Early neurologic assessment in preterm-infants: integration of traditional neurologic examination and observation of general movements.
OBJECTIVE
To evaluate the possible additional benefit in terms of prognostic accuracy of an integrated application of a traditional scorable method of neurologic examination and the Prechtl's method of qualitative assessment of general movements (GMs) in a large population of 903 consecutive preterm infants.


METHODS
Infants were enrolled from the Intensive Care Unit of the University of Catania. Inclusion criteria were a gestational age below 37 weeks and the absence of genetic disorders. All infants underwent serial ultrasound and at 3 months performed both the GMs assessment and the Hammersmith Infant Neurologic Examination (HINE). Outcome was assessed at 2 years by the Touwen neurologic examination and the Clinical Adaptive Test/Clinical, Linguistic and Auditory Milestone Scale.


RESULTS
The integration of the two methods was shown to be more effective than the single assessments in predicting neurologic outcome. The additional benefit of combining the two approaches was particularly clear for the discrimination between unilateral and bilateral cerebral palsy.


CONCLUSIONS
The integrated use of a scorable neurological examination and Prechtl's assessment of GMs can improve early prediction of neurodevelopmental outcome in preterm infants and should complement other clinical and instrumental exams in follow-up programs.
Romeo
Domenico Marco Maurizio
DM
Division of Child Neurology and Psychiatry, Department of Paediatrics, University of Catania, Italy.
Guzzetta
Andrea
A
Scoto
Mariacristina
M
Cioni
Matteo
M
Patusi
Pietro
P
Mazzone
Domenico
D
Romeo
Mario Giuseppe
MG
D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology*; D009068:Movement / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods*; D019370:Observation / Q000379:methods; D011596:Psychomotor Disorders / Q000175:diagnosis*; D014743:Videotape Recording