Quality of general movements and the development of minor neurological dysfunction at toddler and school age.
OBJECTIVE
To evaluate the reliability of assessing infants' general movements (GMs) using a new classification and its validity in predicting complex minor neurological dysfunction (MND) at toddler and at school age.


METHODS
Prospective study of two groups of infants, each consisting of a mix of low-risk and high-risk infants.


METHODS
University Hospital Groningen, the Netherlands.


METHODS
Group A consisted of 16 low-risk and 21 high-risk infants; group B of 28 low-risk and 24 high-risk infants.


METHODS
Between term age and four months post term: multiple assessments of neurological condition by means of (a) assessment of GMs, and (b) a traditional neurological examination. GMs were classified into four classes using a standardized qualitative description: two classes of normal movements (normal-optimal and normal-suboptimal) and two classes of abnormal movements (mildly and definitely abnormal movements). Follow-up neurological examination with special attention to presence of MND was carried out in group A at 1 1/2 years, in group B at 4-9 years.


RESULTS
GMs could be assessed reliably. They were stable over age in about 60% of the infants. Both the condition of the GMs and the infant neurological condition were significantly related to neurological condition at follow-up. Best prediction of complex MND was achieved when both types of infant assessment at the age of 2-4 months post term were combined.


CONCLUSIONS
The assessment of GMs is a valuable tool, in particular when combined with the traditional neurological examination, to predict at early age the development of complex MND.
Hadders-Algra
Mijna
M
Department of Neurology, University of Groningen, The Netherlands. m.hadders-algra@med.rug.nl
Mavinkurve-Groothuis
Annelies M C
AM
Groen
Sabina E
SE
Stremmelaar
Elisabeth F
EF
Martijn
Albert
A
Butcher
Phillipa R
PR
D002648:Child; D002657:Child Development; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009068:Movement; D009069:Movement Disorders / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D009422:Nervous System Diseases / Q000150:complications / Q000175:diagnosis*; D009460:Neurologic Examination; D011446:Prospective Studies; D012016:Reference Values; D015203:Reproducibility of Results; D012307:Risk Factors