Hyperbilirubinemia and asphyxia in children with dyskinetic
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Researchers aimed to study the clinical, etiological and radiological characteristics in children with dyskinetic cerebral palsy (DCP) and to compare the etiological subtypes of hyperbilirubinemia and perinatal asphyxia.

A Cross-sectional, observational study was carried out that enrolled consecutive children with DCP, aged 1-14 years.

--65 children with DCP (91%, n=59 dystonia; 9%, n=6 choreoathetosis) were evaluated.

--The majority of children were boys (77%), first-born (49%), term gestation (80%), and in the age group 1-2 years (55.4%).

--Presenting concerns were global developmental delay (97%) and abnormal involuntary movements (60%) in the majority.

--Hyperbilirubinemia (66%) and perinatal asphyxia (29%) were the most important causes of DCP.

--The majority (83%) of the children were severely disabled and non-ambulatory (level V and IV); only 9% (n=6) achieved ambulation (level I and II).

--The mean dystonia scales were higher in the hyperbilirubinemia group. The hyperbilirubinemia group had significant motor delay (63% vs. 37%) and upgaze palsy (69.7% vs. 31.5%) as compared to the perinatal asphyxia group.

--Hyperbilirubinemia significantly involved pallidi (86% vs. 10%) and subthalamic nucleus (26% vs. none), while asphyxia significantly involved putamen (58% vs. none), thalamus (63% vs. none), and periventricular white matter (79% vs. 19%).

To summarize, DCP is the most common form of cerebral palsy in term babies with extreme dystonia, developmental delay, and motor impairment. In the research, hyperbilirubinemia accompanied by asphyxia was the leading cause of DCP. Motor delay, upgaze palsy, prominent dystonia, and involvement of the globus pallidi and subthalamic nuclei are all linked to hyperbilirubinemia.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0887899421000229?dgcid=rss_sd_all