80 Predictive Value of General Movements (GMS) for Neurological Outcome. Preliminary Data.

The aim of our study has been to evaluate predictive value of general movements (GMs) for neurological outcome in two groups of newborns: high-risk preterm and asphyxiated fullterm. We have evaluated 23 high-risk preterm (gestational age <32 weeks) and 7 fullterm infants affected by hypoxic-ischemic encephalopathy or neonatal stroke, admitted to the NICU of the Department of Biomedicine of Evolutive Age of Bari University from January 2004 to February 2005. Infants were videotaped for 1 hour at 35 (preterm), 40 and 45 (fullterm) weeks corrected age (CA) and then again for 15 minutes at 50 and 55 weeks CA, while another operator, blind to videotape data, evaluated Prechtl method. A complete neurological examination was performed in all infants. GMs individual developmental trajectory was compared with neurological examination at the age of one year. 8 preterms and 6 fullterm infants have been evaluated at 7 months and 12 months CA. At 7 months CA, 3 infants had cerebral palsy (CP) and 4 developmental retardation (DR). At one year CA, 5 out of 7 of these infants completed the evaluation: 3 cerebral palsy have been confirmed and 2 out of 4 with DR evolved in CP. 7 infants (5 preterm and 2 fullterm) with normal (6) or abnormal (1) fidgety show normal neurological outcome; 7 infants with absent fidgety movements (3 preterm and 4 fullterm) were affected by CP (1 preterm and 4 fullterm) or DR (2); of this group 6 infants (2 preterm and 4 fullterm) showed also cramped synchronized GMs. Cramped syncronized GMs and absent fidgety movements do predict poor neurological outcome so improving early detection and diagnosis of cerebral palsy. This technique is simple, non-intrusive, reliable and quick.