Electroencephalogram and brainstem auditory evoked potential in 539 patients with central coordination disorder

BACKGROUND： Electroencephalogram （EEG） and brainstem auditory evoked potential （BAEP） are objective non-invasive means of measuring brain electrophysiology. OBJECTIVE： To analyze the value of EEG and BAEP in early diagnosis, treatment and prognostic evaluation of central coordination disorder. DESIGN, TIME AND SETTING： This case analysis study was performed at the Rehabilitation Center of Hunan Children＇s Hospital from January 2002 to January 2006. PARTICIPANTS： A total of 593 patients with severe central coordination disorder, comprising 455 boys and 138 girls, aged 1-6 months were enrolled for this study. METHODS： EEG was monitored using electroencephalography. BAEP was recorded using a Keypoint electromyogram device. Intelligence was tested by professionals using the Gesell scale. MAIN OUTCOME MEASURES： （1） The rate of abnormal EEG and BAEP, （2） correlation of abnormalities of EEG and BAEP with associated injuries, （3） correlation of abnormalities of EEG and BAEP with high risk factors. RESULTS： The rate of abnormal EEG was 68.6% （407/593 patients）, and was increased in patients who also had mental retardation （P 〈 0.05）. The rate of abnormal BAEP was 21.4% （127/593 patients）. These 127 patients included 67 patients （52.8%） with peripheral auditory damage and 60 patients （47.2%） with central and mixed auditory damage. The rate of abnormal BAEP was significantly increased in patients who also had mental retardation （P 〈 0.01 ）. Logistic regression analysis showed that asphyxia （P 〈 0.05）, jaundice, preterm delivery, low birth weight and the umbilical cord around the neck were closely correlated with abnormal EEG in patients with central coordination disorder, lntracranial hemorrhage, jaundice （P 〈 0.05）, low birth weight and intrauterine infection （P 〈 0.05） were closely correlated with abnormal BAEP in patients with central coordination disorder. CONCLUSION： Central coordination disorder is often associated with abnormal EEG and BAEP. The rate of EEG or BAEP abnormality is positively associated with the size of the brain injury. Asphyxia is a high risk factor for abnormal EEG in central coordination disorder. Jaundice and intrauterine infection are high risk factors for abnormal BAEP in central coordination disorder.

Effect of intervention treatment from different stages on prognosis in children with central coordination disturbance

BACKGROUND： Central coordination disturbance is regarded as the early-stage symptom of brain injury-induced cerebral palsy. This disease manifests itself as motor disorder, abnormal attitudinal reflex and muscular tension. Early intervention may improve its prognosis. OBJECTIVE： To observe the effects of intervention treatment from different stages on the prognosis of central coordination disturbance following brain injury in children patients. DESIGN： A contrast observation experiment SETTING： Department of Neurology and Rehabilitation, Urumqi Children＇s Hospital PARTICIPANTS ： Totally 151 children who were diagnosed as central coordination disturbance from January 2002 to December 2003 in the Department of Neurology and Rehabilitation of Urumqi Children＇s Hospital were recruited. All the children patients, including 101 male and 50 female, aged from 3 months to 1 year old, met the diagnosis criteria of central coordination disturbance from Vojta. They were divided into slight, moderate and severe abnormity according to Vojta attitudinal reflex. All 151 patients were divided into 2 groups according to their age at diagnosis： 3-6 months old group （n=74）, 62 severe, 10 moderate and 2 slight; 7-12 months old group （n=77）, 66 severe, 7 moderate and 4 slight. All the relatives of children patients were informed of the experiment. METHODS： ① Both groups received physical training （PT） as the main treatment; Hand training was given if necessary. All of the patients received additional hyperbaric oxygen therapy, bioelectric therapy, scalp acupuncture, drug treatment and family training. The importance of integration of hospital and family based rehabilitation was stressed. Those who did not catch up with the normal development or had abnormal reflexes continued to receive treatment. ② Around the age of 2 years old, all children did a final evaluation using Bayley Scales of Infant Development （BSID）. Mental development index （MDI） and physical development index （PDI） were taken as evaluative criteria. Children with scores 80 and above on MDI and PDI were considered to have normal motor and mental development; 79 and below were considered delayers. The Diagnostic Criteria of Cerebral Palsy and Infantecondary School Social Adaptation Scale were used in the final evaluation[scores ≤5 was extremely severe （extremely severe cerebral palsy）, 6 was severe（severe cerebral palsy）, 7 was moderate（moderate cerebral palsy）, 8 was slight（slight cerebral palsy）, 9 was borderline（slight cerebral palsy）, 10 was normal, 11 was above average, 12 was excellent and ≥13 was extremely excellent]. ③ Final evaluative results of 2 groups were compared. And u test was used for the comparison of Bayley development index and Chi-square test for the comparison of normalization rate. MAIN OUTCOME MEASURES： BSID MDI and PDI as well as the normalization rate of motor function and mental behavior of children patients at 2 years old. RESULTS： Totally 151 children patients entered the stage of result analysis. ①Two groups of children patients were given integrated rehabilitation therapy , and evaluated at 2 years old . The 3-6 months old group had higher MDI and PDI than the 7-12 months old group （91.81＋19.99 vs 71.93＋18.98;91.55＋23.61 vs 68.95＋23.51, u=6.265,5.894,P 〈 0.01 ）.②After being given integrated rehabilitation therapy, children patients of 3-6 months old group had significantly higher normalization rate of motor function and mental behavior than 7-12 months old group （73% ,27%,X2=29.723 9,P 〈 0.01 ）. ③Six slight and 17 moderate central coordination disturbance children of 2 groups all completely recovered; After intervention treatment, among 128 severe central coordination disturbance children, 52 recovered and 76 were still abnormal, in which, 43 slight cerebral palsy, 18 moderate cerebral palsy, 5 severe cerebral palsy and 10 extremely severe cerebral palsy. CONCLUSION： To perform integrated intervention treatment before 6 months old can better improve and promote mental and physical development levels of children patients with central coordination disturbance after brain injury than 6 months later.

Eurasia Continental Bridge——An Important Link of the Coordinated Development between China's Eastern,Central and Western Regions

The new Eurasia Continental Bridgeruns from East China to Central andWest China, crossing 11 provincesand regions, namely Jiangsu, Shandong,Hubei, Anhui, Shaanxi, Gansu, Shanxi,Sichuan, Qinghai, Xinjiang and Ningxia.The total area is 3.6 million sq km and thepopulation is about 300 million, accountingfor a third and a quarter of the whole countryrespectively. The area is very rich in naturalresources, so it is called an "Economic goldbelt" and "Gold corridor". Aerial remote-control survey indicates that along thecontinental bridge from Lianyungang to theAla Mountains within China’s boundary,