Visual impairment due to a dyskinetic eye movement disorder in children with dyskinetic cerebral palsy

master's thesis

• Title (croatian): Oštećenja vida uslijed diskinetskih poremećaja pokreta očiju u djece s diskinetskom cerebralnom paralizom
• Author: Mihaela Ivošević
• Mentor: Sonja Alimović (mentor)
• Mentor: Els Ortibus https://orcid.org/0000-0002-1020-4408 (komentor)
• Committee member: Sonja Alimović (predsjednik povjerenstva)
• Committee member: Renata Pinjatela (član povjerenstva)
• Committee member: Dominik Sikirić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Education and Rehabilitation Sciences; Zagreb
• Defense date and country: 2019, Croatia
• Scientific / art field, discipline and subdiscipline: SOCIAL SCIENCES; Education/Rehabilitation Sciences

Abstract

Despite the fact that ocular and cerebral visual abnormalities are shown to be very frequent in cerebral palsy (CP), children with CP are underreferred to rehabilitation services for visual impairments. Visual component is, together with the motor disorder, an integral part of the clinical picture of CP and not an associated symptom. Therefore, an accurate detection of visual disorders and visual function not only lead to a complete clinical diagnosis but also to an appropriate intervention plan. Hence, the need for a study aiming specifically to describe all the aspects of visual involvement in the dyskinetic CP. Research goals were aimed at gaining insights into the nature of visual impairments and functional vision of children with dyskinetic CP, determining the nature of connection between visual functions and functional vision, with an emphasis on searching for dyskinetic eye movement disorder for understanding the difficulties in performing visual activities of two children with dyskinetic CP from the Zagreb’s county register of CP, which is part of national C28 RCP-HR-Register of cerebral palsy of Croatia included in Surveillance Cerebral Palsy Europe (SCPE). The data were collected using standardized and non-standardized tests for visual function assessment. Dyskinetic eye movement disorder was tested comparing the tested results of visual functions. Functional vision was tested through the observation of the children’s behavior and through open structured questions addressed to parents. Cerebral visual impairment was examined by a questionnaire for cerebral visual impairment screening. Qualitative research analysis shows which ocular and cerebral visual impairments are present as well as their relation to visual functioning. Moreover, it shows clinical features of dyskinetic eye movement disorder that haven’t been shown present among tested children. Since this is the second research up to this date, testing an eye movement disorder that specifically occurs in dyskinetic CP, its characteristics are further discussed and defined. In contrary to previous study, in a child where highly inefficient visual functioning was shown, the cause goes wider from the abnormal eye motility. It consists of combination of several motor and sensory problems (lacking binocular visual acuity, contrast sensitivity, fixation, voluntary eye movements and oculomotricity). Due to the small sample and findings that are, on account of heterogeneity of dyskinetic CP hard to compare, future research is needed to expand overall knowledge of functional vision and visual functions needed for planning rehabilitation and education management for children with dyskinetic CP.

Abstract (croatian)

Unatoč činjenici da su okularne i cerebralne vizualne abnormalnosti česte u cerebralnoj paralizi (CP), djeca s CP nedostatno podliježu uslugama rehabilitacije oštećenja vida. Vizualna komponenta je, zajedno s motoričkim poremećajem, sastavni dio kliničke slike CP, a ne samo pridruženi simptom. Točno otkrivanje vizualnog profila djece s CP dovodi do sveobuhvatne kliničke dijagnoze i do odgovarajućeg plana intervencije. Stoga je potrebna studija čiji je cilj opisati sve aspekte vizualne uključenosti u diskinetskom tipu CP. Ciljevi istraživanja bili su usmjereni na stjecanje uvida u prirodu vidnih funkcjia i funkcionalnog vida djece s diskinetskom CP, utvrđivanje prirode povezanosti vizualnih funkcija i funkcionalnog vida, s naglaskom na otkrivanje diskinetskog poremećaja pokreta očiju, kako bi se poboljšalo razumijevanje poteškoća u izvođenju vizualnih aktivnosti dvoje djece s diskinetskom CP iz zagrebačkog županijskog registra CP-a, koji je dio nacionalnog registra C28 RCP-HR cerebralne paralize Hrvatske uključen u Surveillance Cerebral Palsy Europe (SCPE). Podaci su prikupljeni korištenjem standardiziranih i nestandardiziranih testova za procjenu vidnih funkcija. Diskinetski poremećaj pokreta očiju testiran je uspoređujući testirane rezultate vidnih funkcija. Funkcionalni vid testiran je promatranjem dječjeg ponašanja u vizualnim zadacima i kroz otvorena strukturirana pitanja upućena roditeljima. Cerebralno oštećenje vida ispitano je upitnikom za screening na cerebralno oštećenje vida. Kvalitativna analiza podataka pokazuje koja su okularna i cerebralna oštećenja vida prisutna kao i njihov odnos prema funkcionalnom vidu. Budući da je ovo drugo do sada istraživanje ispitivanja diskinetskog poremećaja pokreta očiju koji je karakterističan za diskinetsku CP, opisana su njegova klinička obilježja. Suprotno već objavljenoj studiji, kod djeteta kod kojeg je prikazano vrlo neučinkovito vizualno funkcioniranje, uzrok je širi od abnormalne pokretljivosti oka. Sastoji se od kombinacije nekoliko motoričkih i senzoričkih problema (nedostatna binokularna oštrina vida, kontrastna osjetljivost, fiksacija, voljni pokreti očiju i okulomotorika). Zbog malog uzorka i nalaza koji su zbog heterogenosti diskinetičke CP teško usporedivi, potrebna su buduća istraživanja kako bi se proširilo sveukupno znanje o diskinetskom poremećaju pokreta očiju, funkcionalnom vidu i vizualnim funkcijama potrebnim za planiranje edukacije i rehabilitacije djece s diskinetskom CP.

• Keywords: dyskinetic cerebral palsy; dyskinetic eye movement disorder; visual impairments; visual functions; functional vision
• Keywords (english): diskinetska cerebralna paraliza; diskinetski poremećaj pokreta očiju; oštećenja vida; vidne funkcije; funkcionalni vid
• Language: english
• URN:NBN: urn:nbn:hr:158:974948
• Study programme: Title: Graduate study of Educational Rehabilitation; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra edukacijske rehabilitacije (magistar/magistra edukacijske rehabilitacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-12-17 14:15:53