BACKGROUND Unilateral spastic cerebral palsy (USCP) occurs in 30%-68% of infants with perinatal stroke. Early detection of USCP is essential for referring infants to early intervention. The aims of this study were to report motor outcomes after perinatal stroke, and to determine the predictive value of the General Movements Assessment (GMA) and Hand Assessment for Infants (HAI) for detection of USCP. MATERIALS AND METHODS This was a prospective observational study involving infants with perinatal stroke. GMA was conducted between 10 and 15 weeks post term-age (PTA). The HAI was performed between 3 and 5 months PTA. Motor outcome was collected between 12 and 36 months PTA. RESULTS The sample consisted of 46 infants. Fifteen children (32.6%) were diagnosed with CP, two children with bilateral CP and 13 with USCP. Abnormal GMA had a sensitivity of 85% (95% confidence interval [CI] 55-98%) and a specificity of 52% (95% CI 33-71%) to predict USCP. When asymmetrically presented FMs were also considered as abnormal, sensitivity increased to 100%, hence the specificity declined to 43%. A HAI asymmetry index cut-off of 23, had both a sensitivity and a specificity of 100% to detect USCP. CONCLUSION Using GMA and HAI can enable prediction of USCP before the age of 5 months in infants with perinatal stroke. Nevertheless, GMA must be interpreted with caution in this particular population. The HAI was found to be a very accurate screening tool for early detection of asymmetry and prediction of USCP.

中文翻译：

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围产期卒中后运动结局及单侧痉挛性脑瘫的早期预测

背景单侧痉挛性脑瘫 (USCP) 发生在 30%-68% 的围产期卒中婴儿中。早期发现 USCP 对于将婴儿转诊到早期干预至关重要。本研究的目的是报告围产期卒中后的运动结果，并确定一般运动评估 (GMA) 和婴儿手部评估 (HAI) 对 USCP 检测的预测价值。材料和方法 这是一项前瞻性观察研究，涉及围产期卒中婴儿。GMA 在足月 (PTA) 后 10 至 15 周之间进行。HAI 在 3 到 5 个月的 PTA 之间进行。在 12 至 36 个月 PTA 之间收集运动结果。结果 样本包括 46 名婴儿。15 名儿童 (32.6%) 被诊断为 CP，2 名儿童患有双侧 CP，13 名儿童患有 USCP。异常 GMA 预测 USCP 的敏感性为 85%（95% 置信区间 [CI] 55-98%）和 52%（95% CI 33-71%）的特异性。当不对称呈现的 FM 也被认为是异常时，敏感性增加到 100%，因此特异性下降到 43%。HAI 不对称指数截止值为 23，检测 USCP 的灵敏度和特异性均为 100%。结论 使用 GMA 和 HAI 可以预测 5 个月前围产期卒中婴儿的 USCP。尽管如此，在这个特定人群中必须谨慎解释 GMA。发现 HAI 是一种非常准确的筛选工具，用于早期检测不对称性和预测 USCP。敏感性增加到 100%，因此特异性下降到 43%。HAI 不对称指数截止值为 23，检测 USCP 的灵敏度和特异性均为 100%。结论 使用 GMA 和 HAI 可以预测 5 个月前围产期卒中婴儿的 USCP。尽管如此，在这个特定人群中必须谨慎解释 GMA。发现 HAI 是一种非常准确的筛选工具，用于早期检测不对称性和预测 USCP。敏感性增加到 100%，因此特异性下降到 43%。HAI 不对称指数截止值为 23，检测 USCP 的灵敏度和特异性均为 100%。结论 使用 GMA 和 HAI 可以预测 5 个月前围产期卒中婴儿的 USCP。尽管如此，在这个特定人群中必须谨慎解释 GMA。发现 HAI 是一种非常准确的筛选工具，用于早期检测不对称性和预测 USCP。