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腦性痲痺의 臨床症狀에 關한 觀察

Motor Irapairment of Cerebral Palsy

전남의대잡지 1966년 3권 2호 p.179 ~ 189
김동열,
소속 상세정보
김동열 (  ) - 전남대학교 의과대학 소아과학교실

Abstract


Based on the observation of , 300, cases of cerebral palsy, the author attempted to elucidate the distribution and degree of motor (impairment of this -disease with due consideration of their relationship to the etiology.
1. Of all 300 cases, the first clinical manifestation of this lesion could be detected at birth in 25.0%, in six. months in 54.3%, and between four and five years in 5.3%.
2. The degree of muscular development was such that sitting`. was possible in eight to ten monthsin 28.7%, at one year in 23.0%, after one year in 37.0%, and completely impossible in 3.3%.
The ability of standing was gained in one year in 40.0%, after, one year in 34.7%, within seven years in 2.7%, while it was lost completely in 13.7%. The initiation of gait was normal in 22.7%, delayed in 60.3%, and impossible in 15.7%.
3. Of six types into which this condition could be divided the incidence oof athetosis was slightly higher than usual spasticity ,in-50.7% athetosis in 30.7%, mixed type in 16.3%, rigidity in 0.7% and tremor in 0.3%.
The topographic classification 25.3% of hemiplegia, 4.3% of paraplegia, 30.0% of quadriplegia, 30.0% of diplegia and1.7% of monoplegia, the incidence of diplegia and quadriplegia being high.
Comparison of the above two criteria showed that spasticity type.-consisted of 46.7% hemiplegia, 31.6% quadriplegia, 10.5% diplegia, 3.3% monoplegia and 7.9% paraplegia, athetosis type of 55.4% diplegia, 29.4% quadri plegia, and 1.1% paraplegia, while mixed type of, 42.9% diplegia, 28.6% quadriplegia, 6.1% hemiplegia, and 2.0% paraplegia. It was also shows that most of them all belonged to the severe type of the disease.
4. Detailed examination of the impairment based - on the etiologicalfactors was as follows:
A. In congenital defect there were spasticity (71.7%,) mixed type (16.9%), athetosis (11.3%), quadriplegia (33.9%) hemiplegia (33.9% and diplegia (18.9%).
B. Toxemia of mother resulted in spasticity(60. 0%) and hemiplegia(40.O%)
C. Rh incompatibility was present in athetosis(88.9%), and quadriplegia (44.4%).
D. Prematurity was followed by spasticity (59.6%), athetosis (17.5%),
Mixed type (21.2%), quadriplegia (38.6%), diplegia (22.8%), hemiplegia (17.5%), and paraplegia (8.8%).
E. Birth injury was attributable for spasticity (65.5%), hemiplegia(40.0%), and diplegia. (30.0%).
F. In anoxia was observed athetosis (52.4%), spasticity (36.8%), quadriplegia (36.8%), hemiplegia (31.5%), and diplegia (26.3%).
G. Abnormal delivery had athetosis (43.9%), spasticity (34.6%), mixed type(19.6%), diplegia(45.8%), quadriplegia, (28.0%), and hemiplegia
H. In sequels of lesions. of central nervous, system there were spasticity (66.7%) and hemiplegia (55.6%).

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