Impaired balance and neurodevelopmental disabilities among children with congenital cytomegalovirus infection.

AIM: Although cytomegalovirus (CMV) is the most common congenital infection, existing research has not provided us with a full picture of how this can affect children in the future. The aim of this case-control study was to evaluate disabilities in a well-defined group of children with congenital cytomegalovirus (CMV) infection, who had been fitted with cochlear implants because of severe hearing impairment. METHODS: A multidisciplinary team assessed 26 children with congenital CMV infection for balance difficulties, neurodevelopmental disabilities and language and visual impairment. We also included a control group of 13 children with severe hearing impairment due to connexin 26 mutations. RESULTS: The majority of the children with congenital CMV infection (88%) displayed balance disturbances, including walking at a later age, but there were no cases in the control group. The CMV group also displayed frequent neurodevelopmental disabilities and feeding difficulties. CONCLUSION: Congenital CMV infection affects the general development of the brain and gives rise to a complex pattern of difficulties. Identifying comorbid conditions is very important, as children with associated difficulties and disabilities need more support than children with just hearing impairment. Congenital CMV infection needs to be considered in children with hearing impairment and/or balance disturbance and/or neurodevelopmental disabilities.

Disability and health status in patients with chronic inflammatory demyelinating polyneuropathy.

PURPOSE: Chronic inflammatory demyelinating polyneuropathy (CIDP) is a disorder affecting the peripheral nerves. The purpose of this study was to describe disability and health status in patients with CIDP in Sweden. METHODS: All 22 adult patients with CIDP at the Karolinska University Hospital, Huddinge were invited to participate. Twenty-one patients performed all measures. Their mean age was 54 years. The following measures were used: vibration perception threshold (VPT); the Fatigue Severity Scale (FSS); the Berg Balance Scale; finger dexterity using the Nine-Hole Peg Test (NHPT); functional mobility using the Timed 'Up and Go' Test; health status with the SF-36 questionnaire. RESULTS: Fifty-seven per cent of the patients had a higher thumb and ankle VPT than published normative data. The FSS showed that 38% scored over 5, indicating severe fatigue. The majority of the patients had reduced functional balance. Sixty-two per cent had a subnormal result on the NHPT. Results of the SF-36 showed lower scores than the Swedish norm on the sub-scales describing physical health. CONCLUSIONS: The majority of the patients with CIDP had disabilities and decreased physical health status. The presence of fatigue may be taken into consideration in immunomodulatory treatments and during physical rehabilitation.