TAILIEUCHUNG - Musculoskeletal Complications of Neuromuscular Disease in Children

The panel concluded that treatment of children aged 5 to15 years with hydroxyurea does not cause a growth delay. They felt there were insufficient data to allow them to evaluate the effects of hydroxyurea on pubertal development. The panel found no data regarding the effects on subsequent generations after exposure of germ cells to hydroxyurea, including exposure during fetal life, infancy, childhood, and adolescence. The CERHR report did not describe any studies on the long-term health effects, including carcinogenicity, of childhood exposure to hydroxyurea; we also found no such studies. The expert panel had concerns about the adverse effect of. | ELSEVIER SAUNDERS Phys Med Rehabil Clin N Am 19 2008 163-194 PHYSICAL MEDICINE AND REHABILITATION CLINICS OF NORTH AMERICA Musculoskeletal Complications of Neuromuscular Disease in Children Sherilyn W. Driscoll MDa b Joline Skinner MDa aPediatric Physical Medicine and Rehabilitation Mayo Clinic 200 First Street SW Rochester MN 55901 USA bMayo Clinic College of Medicine 200 First Street SW Rochester MN 55901 USA A wide variety of neuromuscular diseases affect children including central nervous system disorders such as cerebral palsy and spinal cord injury motor neuron disorders such as spinal muscular atrophy peripheral nerve disorders such as Charcot-Marie-Tooth disease neuromuscular junction disorders such as congenital myasthenia gravis and muscle fiber disorders such as Duchenne s muscular dystrophy. Although the origins and clinical syndromes vary significantly outcomes related to musculoskeletal complications are often shared. The most frequently encountered musculoskeletal complications of neuromuscular disorders in children are scoliosis bony rotational deformities and hip dysplasia. Management is often challenging to those who work with children who have neuromuscular disorders. Scoliosis Scoliosis refers to deviation from normal spinal alignment. A commonly accepted definition of scoliosis is a curvature in the coronal plane of greater than 10 . The coronal curvature is almost always associated with a sagittal alignment abnormality such as kyphosis lordosis or a rotational component. Scoliosis may be classified as idiopathic congenital or neuromuscular in origin. Overall idiopathic scoliosis accounts for the significant majority of cases of scoliosis in children and adolescents whereas scoliosis associated with neuromuscular disease congenital deformity and other causes occurs less frequently in the total population. Neuromuscular scoliosis can occur as Corresponding author. Pediatric Physical Medicine and Rehabilitation Mayo Clinic 200 First Street SW .

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