PEDIATRICS Vol. 39 No. 4 April 1967, pp. 629
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Letters to the Editor

NATHAN RUDOLPH M.D.1

1 Department of Pediatrics, Albert Einstein College of Medicine, Bronx, New York, 10461

Thank you for the opportunity to comment on Dr. Gordon Millichap's letter.

I agree with Dr. Millichap that perinatal cerebral trauma or cerebral hypoxia cannot be overlooked as a possible additional etiological factor in the elevation of serum CPK levels in some infants. However, the lack of correlation with 1-minute Apgar scores, and the frequency of elevated serum enzyme levels in newborns who do not exhibit clinical signs of neurological damage, make it unlikely that a central neurogenic mechanism is operative in the majority of cases.