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388
Abstracts
activity even after TCDD exposure. These observations
taken together, the reduction in the LI’s after TCDD exposure
indicates that TCDD exposure caused G1 phase prolongation
in the neural progenitor cells. These results suggest
that in utero exposure to dioxin may affect cell cycle regulation
of the neural progenitor cells and thus, alter the process
of neuron production and eventually result in abnormal
development of the neocortex. Supported by Grant-in-Aid
from the Ministry of Health and Welfare, Pharmacia Fund
for Growth and Development Research, Science and Technology
Agency and CREST Tohyama Team, JST.
FO-2
Cerebral Palsy (1)
FO-2-1
Botulinum toxin type A in prevention of hip luxation of
bilateral cerebral palsy. Treatment of 65 patients
P.P. Si, P. Castroviejoi
Service of Pediatric Neurology, Hospital Infantile ‘La Paz’,
Madrid, Spain
Introduction: In bilateral CP, tetraplegic or diplegic, the
spasticity of flexor and adductor muscles of the hip often
produce hip dysplasia and/or progressive luxation. Objective:
To study the effectiveness of botulinum toxin type A
(BT-A) in prevention of external femoral head migration
and hip luxation in CP. Material and methods: All CP
patients treated with BT-A because pelvic girdle spasticity
were revised. Ages at the first injection were two–7 years.
The clinical and radiological evolution prior to BT-A treatment
and after it is analyzed. The drug was infiltrated in
adductors, medial hamstring muscles in every patient and
also in iliac psoas muscles if required. Post-treatment
follow-up ranged between 1 and 4 years. Results: Sixtyfive
children, 22% of 295 patients treated in our hospital
with BT-A because CP, suffered hip disorder. A total of 122
hips were treated. Pre-treatment evolution was bad, progressive
external femoral head migration out of Perkins’ line
was seen (10% of mean migration at 1 year of age, 21%
at 2, 26% at 3, 31% at 4 years of age). Nineteen/122 hip
were already luxated (more than 50% of migration) at the
onset of treatment, in spite of correct physiotherapy and
other treatments. After BT-A treatment, the progressive
impairment stopped. There was not statistical difference in
radiograph migration in patients group analysis, 10% of
femoral heads improved it position, 8% worsened and the
rest did not change during follow-up). Only one hip resulted
luxated after treatment. This is a very good result according
to the negative natural evolution of the disorder. Motor
function improved in every case whose hip was not luxated.
Conclusion: It is necessary to study clinically and radiologically
the hips of every child with bilateral CP before 3
years old. BT-A allows us to treat all the muscles implicated
in hip spasticity and avoids the progressive functional
impairment of hip mobility, so negative for the future physical
independence of CP patients.
FO-2-2
An epidemiological study of cerebral palsy in Henan
Province, China
L. Gao, Y. Meng, S.-Y. Zhao, C.-J. Zhou, C.-Z. Yuan, Y.-H.
Wang, M. Zhao, S.-L. Ma
Department of Pediatrics, Henan Provincial People’s
Hospital, Zhengzhou City, China
Objective: To investigate the prevalence, distribution of
different types and correlative etiologic factors and complications
of CP in Henan Province, China. Methods: From
January to December 2001, a random cluster sampling of
children aged 0 , 6 years were investigated in ten cities and
counties, including three districts – JinShui, ErQi,
MangShan in Zhengzhou City; JianXi district in Luoyang
City; JiYuan City and counties as YuanYang, XinYie,
TangHe, TaiKang, YuCheng, among others. The etiology,
clinical types, computed tomography and magnetic resonance
imaging of all cases were analyzed. Results: There
were 582 CP patients among 434 920 children investigated;
the total prevalence rate of CP was 1.58%, Of the 582 cases
of CP, spastic type was 56.87%, hypotonic type 21.13%,
mixture type 7.56%, tonic type 6.70%, ataxia type 5.33%,
tremor type 1.38%, and athetosis type 1.03%. The causes of
CP were perinatal asphyxia or hypoxic-ischemic encephalopathy
(HIE) (38.32%); premature or low birth weight
(16.84%); maternal infections during early pregnancy
(11.86%); hyperbilirubinemia (10.14%); intraventricular
hemorrhage (IVH) (8.25%). The incidence rate of complications
was 68.38%, 47.08% related to mental retardation
(MR). Conclusion: This investigation demonstrated the
approximate prevalence of CP in Henan Province. The spastic
type is the most common type of CP. Asphyxia and HIE,
premature and low birth weight, maternal infections during
early pregnancy and hyperbilirubinemia, among others were
high-risk factors. The main complication was MR. Most of
the causes could be prevented by health care in perinatal
period.
FO-2-3
Neonatal periventricular/intraventricular hemorrhage:
incidence and some risk factor
T.S. Al-Karagully
Department of Pediatrics, Saddam College of Medicine,
Baghdad, Iraq
Background: In a prospective study extending along an 8-
month period (April–November 1998), 100 newborns at the
University Hospital/Saddam College of Medicine, were
randomly selected and examined by cranial ultrasound (U/
S) to determine the incidence of periventricular hemorrhage/