Question

A 3-month-old infant, born at 30 weeks gestation, is brought for developmental follow-up. On assessment, the infant shows absence of fidgety movements and cramped-synchronized general movements. According to the Prechtl General Movements Assessment, what does this finding most strongly predict?

• A. Autism spectrum disorder
• B. Severe visual impairment
• C. Development of cerebral palsy
• D. Attention deficit hyperactivity disorder (ADHD)

Hint:

Prechtl GMA Clinical Value: Absent fidgety movements at $3\text{--}5\text{ months}$ post-term + cramped-synchronized movements = $>95\%$ predictive value for Cerebral Palsy.

Answer 1

The Correct Option is C

Concept:
Prechtl's Qualitative Assessment of General Movements (GMA) is a highly sensitive, standardized, non-invasive neuromotor evaluation tool used in high-risk preterm and term infants.
It analyzes spontaneous, endogenous movement patterns generated by the brain to detect early signs of neurological dysfunction.
Explanation:
• Spontaneous general movements are observed from early fetal life until approximately 20 weeks post-term age and occur in two age-specific stages:
1. Writhing movements: From preterm period until $6$--$9$ weeks post-term.
2. Fidgety movements: Tiny, continuous movements of moderate speed and variable acceleration of the neck, trunk, and limbs present from $9$ to $20$ weeks post-term age.

• Normal fidgety movements indicate intact neural integrity.

• Pathological patterns include cramped-synchronized movements (rigid, simultaneous contraction and relaxation of limb and trunk muscles) during the writhing stage, and the absence of fidgety movements during the 3- to 5-month post-term window.

• The combination of absent fidgety movements and cramped-synchronized patterns has a sensitivity and specificity exceeding $95\%$ for predicting the subsequent development of Cerebral Palsy (particularly bilateral spastic CP).
Final Answer:
According to Prechtl's General Movements Assessment, the absence of fidgety movements combined with cramped-synchronized movements strongly predicts the development of cerebral palsy.