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At age 6 months,21 of 51(41%)cocaine-positive children exhibited hypertonia of any type(hypertonic tetraparesis,hypertonic diparesis,and hypertonic hemiparesis)compared with 17 of 68(25%)cocaine-negative infants (OR=2.1,CI=1.0-4.6).Cocaine-positive infants were four times more likely to show hypertonic tetraparesis(HTP)than cocaine-negative infants(OR=4.0; CI=1.5-10.8).The association remained significant in multivariate analyses.Hypertonia,consistent with cerebral palsy,diminished over time in both groups.In 97%of affected infants hypertonia resolved by 24 months.Arm hypertonia abated first;leg hypertonia remained in some children up to age 18 months.No differences in development scores between cocaine-positive and cocaine-negative were noted at any age interval.However,among cocaine- positive infants,those with early HTP showed significantly lower mean developmental scores at 6 and 12 month compared to infants without HTP. Cocaine positively urine toxicology at birth is associated with hypertonia during infancy.Such cocaine-induced effects are usually symmetrical, transient,and the majority of exposed children outgrow hypertonia by 24 months of life.Among cocaine-positive infants,HTP may be a marker for later developmental impairments. |
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