Cerebral Palsy in a Term Population: Risk Factors and Neuroimaging Findings

Cerebral palsy is a common cause of pediatric motor disability. Although there are increasing amounts of data on the clinical profile of children with cerebral palsy in high-income countries, corresponding information about low-income countries and developing countries is lacking. Therefore, we aimed to describe the clinical spectrum of cerebral palsy in children in Benin, a representative West African low-income country. Our cross-sectional observational study included 114 children with cerebral palsy recruited from community-based rehabilitation centers and teaching hospitals (median age: 7 years, range 2-17; sex: 66% male). Data were collected through review of medical records and interviews with children’s mothers. Assessment included risk factors, clinical subtypes according to the Surveillance of CP in Europe criteria, severity of motor outcome scored by the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System, comorbidities, and school attendance. We recorded a high prevalence of intrapartum adverse events. Seventeen percent of children had postneonatal cerebral palsy, with cerebral malaria being the most common cause. Most children were severely affected (67.5% as bilateral spastic; 54.4% as GMFCS IV or V), but severity declined substantially with age. Only 23% of the children with cerebral palsy had attended school. Poor motor outcomes and comorbidities were associated with school nonattendance. These results suggest that intrapartum risk factors and postnatal cerebral malaria in infants are opportune targets for prevention of cerebral palsy in Sub-Saharan low-income countries.

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Risk factors for hip dislocation in dyskinetic cerebral palsy

Journal of Orthopaedic Surgery ◽

10.1177/23094990211001196 ◽

2021 ◽

Vol 29 (1) ◽

pp. 230949902110011

Author(s):

Kyoko Okuno ◽

Yukihiro Kitai ◽

Toru Shibata ◽

Hiroshi Arai

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Birth Weight ◽

Gestational Age ◽

Brain Mri ◽

Brain Lesion ◽

Brain Lesions ◽

Lesion Location ◽

Hip Displacement ◽

Gmfcs Level

Purpose: To investigate the risk factors for hip displacement in patients with dyskinetic cerebral palsy (DCP). Methods: We evaluated 81 patients with DCP, 45 males and 36 females, aged 10–22 years, risk factors for hip displacement were evaluated using multivariate logistic regression analysis with primary brain lesions, Gross Motor Function Classification System (GMFCS) level, gestational age, birth weight, Cobb’s angle, and complication of epilepsy as independent factors. Hip displacement was defined as migration percentage >30%. Primary brain lesions were classified into globus pallidus (GP), thalamus and putamen (TP), and others using brain magnetic resonance imaging (MRI). Perinatal and clinical features were compared between patients with GP lesions and those with TP lesions. Results: Hip displacement was observed in 53 patients (67%). Higher GMFCS levels (p = 0.013, odds ratio [OR] 2.6) and the presence of GP lesions (p = 0.04, OR 16.5) were independent risk factors for hip displacement. Patients with GP lesions showed significantly higher GMFCS levels, more frequent hip displacement, and lower gestational age and birth weight than those with TP lesions. Conclusion: Primary brain lesion location may be an important factor in predicting hip displacement among patients with DCP. Appropriate risk assessment using brain MRI may contribute to the early detection and intervention of hip displacement because brain lesion location can be assessed during infancy before GMFCS level is decided.

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Evaluation of risk factors for cerebral palsy

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-020-00265-1 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Dina Salama Abd Elmagid ◽

Hend Magdy

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Intracranial Hemorrhage ◽

Cns Infection ◽

Motor Impairments ◽

Cerebrovascular Accidents ◽

Common Causes ◽

Children With Cerebral Palsy ◽

Infant Brain ◽

Cns Malformation

Abstract Background Cerebral palsy (CP) has been identified as one of the most important and common causes of childhood disabilities worldwide and is often accompanied by multiple comorbidities. CP is defined as a group of disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The objective of our study was to describe main clinical pattern and motor impairments of our patients, and to evaluate the presence of risk factors and if there is a relation to the type of cerebral palsy. Methods Children with cerebral palsy were retrospectively enrolled over 2 years from the neurology outpatient clinics. Cerebral palsy risk factors and motor impairments were determined through caregiver interviews, review of medical records, and direct physical examination. Results One thousand children with cerebral palsy were enrolled. Subjects were 64.4% male, with a median age of 2.5 years. The risk factors for cerebral palsy in our study were antenatal (21%), natal and post-natal (30.5%), post-neonatal (17.1%), and unidentified (31.4%). Antenatal as CNS malformation (26.6%), maternal DM (17.6%), prolonged rupture of membrane (11.9%), maternal hemorrhage (10.4%), and pre-eclampsia (4.7%). Natal and post-natal as hypoxic ischemic encephalopathy (28.5%), infection (16.3%), hyperbilirubinemia (12.7%), cerebrovascular accidents (8.8%), meconium aspiration (6.2%), and intracranial hemorrhage. Post-neonatal as CNS infection (34.5%), cerebrovascular accidents (28.6%), sepsis (23.9%), and intracranial hemorrhage (8.7%). Conclusions Cerebral palsy has different etiologies and risk factors. Further studies are necessary to determine optimal preventative strategies in these patients.

