AN EARLY MARKER FOR NEUROLOGICAL DEFICITS AFTER PERINATAL BRAIN-LESIONS

Background In normal awake infants, fidgety movements are seen from th e age of 6 weeks to 20 weeks. The aim of the study was to test the pre dictive value of absent or abnormal spontaneous movements in young inf ants for the later development of neurological deficits. Methods In a collaborative study involving five hospitals we collected data on the normal and abnormal quality of fidgety movements of 130 infants and co mpared it with assessments of neurological development done longitudin ally until the age of 2 years. On the basis of ultrasound scans infant s were classified as at low-risk or at high-risk of neurological defic its. Infants were videoed for Ih every week from birth to discharge an d then for 15 min every 3 to 4 weeks; quality of general movements was assessed, Repeated neurological assessments were also done until 24 m onths of corrected age. Findings 67 (96%) of 70 infants with normal fi dgety movements had a normal neurological outcome. Abnormal quality or total absence of fidgety movements was followed by neurological abnor malities in 57 (95%) of the 60 infants (49 had cerebral palsy and eigh t had developmental retardation or minor neurological signs). Specific ity and sensitivity of fidgety movement assessment were higher (96% an d 95%, respectively) than of ultrasound imaging of the infants' brain (83% and 80%, respectively). Interpretation Our technique of assessing spontaneous motor activity can identify and distinguish between those infants who require early intervention for neurological abnormalities and those who do not. Our technique is simple, non-intrusive, reliabl e, quick, and can be done on very young infants.