Article

The aim of the study was to map clinical patterns of dystonia and
choreoathetosis and to assess the relation between functional classifications and
basal ganglia and thalamus lesions in participants with dyskinetic cerebral palsy
(CP). METHODS: In this cross-sectional study, 55 participants with dyskinetic CP
(mean age 14y 6mo, SD 4y 1mo; range 6-22y) were assessed with the Dyskinesia
Impairment Scale and classified with the Gross Motor Function Classification
System (GMFCS), Manual Ability Classification System (MACS), and Communication
Function Classification System (CFCS). RESULTS: Dystonia and choreoathetosis are
simultaneously present. Median levels of dystonia (70.2%) were significantly
higher than levels of choreoathetosis (26.7%) and both were significantly higher
during activity than at rest (both p<0.01). High correlations were found between
dystonia levels and GMFCS level (Spearman's rank correlation coefficient, rS
=0.70; 95% confidence interval [CI] 0.53-0.81; p<0.01) and MACS (rS =0.65; 95% CI
0.47-0.81; p<0.01), and fair correlation with CFCS (rs =0.36; 95% CI=0.11-0.57;
p<0.05). No significant correlation was found between choreoathetosis levels and
motor classifications. Finally, higher choreoathetosis levels were found in
participants with pure thalamus and basal ganglia lesions (p=0.03) than mixed
lesions, but not for dystonia (p=0.41). INTERPRETATION: Dystonia and
choreoathetosis increase during activity. However, dystonia predominates and
seems to have a larger impact on functional abilities. Our findings further
suggest that choreoathetosis seems to be more linked to pure thalamus and basal
ganglia lesions than dystonia.
CI - (c) 2015 Mac Keith Press.

Langue : ANGLAIS