Abstract
A common problem in children affected by cerebral palsy, independently of its etiology, is the existence of visual impairment. In this retrospective study we analyzed the effects of Growth hormone (GH) administration (0,04 mg/kg/day, 5 days/week) together with visual stimulation with a tachistoscope in 42 children with cerebral palsy (22 boys, 20 girls, aged 2,48 ± 1,5 years [mean ± SD) in whom there was an evident lesion of the visual pathway. In 17 of these cases, prematurity was the responsible factor, while in the other 25 children, ischemic encephalopathy due to pre/perinatal problems was the origin of visual impairment. In addition, we analyzed three other children (1, 2 months and 1 year of age) in whom multicystic encephalopathy (due to severe hypoxia-ischemia at delivery) mainly affecting the occipital lobes was the responsible factor. Visual evoked potentials were recorded before beginning and after treatment, assessing the latency in ms of the N75, P100 and N140 waves, as well as the amplitude of the waves (µV). Treatment duration (mean ± SD) was 5.20 + 2.05 months. Completion of treatment was established by clinical criteria. The statistical significance of the data was carried out using the Wilcoxon test.
The treatment induced a significant decrease in the latency of N75, P100 and N140 (p < 0.001), as well as a clear tendency to increase the amplitude of the waves (p < 0.05). Of special interest is the case of a child affected by Multicystic Encephalopathy in which the cystic cavities in the occipital lobes detected by MRI before starting treatment (15 days of age) completely disappeared in a new MRI performed 1 year later. That child is now totally independent for activities of daily living. GH treatment did not produce any adverse effects. In summary, from our results we can conclude that the administration of GH added to visual stimulation with a tachistoscope is an effective and safe method for the repair of visual deficiencies in children with cerebral palsy, regardless of the existence or not of GH deficiency.