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Gross motor dysfunction as a risk factor for aspiration pneumonia in children with cerebral palsy

Paediatrica Indonesiana ◽

10.14238/pi57.5.2017.229-33 ◽

2018 ◽

Vol 57 (5) ◽

pp. 229 ◽

Cited By ~ 1

Author(s):

Cut Nurul Hafifah ◽

Darmawan Budi Setyanto ◽

Sukman Tulus Putra ◽

Irawan Mangunatmadja ◽

Teny Tjitra Sari ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cerebral Palsy ◽

Aspiration Pneumonia ◽

Motor Dysfunction ◽

Silent Aspiration ◽

Gross Motor ◽

Respiratory Problems ◽

Children With Cerebral Palsy ◽

Chest X Ray

Background Respiratory problems, such as aspiration pneumonia, are major causes of morbidity and mortality in children with cerebral palsy (CP) and greatly affect the quality of life of these children. Nevertheless, there is limited data on the incidence and risk factors of aspiration pneumonia in children with CP in Indonesia. Objective To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy.Methods In children with CP aged 1-18 years, incidence of pneumonia was studied prospectively for 6 months and the prevalence of the risk factors was studied cross-sectionally. At baseline, we evaluated subjects’ by history-taking, physical examination, risk factors, and chest X-ray to assess the incidence of silent aspiration. Subjects were followed-up for six months to determine the incidence of overt or silent aspiration pneumonia.Results Eight out of 36 subjects had one or more episodes of aspiration, consisting of silent aspiration (2/36) and clinically diagnosed aspiration pneumonia (7/36). Subjects with more severe gross motor dysfunction experienced more episodes aspiration pneumonia, although it was not statistically significant (p = 0.06), while dysphagia (P=0.2) and nutritional status (P=0.11) were not associated with pneumonia or silent aspiration.Conclusion Twenty-five percent of children with CP experienced aspiration pneumonia during the 6-month study period, with gross motor dysfunction as a possible risk factor.

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Risk Factors for Cerebral Palsy in Brazilian Children: A Case-Control Study

10.1101/2020.12.01.20242248 ◽

2020 ◽

Author(s):

Marcus Valerius da Silva Peixoto ◽

Andrezza Marques Duque ◽

Allan Dantas dos Santos ◽

Shirley Verônica Melo Almeida Lima ◽

Caíque Jordan Nunes Ribeiro ◽

...

Keyword(s):

Risk Factors ◽

Cerebral Palsy ◽

Birth Weight ◽

Preterm Birth ◽

Case Control Study ◽

Case Control ◽

Perinatal Factors ◽

Apgar Scores ◽

Control Study ◽

Brazilian Children

ABSTRACTBackgroundCerebral palsy is the main cause of physical disability in childhood.ObjectivesThis study analyzed prenatal and perinatal risk factors that contribute to cerebral palsy in Brazilian children.MethodsA case-control study was conducted with 2- to 10-year-old children in the city of Aracaju, Sergipe, Brazil. The cases were population-based, selected from the Primary Health Care services. The controls were selected from the database of the Brazilian Live Births Information System. Controls were paired with cases by gender, year, and hospital of birth.ResultsA total of 570 participants (114 cases and 456 controls) were studied. Most of the participants were male, with bilateral spastic cerebral palsy. Among the prenatal factors examined, the presence of congenital anomalies was significantly different between cases and controls (OR = 54.28, [95% CI 12.55, 234.86]). The analysis of perinatal factors revealed significant differences between cases and controls in low birth weight (OR = 3.8, [95% CI 2.34, 6.16]), preterm birth (OR = 2.31, [95% CI 1.41, 3.80]), and low Apgar scores (OR = 14.73, [95% CI 5.27, 41.15]).ConclusionsThe main prenatal and perinatal factors associated with cerebral palsy in our population were congenital anomalies, low Apgar scores, low birth weight, and preterm birth. The perinatal period had more risk factors, demanding a deeper study of their causes and of possible preventive measures.

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CEREBRAL PALSY : ANTENATAL RISK FACTORS

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/944 ◽

2015 ◽

Vol 4 (37) ◽

pp. 6512-6516

Author(s):

Srinivasa Rao Tatavarti ◽

Vidyullatha Arimilli ◽

Subbalakshmi T D P

Keyword(s):

Risk Factors ◽

Cerebral Palsy

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Faktor Risiko Prenatal Perinatal Dan Postnatal Pada Kejadian Cerebral Palsy

Interest : Jurnal Ilmu Kesehatan ◽

10.37341/interest.v8i2.177 ◽

2019 ◽

Vol 8 (2) ◽

pp. 204-209

Author(s):

Bambang Trisnowiyanto ◽

Yohanes Purwanto

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Cerebral Palsy ◽

Postnatal Period ◽

Spastic Diplegia ◽

Prenatal Risk ◽

Prenatal Risk Factors ◽

Spastic Hemiplegia ◽

Postnatal Risk Factors ◽

Observational Descriptive Study

Background: Cerebral Palsy (CP) is a disability disorder motor motorization is most common in children with a prevalence of 2-3 per 1000 live births. The term CP is explained as a group of movement and posture disorders that are often accompanied by impaired sensation, perception, cognition, communication, behavior, epilepsy, and secondary disorders of the musculoskeletal system. Disorders of CP occur in the immature central nervous system with non-progressive traits occurring in the prenatal, perinatal, and postnatal period. Methods: The purpose of this study is to determine how much prenatal risk factors, perinatal, and postnatal events in CP at the Kitty Center Clinic in Jakarta for 5 year (2013 - 2017). Result: An observational descriptive study, which described prenatal perinatal, and postnatal risk factors for CP events at the Kitty Center Clinic in Jakarta for a period of 5 years (2013-2017) with a total of 523 study subjects. Based on the analysis of data obtained, based on the type of CP 35% quadripelgia spastic, 36% spastic diplegia, 6% spastic hemiplegia, 9% athetosis, and 14% hypotonia. Based on sex 62% are men, and 38% are women with a ratio of 1.6: 1.0. Based on the age of the child 11% <2 years, 34% 3-6 years, 33% 7-12 years, and 22%13-18 years. Conclusion: Based on risk factors of 62% prenatal, 25% perinatal, and 12% postnatal. Prenatal risk factor is the biggest risk factor as much as 62% which causes Cerebral Palsy at the Kitty Center Clinic in Jakarta.

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