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MENTAL RÖTARDE OTİSTİKLERDE YÜRÜME GELİŞİMİNDE GECİKMENİN KLİNİK PROGNOZLA İLİŞKİSİ

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Abstract (2. Language): 
This retrospective clinical study was aimed to make a statistical comparison between the mentally retarded autistic patients with delay at onset of walking and cases with no history of neuromotor delay in relation to certain clinical and laboratory features with regards to the prognosis in relation to the clinical subtypes. Design.- The study included 90 patients, 70 boys (78%) and 20 girls (22%) diagnosed as having typical symptoms of autism according to DSM-IV. The non-delay group (group A) had 64 (71%) patients while the delay group (group B) included 26 patients (29 %). The variables considered were, demographic data (age, sex), medical history (pre-perinatal problems, presence of epileptic seizures and/or febrile convulsions), family history (consanguinity, family history of any neurodevelopmental problem such as a language disorder), medical examination (neurological examination, dysmorphism, hand dominance), behavioral features accompanying autism (such as abnormal reactivity to sensory stimuli, presence of unusual emotional lability with sudden bursts of laugh or cry, language profile, hyperactivity), neuroimaging findings and EEG features. Results.- Significant results included the predominance of hyperactivity (p<0.001) and echolalia +cliché phrases (p<0.02) in group A, consanguinity (p<0.05), epileptic seizures (p<0.001), abnormal neurological examination (p<0.01) and dysmorphism (p<0.02) in group B. Conclusion.- These results suggested that seizures were more likely for autistic kids who started to walk late and it was less likely to attain verbal ability for them.
Abstract (Original Language): 
Bu çalışmada mental rötarde otistiklerde yürüme gelişiminde gecikmenin klinik prognozla ilişkisi belli klinik ve laboratuvar özellikleri bağlamında araştı- rılmıştır. Bu amaçla DSM-IV ölçütlerine göre tipik otizm tanısı alan 70 erkek (%78), 20 kız (%22) toplam 90 hasta çalışmaya alınmış ve bu hasta grubu içinde yer alan ve zamanında yürümüş olan 64 hastanın (grup A) bazı klinik ve laboratuvar özellikleri, yürüme gecikmesi olan 26 olgunun özellikleri ile (grup B) karşılaştırılmıştır. Değerlendirilen parametreler arasında Demografik veriler (yaş, cins), tıbbi öykü (pre-perinatal olumsuz olaylar, febril konvülsiyon, epileptik nöbet), aile öyküsü (ailede benzer gelişimsel sorun öyküsü, akraba evliliği), muayene bulguları (nörolojik muayene, dismorfizm, el dominansı) bazı davranış özellikleri (dil ve davranış sorunları), görüntüleme ve EEG bulguları yer almıştır. Yapılan çalışmada istatistiksel açıdan anlamlı olarak, grup A’da hiperaktivite (p<0.001) ve ekolali+ klişe tarzında konuşma (p<0.02) daha fazla saptanmış, buna karşın akraba evliliği (p<0.05), epileptik nöbetler (p<0.001), anormal nörolojik muayene (p<0.01) ve dismorfizm (p<0.02) grup B’de yüksek bulunmuştur. Sonuçlar, yürüme gecikmesinin otistik çocuklarda daha sonra epilepsi nöbeti gö- rülme olasılığını artırdığını, buna karşın zamanında yürüyen otistiklerde sonradan lisan gelişimi düzeyinin daha iyi olabileceğini düşündürmüştür.
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