Hyperreflexia in Patients with Cerebral Palsy
SH Lee, M.D., SJ Kim, M.D. and YH Park, M.D. (Kuro Hospital, Korea University, Seoul, Korea)
Ten children with spastic cerebral palsy and 20 normal children were examined to compare the reflex characteristics in spastic patients with the normal children. Tendon taps were applied to the patellar, Achilles' tendons and shin using a reflex hammer. EMGs were recorded from thigh and leg muscles by surface electrodes. The response ratios were determined from EMG amplitude. The mean hamstrimg (HAM): rectus femoris (RF) ratio after patellar taps in cerebral palsy, normal infant and children over 1 year of age were 0.44±0.41, 0.27±0.37 and 0.16±0.23 each. The mean tibialis anterior(TA):gastrocnemius(GCL) ratio following Achilles tap were 0.50±0.64, 0.76±0.50, and 0.34±0.36 each. After shin tap all the spastic children showed muscle response in RF, HAM, TA and GCL, but not normal children. Above results reflect the exaggerated reflex responses in children with spastic cerebral palsy, and it can be used in early diagnosis of cerebral palsy.
DISLOCATION OF THE HIP IN SEVERE CEREBRAL PALSY
Tetsuko Okuno (Yanagawa Rehabilitation Hospital, Yanagawa, Japan)
We have examined all 90 cases of non-ambulatory cerebral palsy, seen at two children's hospitals. Their mean age was 12 years, ranging from 2 to 24 years. They were divided into two groups according to their severity. Group 1 consisted of 62 cases that were bedridden, while Group 2 consisted the other 28 cases that were able to sit or to crawl.
All the cases were examined by X-ray to investigate the hip dislocation or subluxation and the presence and severity of scoliosis.
The results showed that in Group 1, there were 45 unstable hips (36.2%) with 31 dislocated and 14 subluxated hips, while in Group 2, there were only 7 unstable hips (12.5%) with 5 dislocated and 2 subluxated hips.
There were 22 cases of structural scoliosis in the patients with unstable hips. Most cases showed a single type of left-sided lumbar curve. When a dislocation occurred in combination with scoliosis, the dislocation tended to be contra-lateral side of the convex.
There were high relations among the incidence of dislocation, the severity of cerebral palsy and the presence of scoliosis.