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Neurological assessment of Chinese infants with positional plagiocephaly using a Chinese version of the Infant Neurological International Battery (INFANIB)

Child's Nervous System volume 33, pages 281–288 (2017)Cite this article

Abstract

Purpose

Positional plagiocephaly (PP) is the most common subtype of asymmetric deformity in the infant skull. Cumulative evidence has demonstrated that PP is associated with abnormal neuromotor development; however, neurological assessment scores of infants with PP have not been well established, and PP has not attracted sufficient attention in China. This study used a Chinese version of the Infant Neurological International Battery (INFANIB) to identify neurological abnormalities among infants with PP and to determine the differences between infants with different (mild, moderate, and severe) degrees of PP.

Methods

We compared the neurological evaluation scores between 393 infants with different degrees of PP and 390 healthy infants from 0 to 18 months of age using a Chinese version of the INFANIB.

Results

The infants with PP aged 0–7.9 months had lower scores on the spasticity, head and trunk, leg, and French angle subscales and lower total scores than the normal infants. Additionally, the infants with PP aged 9–18 months showed statistically significantly lower scores on the spasticity, head and trunk, vestibular function, leg, and French angle subscales and total scores than the normal infants. Among the PP subgroups, the infants with mild PP had the highest scores, followed by the infants with moderate PP and the infants with severe PP. Compared with the normal infants, the infants with PP had abnormal neurological assessment scores, and the degree of neurological abnormality was associated with the severity of PP.

Conclusions

The INFANIB revealed neurological abnormalities, including asymmetric movements and abnormal muscle tone, postures, and reflexes, in infants with PP, especially those with moderate or severe PP. These abnormalities were similar to those of infants with cerebral palsy. Therefore, PP may serve as a marker of neurodevelopmental risk and should receive considerable attention. Whether moderate or severe PP is related to cerebral palsy remains to be confirmed in long-term follow-up studies and other future studies.

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Acknowledgments

We would like to thank Dr. Geoffrey Heintzelman for his proofreading and his suggestions regarding this manuscript. This work was supported by the Chongqing Integrated Demonstration Program (Huimin Project, No. CSTC2013JCSFC0007).

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Affiliations

  1. Department of Pediatrics, Xinqiao Hospital, Third Military Medical University, 2-V Xinqiao Street, Chongqing, 400037, China

    Xue-Qing Zhao, Li-Yan Wang, Cong-Min Zhao, Qing Men, Zhi-Feng Wu & Yu-Ping Zhang

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  1. Xue-Qing Zhao
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  2. Li-Yan Wang
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  3. Cong-Min Zhao
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  4. Qing Men
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  5. Zhi-Feng Wu
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Corresponding author

Correspondence to Yu-Ping Zhang.

Ethics declarations

Participants were enrolled after a signed informed consent form was received from a parent or guardian; approval was obtained from the Human Research Ethics Committee of Xinqiao Hospital of Third Military Medical University.

Conflict of interest

The authors have no conflict of interest.

Additional information

Xue-Qing Zhao and Li-Yan Wang contributed equally to this report.

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Cite this article

Zhao, XQ., Wang, LY., Zhao, CM. et al. Neurological assessment of Chinese infants with positional plagiocephaly using a Chinese version of the Infant Neurological International Battery (INFANIB). Childs Nerv Syst 33, 281–288 (2017). https://doi.org/10.1007/s00381-016-3260-6

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  • DOI: https://doi.org/10.1007/s00381-016-3260-6

Keywords

  • Positional plagiocephaly (PP)
  • Infant Neurological International Battery (INFANIB)
  • Neurological abnormality
  • Cerebral palsy