scholarly journals Changing Trends in Clinical Profile of Cerebral Palsy

2016 ◽  
Vol 27 (1) ◽  
pp. 10-13
Author(s):  
Vinay Goyal ◽  
Nonica Laisram ◽  
Tufail Muzaffar ◽  
Shikha Bhatnagar
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Birth Asphyxia ◽  
Clinical Profile ◽  
Aetiological Factor ◽  
Speech Impairment ◽  
Group A ◽  
Care Health ◽  
Group B ◽  
Previous Group

Abstract Background There may be change in clinical spectrum of cerebral palsy (CP) due to improvement in maternal and child care health service. The clinical profi le, aetiological factors and comorbidities of children with CP attending Department of PMR, VMMC & Safdarjang Hospital during the years 1981- 1989 and 2008 - 2012 were therefore compared and analysis done. Methods Four hundred and ten (group B) children with CP registered in last 4 years (2008 - 2012) at PMR Department of VMMC & Safdarjang Hospital were compared with previous study of 544 (group A) children during year 1981 - 1989 from same centre. Results Spastic CP remained most common in both the groups. Diplegia is commonest type of CP (38.78%) as compared to previous group where quadriplegia (34.9%) was most common. The mixed type showed a statistical signifi cant increase in percentage (group A: 0.18 % versus group B: 3.7 %). In aetiology, there is decrease in prenatal and postnatal causes and increase in natal causes which were statistically signifi cant. Birth asphyxia (50.3 %) remains the main aetiological factor as earlier (24.5%). Speech problems (59.7%), mental retardation (31.7%) and seizures (26.8%) are common comorbidities as compared to previous studies where mental retardation (47.2 %) was found to be most common followed by speech impairment (37%), visual impairment (9%) and seizures (8.8%). Conclusions Clinical profile of CP has evolved with an increase in diplegic and a decrease in quadriplegic CP.

scholarly journals Clinical profile of childhood epilepsy in Nigerian children seen in a tertiary hospital

2017 ◽  
Vol 4 (4) ◽  
pp. 1138 ◽  
Author(s):  
Komomo Ibor Eyong ◽  
Emmanuel E. Ekanem ◽  
Asindi A. Asindi ◽  
Torty Chimaeze
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Age At Onset ◽  
Central Nervous System Infection ◽  
Birth Asphyxia ◽  
Sub Saharan Africa ◽  
Cns Infection ◽  
Seizure Type ◽  
P Value ◽  
Neurology Clinic

Background: Epilepsies are the most common conditions encountered in most paediatric neurology clinics in many parts of the developing world. In sub-Saharan Africa epilepsies are secondary, reflecting persistently high risks at birth, and the adverse neurological sequelae of CNS infections during and beyond childhood. The study was designed to determine the clinical pattern of childhood epilepsies, probable aetiologies and associated comorbidities of the disease children.Methods: The study was conducted within an 18 months period among children having established epilepsy attending the Neurology Clinic of University of Calabar Teaching Hospital (UCTH). The children and or care givers were interviewed by the authors and the following data were obtained and recorded in a questionnaire; bio data, age at onset of seizure. History was obtained to determine the possible cause of the seizure, type of epilepsy and associated comorbidities. The data obtained was analysed with SPSS version 20. P-value <0.05 was considered significant.Results: Of the one hundred eighty children seen with various neurological morbidities during the study period, one hundred and seven had epilepsy which constitutes 59.4%. Generalized tonic clonic epilepsy was the commonest type of epilepsy found in 66 (61.1%) of the children with epilepsy, followed by simple partial and myoclonic epilepsy in 18.5% and 6.5% respectively. Severe birth asphyxia was responsible was the commonest identifiable cause of epilepsy in 19 (17.8%) of cases while central nervous system infection accounted for 14 (13.1%). Cerebral palsy was the commonest comorbidity in 20 (18.6%) followed by mental retardation in 17 (15.9%) of the children.Conclusions: The study showed epilepsy to be the commonest neurological presentation among children presenting at the paediatric neurology clinic of our facility. Primary generalised tonic clonic epilepsy was the commonest type of epilepsy seen, followed by simple partial seizures. Cerebral palsy and mental retardation were the main associated comorbidities. Birth injuries mainly severe birth asphyxia and CNS infection were the major causes of epilepsy in our study. In conclusion, epilepsy is the commonest neurological morbidity in our environment, limited facilities and resources still militate against identifying the actual aetiology in most children with the disease. Effort should be intensifying to eradicate the preventable causes of the disease.

scholarly journals Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

2021 ◽  
Vol 11 (9) ◽  
pp. 1189
Author(s):  
Tasneem Karim ◽  
Mohammad Muhit ◽  
Israt Jahan ◽  
Claire Galea ◽  
Catherine Morgan ◽  
...  
Keyword(s):  
Experimental Study ◽  
Cerebral Palsy ◽  
Early Intervention ◽  
Intervention Program ◽  
Community Based ◽  
Children With Cerebral Palsy ◽  
Functional Measure ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

