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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.4 São Paulo  1997

http://dx.doi.org/10.1590/S0004-282X1997000500014 

Encefalopatia hipóxico-isquêmica em recém-nascidos a termo: aspectos da fase aguda e evolução

 

Perinatal hypoxic-ischemic encephalopathy: acute period and outcome

 

 

Carolina A. R. FunayamaI; Maria Valeriana L. de Moura-RibeiroII; Arthur Lopes GonçalvesIII

IProfessor Doutor do Departamento de Neurologia, Psiquiatria e Psicologia Médica da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP/USP)
IIProfessor Associado do Departamento de Neurologia da Faculdade de Medicina da Universidade Estadual de Campinas
IIIProfessor Titular do Departamento de Puericultura e Pediatria da FMRP/USP

 

 


RESUMO

Noventa e quatro recém-nascidos com encefalopatia hipóxico-isquêmica (EHI), atendidos no Hospital das Clínicas de Ribeirão Preto desde 1982, foram avaliados evolutivamente na fase aguda e por período médio de 47 meses. De 43 casos com EHI 1,40 se recuperaram em 96 horas e 3 faleceram. Dos 40 com EHI II, 37,5% se recuperaram até o sétimo dia e demais permaneceram com alterações. Os 11 casos com grau III faleceram até o segundo mês de vida. As crianças com EHI grau I não apresentaram seqüelas motoras. Do grupo com EHI grau II 34,5% apresentaram paralisia cerebral e 17,7% atraso neuromotor. 80% dos casos com sequela apresentaram exame neurológico anormal além do sétimo dia, na fase aguda da EHI. Epilepsia ocorreu em 17,5% dos casos com EHI grau II e somente no grupo com seqüelas motoras. Teste de QI não evidenciou diferença significativa entre os grupos com grau I, II sem seqüelas motoras e o grupo controle. Com esses dados os autores reafirmaram a importância prognostica da evolução da EHI na fase aguda.

Palavras-chave: asfixia neonatal, paralisia cerebral, fatores de risco, seguimento.


ABSTRACT

Ninety four neonates with hypoxic ischemic encephalopathy HIE attended at the University of Ribeirão Preto since 1982 were studied in terms of the neurological alterations during the acute phase and outcome over a mean period of 47 months. From 43 newborns with HIE I, 40 recovered within 96 hours and 3 died. Among 40 infants with HIE II, 37.5% recovered within the first week, and the others continued abnormal beyond the 7th day. All 11 infants with HIE III died before the second month of life. The HIE I group had no motor sequelae. Among the HIE II group, 34.5% showed cerebral palsy and 17.7% neuromotor retardation. 80.0% of those with sequelae persisted abnormal beyond 7th day of life, during the acute phase of the HIE. Epilepsy occurred in 17.5% of cases with HIE grade II, only among those with neuromotor sequelae. The 1Q test did not show statistically significant difference between the HIE I, II without motor sequelae and the control groups. The authors reaffirm the value of the findings in the acute phase of HIE on the outcome of these patients.

Key words: neonatal asphyxia, cerebral palsy, risk factors, follow-up.


 

 

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Full text available only in PDF format.

 

 

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Aceite: 11-julho-1997.

 

 

Dra Carolina A. R. Funayama - Departamento de Neurologia - HC - Campus -14048-900 Ribeirão Preto - Brasil

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