Spastic diplegia and other motor disturbances in infants receiving interferon-alpha.
OBJECTIVE
To determine how frequently the use of -interferon (-IFN) is associated with the development of spastic diplegia.


METHODS
Meta-analysis of 600 English manuscripts published January 1991 to June 2002 reporting -IFN use in infants/children. We identified 3,113 children 18 years of age or younger and an estimated 3,055 children 12 years of age or younger who received -IFN therapy. Sixty-nine percent were treated for chronic hepatitis and 14% for vascular neoplasms.


METHODS
Neurologic examination to confirm spastic diplegia or a motor developmental disturbance other than spastic diplegia such as hyperactive deep tendon reflexes, gait disturbances, or impaired fine motor control.


RESULTS
Including our index case, 11 of 441 children with vascular lesions developed spastic diplegia and an additional 16 of 441 developed a motor developmental disturbance. All of these children were less than 1 year of age at initiation of therapy. Mean age of initiation and duration of -IFN therapy were not significantly different between groups (P >.05); however, motor developmental disturbances improved with cessation of therapy, whereas spastic diplegia did not. No child receiving treatment for chronic hepatitis developed neurologic complications; however, only 49 children were less than 1 year of age at initiation of therapy.


CONCLUSIONS
-IFN should not be used in infants under 1 year of age unless life-threatening conditions do not respond to any other form of treatment. If -IFN must be used, children should have monthly neurologic examinations. If a motor developmental disturbance is detected and -IFN therapy can be discontinued, it should be.
Michaud
André-Paul
AP
University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA.
Bauman
Nancy M
NM
Burke
Diane K
DK
Manaligod
José M
JM
Smith
Richard J H
RJ
D000293:Adolescent; D002547:Cerebral Palsy / Q000139:chemically induced*; D002648:Child; D002675:Child, Preschool; D006391:Hemangioma / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D019957:Motor Skills Disorders / Q000139:chemically induced*
D016898:Interferon-alpha