or cerebral palsy with mild motor impairment (16%). Observation of GMs was 100% sensitive, and the specificity of the cramped synchronized GMs was 92.5% to 100% throughout the age range, which is much higher than the specificity of neurological examination.
  
  
  CONCLUSIONS
  Consistent and predominant cramped synchronized GMs specifically predict cerebral palsy. The earlier this characteristic appears, the worse is the later impairment.
authors: Institute of Paediatrics and Neonatal Medicine, University of Modena, Policlinico Universitario, 41100 Modena, Italy. ferrarif@unimo.it
authors: Fabrizio
authors: F
authors: Ferrari
authors: Giovanni
authors: G
authors: Cioni
authors: Christa
authors: C
authors: Einspieler
authors: M Federica
authors: MF
authors: Roversi
authors: Arend F
authors: AF
authors: Bos
authors: Paola B
authors: PB
authors: Paolicelli
authors: Andrea
authors: A
authors: Ranzi
authors: Heinz F R
authors: HF
authors: Prechtl
mesh_terms: D002547:Cerebral Palsy / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies