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Eugenio Mercuri - One of the best experts on this subject based on the ideXlab platform.
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use of the hammersmith infant Neurological Examination in infants with cerebral palsy a critical review of the literature
Developmental Medicine & Child Neurology, 2016Co-Authors: Domenico M. Romeo, Daniela Ricci, Claudia Brogna, Eugenio MercuriAbstract:The Hammersmith Infant Neurological Examination (HINE) has been proposed as one of the early Neurological Examination tools for the diagnosis of cerebral palsy (CP). The aim of the present study was to critically review the existing literature and our experience with the use of the HINE in infants at risk of CP. The published papers confirm that the HINE can play an important role in the diagnosis and prognosis of infants at risk of developing CP, and provide information on aspects of Neurological findings impaired in different forms of CP and brain lesions.
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Neurological Examination in healthy term infants aged 3 10 weeks
Neonatology, 2005Co-Authors: Andrea Guzzetta, Leena Haataja, F M Cowan, Giovanni Cioni, L M S Dubowitz, Laura Bassi, D Ricci, Eugenio MercuriAbstract:Objectives: The neurodevelopmental progress of newborn term infants is checked routinely at around 6 weeks of postnatal age. The maturation of Neurological signs in this age range however has not been systematically studied and normative data are not available. The aim of this study was to document any changes in posture, tone, reflexes, behaviour and movements in low-risk full-term infants between 3 and 10 weeks of postnatal age. Study Design: We performed a structured Neurological Examination previously standardised in full-term newborns in the first 48 h after birth. In the current study, a total of 76 Examinations were performed between 3 and 10 weeks of age in low-risk full-term infants. Results: The results of the Examinations were divided according to postnatal age. In most items, the scores changed with time, with a definite shift in their distribution occurring around 6 weeks. At this age, a reduction in flexor tone of the limbs was observed, together with an increase in active neck tone. Visual orientation in contrast had already improved by 3 weeks when all infants were able to follow a target in a full circle compared to newborns that are often only able to follow a target in an arc. Conclusions: Our results suggest that 6 weeks post-term birth is an important milestone for changes in Neurological signs, particularly those related to muscle tone and posture, probably reflecting maturation of the nervous system. These findings provide important guidelines for the interpretation of the Neurological Examination performed at this age.
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the dubowitz Neurological Examination of the full term newborn
Mental Retardation and Developmental Disabilities Research Reviews, 2005Co-Authors: L M S Dubowitz, Eugenio Mercuri, Daniela RicciwAbstract:In an ideal world, each neonate should have a comprehensive Neurological Examination but in practice this is often difficult. In this review we will describe what a routine Neurological evaluation in the full-term neonate should consist of and how the Dubowitz Examination is performed. The Examination has been used for over 20 years and can be easily performed in a short time as the recording sheet provides simple instructions together with simple diagrams to make the recording and the scoring easier. We will also indicate how the Examination can be used to identify infants with Neurological abnormalities, describing clinical signs which can help to differentiate infants with peripheral neuromuscular disorders from those with central nervous system involvement. The correlation between clinical and imaging findings in infants with neonatal brain lesions will also be reported. Finally we will briefly describe how and when to apply an optimality scoring system in a research setting.
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The Neurological Examination of the newborn baby.
Early Human Development, 2005Co-Authors: Eugenio Mercuri, Daniela Ricci, Marika Pane, Giovanni BaranelloAbstract:This paper provides an overview of the value of a structured neonatal Neurological Examination that may be performed in different settings, from routine Examination to research settings. We will report how a structured Neurological Examination can help to identify infants with central and peripheral nervous system involvement. We also describe a short but structured proforma to be used for the routine Examination of full-term infants. We will finally describe a quantitative assessment to be used in research settings.
Joseph Kamtchumtatuene - One of the best experts on this subject based on the ideXlab platform.