Comparison of Phenobarbital versus Magnesium Sulphate for Management of Neonate with Birth Asphyxia

2021 ◽  
Vol 15 (8) ◽  
pp. 2145-2147
Author(s):  
Lubna Riaz ◽  
Syed Muhammad Ahmed ◽  
Muhammad Ahmad Zakki ◽  
Neelam Faryad ◽  
Shazia Iram ◽  
...  
Keyword(s):  
Magnesium Sulphate ◽  
Demographic Data ◽  
Birth Asphyxia ◽  
Female Ratio ◽  
Group A ◽  
Insignificant Difference ◽  
The Difference ◽  
Group B ◽  
Breathing Effort ◽  
Male To Female

Background: Poor breathing effort results in decrease oxygen supply to brain and other organs that lead to birth asphyxia. Phenobarbital and magnesium sulphate are both neuroprotective to asphyxia! injury to brain. Objective: To compare the frequency of neonatal mortality with phenobarbital versus magnesium sulphate in the management of birth asphyxia Study Design: Randomized control trial Place and Duration of Study: Pediatrics Department, Sheikh Zayed Hospital, from 8th March 2020 to 8th September 2020. Methodology: One hundred and two neonates were enrolled. After taking informed consent from parents their demographic data was obtained. Then patients were divided in to two groups; group A treated with Phenobarbital and other group B treated with magnesium sulphate. Results: The mean age of group A neonates was 54.37+14.303 days and in group B 48.40+15.20 days with male to female ratio was 0.7:1. Adverse outcome occurred in 12 (11.54%) patients. Statistically insignificant difference (P=0.122) was found between groups. Conclusion: There is more adverse effects outcome with magnesium sulphate than phenobarbital however the difference was statistically insignificant for management of neonates with birth asphyxia. Keywords: Birth asphyxia, Neonates, Magnesium sulphate (MgS04), Phenobarbital

scholarly journals FETO-MATERNAL OUTCOME;

2012 ◽  
Vol 19 (03) ◽  
pp. 324-327
Author(s):  
AYESHA ZAHOOR QURESHI ◽  
SHAHID RAO ◽  
SHAZIA SIDDIQUE
Keyword(s):  
Epidural Analgesia ◽  
Controlled Trial ◽  
Birth Asphyxia ◽  
Maternal Outcome ◽  
Outcome Study ◽  
Randomized Controlled ◽  
Group A ◽  
Group B ◽  
Labour Room ◽  
Trial Setting

Objective: To compare the effects of epidural analgesia and parenteral nalbuphine in labouring women with term pregnancieson feto-maternal outcome. Study Design: Randomized controlled trial Setting: It was carried out in the Labour Room, Nishtar Hospital, MultanPeriod: From June 2009 to December 2009. Material and methods: A total of 60 patients were included in the study. Patients were divided intotwo groups, having 30 patients in each group. Results: In group-A, pain control was much better and satisfactory (VAS=00-1), duration of labourwas slightly prolonged and instrumental delivery was more common. Low Apgar score and birth asphyxia were seen in group-B. No babydeveloped RDS in both groups. Conclusions: Feto-maternal outcome is much better in women having epidural analgesia with bupivacaine ascompared to women having intramascular nalbuphine.

scholarly journals Efficacy of task-oriented training vs proprioceptive neuromuscular facilitation on mobility and balance in spastic cerebral palsy

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 297-300
Author(s):  
V. Rajalaxmi ◽  
P Swetha ◽  
R.N.V. Deepthi ◽  
Raja Sathya ◽  
S Omana ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Balance Control ◽  
Spastic Cerebral Palsy ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Post Test ◽  
Group A ◽  
Group B ◽  
Task Oriented

Introduction and Aim:One of the most significant and common clinical finding in a majority of children with (CP)is difficulty in walking and exhibiting poor balance control which results in poor gait and reaching movements as maintenance of stability is critical. There are numerous approaches, protocols and treatment strategies to improve balance and gait control. The aim of this study was to compare the effects of task- oriented training and proprioceptive neuromuscular facilitation exercises (PNF)on mobility and balance in spastic cerebral palsy.   Methodology: This was a comparative study design with pre-post type 20 samples were selected based on the inclusion criteria and were divided into two groups. Group A received task-oriented training and group B proprioceptive neuromuscular facilitation and Pre & post measurements were done using paediatric balance scale and timed up and go test.   Results:On comparing the post-test values of group A and group B both the group showed significant difference with the pre-test, on comparing the post-test values of group A and group B, group A showed better significance than group B.   Conclusion: The present study concluded that there seems to be evidence that task-oriented training is more beneficial in training program for increasing the mobility and balance in spastic cerebral palsy comparing to proprioceptive neuromuscular facilitation.  

