目的 回顾性分析伴神经元移行异常(NMD)脑瘫的临床特点及疗效。方法 选取2005年6月至2015年6月在本科进行综合康复治疗的伴NMD脑瘫患儿(NMD组，n=32)和同期康复治疗的运动、智力水平近似的伴有脑室周围白质软化症(PVL)脑瘫患儿(PVL组，n=60)。分析比较两组脑瘫临床分型、癫痫及癫痫样放电共患病以及综合康复治疗对两组患儿粗大运动功能测试(GMFM)评分和Gesell发育诊断量表发育商(DQ)的影响。同时，对治疗6个月后的随访结果进行统计分析。结果 两组脑瘫临床分型存在非常高度显著性差异(χ2=24.529, P<0.001)。NMD组癫痫及癫痫样放电共患病发生率均高于PVL组(χ2>4.605, P<0.05)。综合康复治疗后，两组GMFM评分随时间均升高(F时间=6.850, P=0.010)，NMD组GMFM评分显著低于PVL组(F组间=29.885, P<0.001)；各功能区DQ得分随时间逐渐增高(F时间>25.041, P<0.001)，NMD组各功能区DQ得分显著低于PVL组(F组间>32.347, P<0.001)。结论 伴NMD脑瘫癫痫伴发率高，临床表现以智力发育障碍和痉挛型偏瘫为主，综合康复治疗疗效差，预后不良。
Objective To discuss the clinical characteristics and efficacy analysis of children with cerebral palsy and neuronal migration disorders (NMD) by retrospective analysis. Methods From June, 2005 to June, 2015, 32 children with cerebral palsy and NMD were enrolled as NMD group, while 60 children with cerebral palsy with periventricular leukomalacia (PVL) as PVL group. Both groups received comprehensive rehabilitation for three months. Their clinical classification, complications of epilepsy or epileptiform discharges, the score of Gross Motor Function Measure (GMFM), and development quotient (DQ) were compared, as well as the follow-up results of six months. Results There was significant difference in the clinical classification of cerebral palsy between two groups (χ2=24.529, P<0.001). The incidence of epilepsy and epileptiform discharges was higher in NMD group than in PVL group (χ2>4.605, P<0.05). After treatment, the score of GMFM improved with time in both groups (Ftime=6.850, P=0.010), and was significantly lower in NMD group than in GMFM group (Fgroup=29.885, P<0.001); the scores of DQ in all the functional areas improved with time in both groups (Ftime>25.041, P<0.001), and were significantly lower in NMD group than in GMFM group (Fgroup >32.347, P<0.001). Conclusion Children with cerebral palsy and NMD are characterized by mental retardation, epilepsy and spastic hemiplegia, and poor outcome.
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