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neuroimaging of headaches in patients with normal Neurological Examination protocol for a systematic review
BMJ Open, 2018Co-Authors: Bernold Kenteu, Yannick F Fogang, Ulrich Flore Nyaga, Joseline Zafack, Jean Jacques Noubiap, Joseph KamtchumtatueneAbstract:Introduction Headache disorders (HD) are among the most frequent Neurological disorders seen in neurology practice. Because secondary HD are rare, patients’ Examination is most often unremarkable. However, the will to relieve patients’ anxiety and the fear of prosecutions lead to overuse of neuroimaging thus resulting in the discovery of incidental findings (IF) or normal variants that can lead to futile or harmful procedures. Knowing the probability of identifying a potentially clinically significant lesion in patients with isolated headache could facilitate decision-making and reduce health costs. This review aims to determine the prevalence of incidental findings and normal anatomic variants (NAV) on neuroimaging studies performed in patients presenting with headache and normal Neurological Examination. Method and analysis Studies reporting neuroimaging findings in patients with headache and normal Neurological Examination and published before the 30 September 2017 will be identified by searching PubMed, Medline and EMBASE (Excerpta Medica Database). Relevant unpublished papers and conference proceedings will also be checked. Full texts of eligible studies will then be accessed and data extracted using a standard data extraction sheet. Studies will be assessed for quality and risk of bias. Heterogeneity of studies will be evaluated by the χ 2 test on Cochrane’s Q statistic. The prevalence of NAV and IF across studies and in relevant subgroups will be estimated by pooling the study-specific estimates using a random-effects meta-analysis. Visual analysis of funnel plot and Egger’s test will be used to detect publication bias. The report of this systematic review will be compliant with the Meta-analysis of Observational Studies in Epidemiology guidelines. Ethics and dissemination The current study is based on published data; ethical approval is, therefore, not required. The final report of this systematic review will be published in a peer-reviewed journal. Furthermore, findings will be presented at conferences and submitted to relevant health authorities. Trial registration number CRD42017079714.
Stacy J Suskauer - One of the best experts on this subject based on the ideXlab platform.
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preliminary use of the physical and Neurological Examination of subtle signs for detecting subtle motor signs in adolescents with sport related concussion
American Journal of Physical Medicine & Rehabilitation, 2018Co-Authors: Jaclyn A Stephens, Martha B Denckla, Teri Mccambridge, Beth S Slomine, Mark E Mahone, Stacy J SuskauerAbstract:Sensitive Examination tools are needed to optimize evaluation after sports-related concussion. The Physical and Neurological Examination of Subtle Signs was preliminarily examined for sensitivity to motor changes in a pilot cohort of adolescents aged 13-17 yrs with sports-related concussion. A total of 15 adolescents (5 female adolescents) with sports-related concussion were evaluated up to three times: within 2 wks of injury, approximately 1 mo later (mean, 35 days between visits), and for those not recovered at the second visit, again after clinical recovery (mean, 70 days between the first and last visits for all participants). Comparison data were acquired from 20 age- and sex-matched healthy control athletes with no history of concussion who were evaluated twice (mean, 32 days apart). Main effects of group, time, and interaction effects were evaluated with an analysis of covariance, which controlled for socioeconomic status, times tested, and days between testing sessions. Adolescents with concussion had poorer Physical and Neurological Examination of Subtle Signs performance than controls did at all time points. Performance improved between visits within the concussion group, with no change within the control group. These findings suggest that the Physical and Neurological Examination of Subtle Signs merits additional study in larger cohorts and in combination with other markers of injury to facilitate an enhanced understanding of sports-related concussion and recovery.
Domenico M. Romeo - One of the best experts on this subject based on the ideXlab platform.
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use of the hammersmith infant Neurological Examination in infants with cerebral palsy a critical review of the literature
Developmental Medicine & Child Neurology, 2016Co-Authors: Domenico M. Romeo, Daniela Ricci, Claudia Brogna, Eugenio MercuriAbstract:The Hammersmith Infant Neurological Examination (HINE) has been proposed as one of the early Neurological Examination tools for the diagnosis of cerebral palsy (CP). The aim of the present study was to critically review the existing literature and our experience with the use of the HINE in infants at risk of CP. The published papers confirm that the HINE can play an important role in the diagnosis and prognosis of infants at risk of developing CP, and provide information on aspects of Neurological findings impaired in different forms of CP and brain lesions.
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Implementation of the Hammersmith Infant Neurological Examination in a High-Risk Infant Follow-Up Program
Pediatric Neurology, 2016Co-Authors: Nathalie L Maitre, Olena Chorna, Domenico M. Romeo, Andrea GuzzettaAbstract:Abstract Background High-risk infant follow-up programs provide early identification and referral for treatment of neurodevelopmental delays and impairments. In these programs, a standardized Neurological Examination is a critical component of evaluation for clinical and research purposes. Methods To address primary challenges of provider educational diversity and standardized documentation, we designed an approach to training and implementation of the Hammersmith Infant Neurological Examination with precourse materials, a workshop model, and adaptation of the electronic medical record. Conclusions Provider completion and documentation of a Neurological Examination were evaluated before and after Hammersmith Infant Neurological Examination training. Standardized training and implementation of the Hammersmith Infant Neurological Examination in a large high-risk infant follow-up is feasible and effective and allows for quantitative evaluation of Neurological findings and developmental trajectories.