scholarly journals Spectrum of clinical profile, co-morbidities and parental burden of cerebral palsy children in a tertiary care centre

2017 ◽  
Vol 4 (4) ◽  
pp. 1364
Author(s):  
Bhanuprakash C. N. ◽  
Chikkanarasa Reddy
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Behavioral Problems ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Spastic Cerebral Palsy ◽  
Childhood Disability ◽  
Common Cause ◽  
Feeding Problem

Background: The cerebral palsy is the most common cause of severe physical disability in childhood. The developmental disabilities are a group of disorders differentiated by the pattern of delay among developmental streams. The four streams of development include language, problem solving, motor and social. Cerebral palsy (CP) is a disorder of development in which motor function abnormalities are a key feature. Severity varies from mild to severe. Cerebral palsy is a very challenging disability for parents and professionals. Cerebral palsy is a heterogeneous group of persistent disorders of movement and posture caused by non-progressive defects or lesions of immature brain, is the most common cause of childhood disability. The incidence of CP is 2 to 2.5 per thousand live births. During the past twenty years, there have been increases in the incidence and prevalence of CP that may be related to improved documentation of cases, advances in neonatal care and other factors.Methods: This study is a cross-sectional study. A total of 100 Cerebral Palsy cases were studied in Neuro-developmental clinic, in BMC and RI.Results: Clinical profile of our study shows 74% Spastic cerebral palsy cases (of which 38% were quadriparetic, 31% were diplegic and 5% were hemiparetic), 19% of Hypotonic CP, 1% of Dystonic CP and 6% of Mixed CP cases. Co morbidities in the form of Mental retardation was seen in 94%, feeding problem 64%, visual problems in 39%, seizure disorder in 39%, hearing problems in 18%, behavioral problems 16% of cases.Conclusions: Perinatal asphyxia was important preventable cause of cerebral palsy. Majority of cerebral palsy children were of spastic type. Mental retardation, feeding problem, hearing and vision impairment and seizures were major co morbidities in children with cerebral palsy. Nuclear type of family and high number of co morbidities of the disabled child correlated significantly with higher caregiver burden.

scholarly journals Comparison between semitendinosus transfer to distal femur and medial hamstrings surgical lengthening for treatment of flexed knee gait in cerebral palsy

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902091097 ◽  
Author(s):  
Mauro César de Morais Filho ◽  
Marcelo Hideki Fujino ◽  
Francesco Camara Blumetti ◽  
Carlos Alberto dos Santos ◽  
Cátia Miyuki Kawamura ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Knee Flexion ◽  
Distal Femur ◽  
Research Question ◽  
Knee Extension ◽  
Flexion Deformity ◽  
Anterior Pelvic Tilt ◽  
Group A ◽  
Knee Flexion Deformity ◽  
Group B

Purpose: Hamstrings surgical lengthening (HSL) has been frequently used for the treatment of flexed knee gait in cerebral palsy; however, recurrence of knee flexion deformity (KFD) and increase of anterior pelvic tilt (APT) were reported in a long-term follow-up. Research question: The aim of this study was to compare semitendinosus transfer to distal femur (STTX) and semitendinosus surgical lengthening (STL) regarding the reduction of KFD and the increase of APT after flexed knee gait treatment. Methods: One hundred and eleven patients were evaluated and they were divided into two groups according to surgical procedures at knees: group A (65 patients/130 knees), including patients who received medial HSL as part of multilevel approach; group B (46 patients/92 knees), represented by patients who underwent orthopedic surgery including an STTX instead of STL. Results: Fixed knee flexion deformity (FKFD) decreased only in group B (from 6.79° to 2.96°, p < 0.001) after intervention. In kinematics, APT increased from 16.38° to 19.03° in group A ( p = 0.003), while group B also increased from 15.26° to 20.59° ( p < 0.001). The minimum knee flexion in stance phase (MKFS) reduced from 25.34° to 21.65° ( p = 0.016) in group A and from 31° to 19.57° ( p < 0.001) in group B. In the comparison between groups A and B, the increase of APT ( p = 0.028) and reduction of FKFD ( p < 0.001), popliteal angle ( p = 0.001), bilateral popliteal angle ( p = 0.003) and MKFS ( p = 0.006) were higher after STTX than STL. Conclusion: In the present study, patients who received STTX exhibited more improvement of knee extension at clinical examination and during gait than those who underwent to STL; however, STTX was not effective to prevent the increase of APT after flexed knee gait treatment.

