PEDIATRICS Vol. 84 No. 2 August 1989, pp. 215-218
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Perlman, J. M.
Right arrow Articles by Volpe, J. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Perlman, J. M.
Right arrow Articles by Volpe, J. J.

Movement Disorder of Premature Infants With Severe Bronchopulmonary Dysplasia: A New Syndrome

Jeffrey M. Perlman MB1 and Joseph J. Volpe MD1

1 The Washington University School of Medicine, Departments of Pediatrics, Neurology, and Biological Chemistry, St Louis, Missouri

A previously unrecognized, striking movement disorder has been observed in 10 premature infants with severe bronchopulmonary dysplasia. Chronic hypoxemia, hypercarbia, bronchospasm, and inadequate nutrition were present in all. The movement disorder developed from approximately the third postnatal month. The dominant movements involve the limbs, neck, trunk, and oral-buccal-lingual structures. The limb movements were most prominent distally and consisted of rapid, random, jerky movements (similar to chorea) and "restless" movements (similar to akathisia). Similar movements of the neck and face were observed; tongue movements had a "darting" quality. The oral-buccal-lingual movements were similar to the dyskinesia of older patients. Movements were exacerbated during episodes of respiratory failure and attenuated during sleep. All infants exhibited feeding disorders, largely due to tongue movements. In 3 infants treated with clonazepam, there was striking improvement in motor function, including feeding. The natural history was partial or complete resolution or a static course. Thus, of the 7 surviving infants, the movements were absent (without therapy) at 15, 18, and 30 months of age. In the remaining 4 infants (3 of whom receive clonazepam), the movements, though attenuated, persisted at 6, 12, 15, and 21 months of age, respectively. Neuropathologically, 1 infant showed neuronal loss with astrocytosis in caudate, putamen, globus pallidus, and thalamus. These data defined a previously unrecognized extrapyramidal movement disorder of infants with severe bronchopulmonary dysplasia; pathogenesis may be related to chronic hypoxemia.

Key Words: bronchopulmonary dysplasia • hypoxia • movement disorder • premature infant

Submitted on May 13, 1988
Accepted on July 18, 1988




This article has been cited by other articles:


Home page
 PediatricsHome page
N. C. Brown, L. W. Doyle, M. J. Bear, and T. E. Inder
Alterations in Neurobehavior at Term Reflect Differing Perinatal Exposures in Very Preterm Infants
Pediatrics, December 1, 2006; 118(6): 2461 - 2471.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
T. E. Inder, S. K. Warfield, H. Wang, P. S. Huppi, and J. J. Volpe
Abnormal Cerebral Structure Is Present at Term in Premature Infants
Pediatrics, February 1, 2005; 115(2): 286 - 294.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
J. S. Hahn and T. Sanger
Neonatal Movement Disorders
NeoReviews, August 1, 2004; 5(8): e321 - e326.
[Full Text] [PDF]

Home page
 Arch. Dis. Child. Fetal Neonatal Ed.Home page
W A Huysman, M de Ridder, N C de Bruin, G van Helmond, N Terpstra, J B Van Goudoever, and P J J Sauer
Growth and body composition in preterm infants with bronchopulmonary dysplasia
Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2003; 88(1): F46 - 51.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
J. Perlman
Concern About Fetus and Newborn Committee Statement on Corticosteroid Use
Pediatrics, November 1, 2002; 110(5): 1034 - 1034.
[Full Text] [PDF]