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prognostic value of a scorable Neurological Examination from 3 to 12 months post term age in very preterm infants a longitudinal study
Early Human Development, 2009Co-Authors: Domenico M. Romeo, Matteo Cioni, M Scoto, Alessandra Pizzardi, M G Romeo, Andrea GuzzettaAbstract:Abstract Aims and study design The Hammersmith Infant Neurological Examination proved effective in predicting locomotor function in very preterm infants after 9 months of age. We performed the Examination in a cohort of 103 very preterm infants (gestational age below 32 weeks) as early as 3 months' post-term age, and longitudinally at 6, 9 and 12 months. Our aim was to establish the frequency distribution of the optimality scores at each age period, to explore the predictive value of the Examination from 3 months onwards as to developmental outcome and locomotor function at 2 years, and to explore its longitudinal consistency. Results The results showed that this standardized Neurological Examination can be performed in preterm infants as early as 3 months' post-term age to predict motor outcome at 2 years, and that its high predictive value is consistent across the first year of life due to an effective combination of different items for each age period. Conclusions We confirm the high predictive value of this Neurological Examination in very preterm infants after 9 months and extend it to the assessments performed as early as 3 months post-term. This is of great relevance as in very preterm infants early prediction of motor function is essential for a prompt planning of therapeutic interventions.
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Neurological Examination of preterm infants at term equivalent age
Early Human Development, 2008Co-Authors: Marika Pane, Domenico M. Romeo, Leena Haataja, Jonna Maunu, D Ricci, Francesca Gallini, Laura Cesarini, Ingrid C Van Haastert, Rita Paola Maria LucianoAbstract:Abstract Backgrounds We previously reported the Neurological findings of the Dubowitz neonatal Examination in a cohort of 157 low-risk preterms born between 25 and 33 weeks gestational age (GA) and examined at term equivalent age (TEA). Median and range of scores were wider than those found in term-born infants and preterms showed a different Neurological behaviour in specific items. However, the cohort number was too small to draw any definitive conclusion about the distribution of findings. Aims We provide normative data from a low-risk cohort of 380 preterm infants; we also assess the findings and their relationship to motor outcome in preterms with major cranial ultrasound (US) abnormality. Study design We assessed, at TEA, 380 low-risk preterms born Results At TEA low-risk preterms had less flexor limb tone, poorer head control but better visual following than term-born infants. For 28/34 of the Neurological items the range and median scores were similar across gestational ages. In infants with major US lesions the range and median scores differed from low-risk preterms in 20/34 items; 40% of infants developing a diplegia and 80% developing a tetraplegia had > 7 items outside the 90th centile; all infants with > 12 items outside the 90th centile developed a tetraplegia. Conclusions We provide reference values for the Neurological Examination of low-risk preterms at TEA. In infants with major US abnormality the number of items outside the 90th centile was an indicator of outcome severity.
Jaclyn A Stephens - One of the best experts on this subject based on the ideXlab platform.
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preliminary use of the physical and Neurological Examination of subtle signs for detecting subtle motor signs in adolescents with sport related concussion
American Journal of Physical Medicine & Rehabilitation, 2018Co-Authors: Jaclyn A Stephens, Martha B Denckla, Teri Mccambridge, Beth S Slomine, Mark E Mahone, Stacy J SuskauerAbstract:Sensitive Examination tools are needed to optimize evaluation after sports-related concussion. The Physical and Neurological Examination of Subtle Signs was preliminarily examined for sensitivity to motor changes in a pilot cohort of adolescents aged 13-17 yrs with sports-related concussion. A total of 15 adolescents (5 female adolescents) with sports-related concussion were evaluated up to three times: within 2 wks of injury, approximately 1 mo later (mean, 35 days between visits), and for those not recovered at the second visit, again after clinical recovery (mean, 70 days between the first and last visits for all participants). Comparison data were acquired from 20 age- and sex-matched healthy control athletes with no history of concussion who were evaluated twice (mean, 32 days apart). Main effects of group, time, and interaction effects were evaluated with an analysis of covariance, which controlled for socioeconomic status, times tested, and days between testing sessions. Adolescents with concussion had poorer Physical and Neurological Examination of Subtle Signs performance than controls did at all time points. Performance improved between visits within the concussion group, with no change within the control group. These findings suggest that the Physical and Neurological Examination of Subtle Signs merits additional study in larger cohorts and in combination with other markers of injury to facilitate an enhanced understanding of sports-related concussion and recovery.