scholarly journals Adaptive neuromodulation in the treatment of spasticity

2020 ◽  
Author(s):  
Barassi Giovanni ◽  
Giannuzzo Giuseppe ◽  
De Santis Romano ◽  
Dragonetti Antonella
Keyword(s):  
Cerebral Palsy ◽  
Operative Procedure ◽  
Lower Limbs ◽  
Rheological Parameters ◽  
Therapeutic Approaches ◽  
Single Session ◽  
Group A ◽  
Analysis Of Results ◽  
Group B

This research has the purpose to evaluate the immediate effects on spasticity of lower limbs of a single session of two different therapeutic approaches in patients affected by cerebral palsy. A total of 30 patients, with an age between and 10-40 years old and affected by cerebral palsy associated to spastic para/tetra paresis, were recruited and equally and randomly divided into 3 groups: group A has was treated with hydrokinesitherapy (HKT). Group B was treated with adaptive electro neuromodulation (ENM). Group C underwent a sham approach respecting the operative procedure of Group B with the device not operating. All patients were evaluated, before (T0) and after (T1) the single session of treatment, through myometric evaluation of muscular rheological parameters. The analysis of results underlined that both HKT and ENM resulted effective in reducing muscu-lar hypertone associated to spasticity, while in Group C no significant results were detected. We can affirm that both ENM and HKT approach can be good alternatives for the treatment of spasticity in patients affected by cerebral palsy.

scholarly journals Clinical profile of children with epilepsy: a cross-sectional study

2020 ◽  
Vol 7 (11) ◽  
pp. 2168
Author(s):  
P. Jagadeesan ◽  
R. Malai Arasu
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Sodium Valproate ◽  
Protein Energy Malnutrition ◽  
Cross Sectional Study ◽  
Clinical Profile ◽  
Sectional Study ◽  
Cross Sectional ◽  
Effective Response ◽  
Positive Effects

Introduction: One of the most common chronic neurological disorders is epilepsy, affecting as many as 45 million individuals worldwide. The occurrence is higher in children below the age of three. Around 60 percent to 70 percent of epilepsy patients have an effective response to treatment with antiepileptic medications. This cross-sectional study aimed to explore the clinical profile of children with epilepsy.Methods: Total of 100 children with different types of epilepsy was included in this study. After getting informed consent from the parents, all the demographic data, family history, clinical and laboratory investigations were recorded, and the results were statistically analyzed and discussed.Results: 69 patients had tonic-clonic seizures, 15 patients had a complete partial seizure, 7 patients had absence seizures, 4 patients had unclassified seizures, 3 patients had simple partial seizures, 1 patient had myoclonic seizures, atonic seizures and multiple seizures. Aetiology, 72 patients had an idiopathic cause, 10 patients had hypoxic ischemia, 8 patients had Central nervous system (CNS) infection, 4 patients had cerebral palsy and space-occupying lesion, 2 patients had trauma. Comorbidity, 84 patients had none, 4 patients had mental retardation, 3 patients had eye diseases, cerebral palsy, protein-energy malnutrition, mental retardation with cerebral palsy, 1 patient had a hearing impairment. Drug therapy, 63 patients had sodium valproate, 11 patients had carbamazepine, 2 patients had multidrug treatment, and 1 patient had sodium phenytoin.Conclusion: A significant amount of the aetiology of the condition is expressed among preventable causes of epilepsy. For generalized tonic clonic seizure, sodium valproate was observed to have more positive effects in paediatric patients.

scholarly journals Women with Severe Anemia in Labor: Adverse Clinical Outcomes

2019 ◽  
Vol 4 (01) ◽  
Author(s):  
Dr. Ruchika Singh ◽  
Dr. Mamta Gupta ◽  
Dr. Vandana Saini
Keyword(s):  
Maternal Morbidity ◽  
Birth Asphyxia ◽  
Near Miss ◽  
P Value ◽  
Severe Anemia ◽  
Maternal Morbidity And Mortality ◽  
Group A ◽  
Anemia Group ◽  
Group B ◽  
Challenging Situation

Background: Severely anemic women in labor is a challenging situation for the obstetrician with increased perinatal and maternal morbidity and mortality. Methods: Evaluation of feto-maternal outcomes in women reporting in labor with severe anemia (group A, n=50) and without anemia (group B,n=50) was done. Results: No maternal mortality and still birth was observed in any of the group. Preterm labor pains, hypertensive disease, occurred more in group A (p value 0.003, 0.037 respectively). Blood transfusion was the commonest intervention required. Congestive heart failure developed (CHF) in 3 women in group A and none in group B. Mean birth weight was more in group B (p value 0.002). Birth asphyxia and NICU admissions were more in group A neonates (p value 0.012, 0.017 respectively). Puerperal morbidity was high in group A women (p value 0.001). Eight women had severe maternal morbidity and 1 woman had near miss event in severe anemia group. Conclusions: Severely anemic women reporting in labor have high maternal and perinatal morbidity.

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