Ivana Dakovic1, Maria da Graça Andrada2, Teresa Folha3, David Neubauer4, Katalin Hollody5, Michaela Honold6, Veronka Horber7, Vlasta Duranovic1, Vlatka Mejaski Bosnjak8. 1. Children's Hospital Zagreb, University of Zagreb, School of Medicine, Department of Neuropediatrics, Klaiceva 16, 10000 Zagreb, Croatia. 2. Federação das Associações Portuguesas de Paralisia Cerebral FAPPC/National Epidemiological Program for Cerebral Palsy, Lisbon, Portugal. 3. Centro de Reabilitação de Paralisia Cerebral Calouste Gulbenkian Santa, Casa da Misericordia de Lisboa/National Epidemiological Program for Cerebral Palsy, Lisbon, Portugal. 4. University Medical Centre Ljubljana, Division of Paediatrics, Department of Child, Adolescent and Developmental Neurology, Ljubljana, Slovenia. 5. University of Pecs, Department of Paediatrics, Pecs, Hungary. 6. Medical University Innsbruck, Division of Pediatric Neurology, Department of Pediatrics I, Innsbruck, Austria. 7. University Children's Hospital Tübingen, Department of Child Neurology, Tübingen, Germany. 8. Children's Hospital Zagreb, University of Zagreb, School of Medicine, Department of Neuropediatrics, Klaiceva 16, 10000 Zagreb, Croatia. Electronic address: vlatka.mejaskibosnjak@gmail.com.
Abstract
BACKGROUND: Human cytomegalovirus is the most common cause of vertically transmitted viral infection, affecting around 1% of liveborns. Infection is symptomatic in nearly 10% of infected children who are at higher risk of development of severe neurological disorders, including cerebral palsy. AIMS: To study the clinical profile of children with cerebral palsy caused by symptomatic congenital cytomegalovirus infection in a multicenter study involving six countries from the Surveillance of Cerebral Palsy in Europe (SCPE) Network. METHODS: Data on 35 children (13 males, 22 females; mean age at last assessment 12y 6mo, age range 14y 6mo, min 4y, max 18y 6mo) on pre/peri/neonatal history and last clinical assessment were collected. Classification of cerebral palsy and associated impairments was performed according to SCPE criteria. RESULTS: The majority of children had bilateral spastic cerebral palsy, 85.7%, with a confidence interval (CI) [69.7-95.2], and 71.4% [CI 53.7-85.4] were unable to walk (GMFCS levels IV-V) while fine motor function was severely affected in 62.8% [CI 44.9-78.5] (BFMF levels IV and V). Most of the children with severe CP had severe associated impairments. 11.4% of children had severe visual and 42.8% severe hearing impairment, 77.1% [CI 59.9-89.6] suffered from epilepsy, also 77.1% had severe intellectual impairment, and speech was undeveloped in 71.4%. Female:male ratio was 1.69:1 and 80% of children were term born. CONCLUSIONS: Cerebral palsy following symptomatic congenital cytomegalovirus infection seems to be in most cases a severe condition and associated impairments are overrepresented.
BACKGROUND:Human cytomegalovirus is the most common cause of vertically transmitted viral infection, affecting around 1% of liveborns. Infection is symptomatic in nearly 10% of infected children who are at higher risk of development of severe neurological disorders, including cerebral palsy. AIMS: To study the clinical profile of children with cerebral palsy caused by symptomatic congenital cytomegalovirus infection in a multicenter study involving six countries from the Surveillance of Cerebral Palsy in Europe (SCPE) Network. METHODS: Data on 35 children (13 males, 22 females; mean age at last assessment 12y 6mo, age range 14y 6mo, min 4y, max 18y 6mo) on pre/peri/neonatal history and last clinical assessment were collected. Classification of cerebral palsy and associated impairments was performed according to SCPE criteria. RESULTS: The majority of children had bilateral spastic cerebral palsy, 85.7%, with a confidence interval (CI) [69.7-95.2], and 71.4% [CI 53.7-85.4] were unable to walk (GMFCS levels IV-V) while fine motor function was severely affected in 62.8% [CI 44.9-78.5] (BFMF levels IV and V). Most of the children with severe CP had severe associated impairments. 11.4% of children had severe visual and 42.8% severe hearing impairment, 77.1% [CI 59.9-89.6] suffered from epilepsy, also 77.1% had severe intellectual impairment, and speech was undeveloped in 71.4%. Female:male ratio was 1.69:1 and 80% of children were term born. CONCLUSIONS:Cerebral palsy following symptomatic congenital cytomegalovirus infection seems to be in most cases a severe condition and associated impairments are overrepresented.