Journal
JOURNAL OF CHILD NEUROLOGY
Volume 27, Issue 7, Pages 845-851Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0883073811415680
Keywords
spinal muscular atrophy; Werdnig-Hoffman Disease; nutrition; feeding failure; growth
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Funding
- Spinal Muscular Atrophy Foundation
- NINDS, Neurological Sciences Academic Development Award [K12 NS01698]
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Growth failure is nearly universal in spinal muscular atrophy type 1 and common in type 2, although acuity is often underappreciated at initial diagnosis. We reviewed 44 consecutive spinal muscular atrophy patients (28 type 1, 16 type 2) under 3 years at initial presentation. Growth failure was conventionally defined: weight below the fifth percentile or dropping 2 major percentiles over 6 months. Growth failure differed among subjects stratified by age at disease onset using the Kaplan-Meier method (P = 0.011). Median time to growth failure among subjects with onset between 0 to 3 months of age was 5 months; Only 1 of 22 avoided failure by 22 months of age. Median time to failure with disease onset between 4 to 6 months was 15 months. Most late onset (> 6 months) subjects avoided growth failure. Early clinical symptoms predict feeding dysfunction and growth failure. Immediate, proactive nutritional intervention is indicated for patients with early symptom onset.
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