Neonatal acquired paraplegia: Retrospective review of 30 patients

Thirty patients with neonatal acquired paraplegia without an identified cau se were reviewed. The mean gestational age was 33 weeks (range, 25-40 weeks ); the mean Apgar scores were 6 and 8 (range, 0-10); the mean weight at bir th was 1.739 kg (range, 0.750-4.200 kg). Half of the infants needed neonata l intensive care for a mean period of 42 days. Fourteen (46%) had local or generalized infections, 12 (40%) had respiratory complications, and seven ( 22%) required mechanical ventilation. Seven (22%) had polycythemia, six (20 %) had anemia, six (20%) underwent umbilical artery catheterization, and fi ve (16%) received full exchange transfusion. Two clinical presentations wer e observed: flaccid (24 patients) and hypertonic (6 patients). The secondar y deformities that were found and the orthopedic procedures to correct them are described. A vascular or intravascular change, such as thrombosis/embo lism or ischemia/hypoxia by vasospasm or failure of autoregulation of spina l blood perfusion, is the final pathway of many events that may produce par aplegia in preterm and low birthweight neonates.