DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20182578

Clinical profile of cerebral palsy: a study from multidisciplinary clinic at tertiary care centre

Raj Kumar, Anand Kumar Gupta, Ritesh Runu, Sanjay Kumar Pandey, Manish Kumar

Abstract


Background: Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain. The aim of this study is to Cerebral Palsy (CP) is combined disorder of movement, posture, and motor function and may be associated sensory, neurological and musculoskeletal complications.  It is a permanent condition attributed to nonprogressive disturbances that occurred in the developing brain.

Methods: Retro prospective cross-sectional study done in super speciality tertiary care centre of East India. Total 70 Children enrolled in multidisciplinary CP clinic in Physical medicine and Rehabilitation (PMR) OPD between September 2017- March 2018.

Results: 78.57%male and 21.42% female, all had hospital delivery with 78.5% had normal and 21.5% caesarean section. 70% had history of birth asphyxia and 61.5% required NICU admission. 61.4% had birth wt. less than 2 kg and 10% had birth wt. less than 1kg. One fourth cases had microcephaly and one third had history of seizures. Visual abnormalities, Hearing impairment and history of jaundice were found in about one sixth children. Spastic CP was the most common (76% cases) followed by Dyskinetic 10%, Hyponic and Ataxic (1%). In spastic CP Diplegia was most common (55%), followed by Quadriplegia 24%, Hemiplegia 19% and Monoplegia 2%. GMFCS score 5 was seen in 29% (mostly quadriplegic), followed by GMFCS level 1, 21.27% (mostly hemiplegic), others mostly diplegic in level 3(19%), level 2 and 4 (14%).

Conclusions: Male CP are more reaching tertiary care centre in Bihar. Perinatal factors (asphyxia) were main etiological risk factor, and Spastic Diplegia is the most common type of CP. Disability need to be detected at the earliest to facilitate a timely and appropriate intervention like early rehabilitation, special education and psycho-social support.


Keywords


Cerebral palsy, Rehabilitation, Risk factor of CP, Spasticity

Full Text:

PDF

References


Sellier E, Platt MJ, Andersen GL, Krägeloh‐Mann I, De La Cruz J, Cans C, et al. Decreasing prevalence in cerebral palsy: a multi-site European population-basedstudy,1980 to2003. Dev Med Child Neurol. 2016;58(1):85-92.

Hagberg B, Hagberg G. The origins of cerebral palsy. Recent advances in Pediatr. 1993;11:67-81.

Nafi OA. Clinical spectrum of cerebral palsy in South Jordan; analysis of 122 cases. Pediatr Ther. 2011;1:101-4.

Pharoah POD, Cooke T, Cooke RWI, Rosenbloom L. Birth weight specific trends in cerebral palsy. Arch Dis Child. 1990;65:602-6.

Morris C. Definition and classification of cerebral palsy: a historical perspective. Dev Med Child Neurol Suppl. 2007;109:3-7.

Singhi PD, Ray M, Suri G. Clinical spectrum of cerebral palsy in North India- an analysis of 1000 cases. J Trop Pediatric. 2002;48(3):162-6.

Srivatsava V K, Laisram N, Srivatsava R K. Cerebral Palsy. Indian Pediatric. 1992;29(8):993-6.

Reddy B. A study of clinical spectrum and risk factors of cerebral palsy in children. (IOSR-JDMS);2018:17(1):9-52.

Laisram N, Goyal V, Bhatnagar S, Muzaffar T, Changing trends in clinical Profile of cerebral palsy. IJPMR. 2016;27(1):10-3.

Makwana M et al. A clinico epidemiological study of cerebral palsy in western Rajasthan. Int J Contemp Pediatr. 2017;4(4):1146-52.

Sharma P, Sharma U, Kabra A. Cerebral Palsy – clinical profile and predisposing factors. Indian Pediatr.1999;36:1038-42.

Anwar S, Chowdhury J, Khatun M, Mollah AH, Begum HA, Rahman Z, et al. Clinical profile and predisposing factors of cerebral palsy. Mymen singh Med J. 2006;15(2):142-5.

Singhi P, Saini A.G. Changes in the clinical spectrum of cerebral palsy over two decades in North India- an analysis of 1212 cases. J Trop Pediatr. 2013;59(6):434-40.

Nelson KB, Ellenberg JH. Antecedents of cerebral palsy: I. Univariate analysis of risks. Am J Dis Child. 1985;139(10):1031-8.

Nelson KB, Grether JK, Causes of cerebral palsy. Curr Opin Pediatr. 1999;11(6):487-91.

O'Callaghan ME et al. Australian Collaborative Cerebral Palsy Research Group. Epidemiologic associations with cerebral palsy. Obstet Gynecol. 2011;118(3):576-82.

Michael EM. Developmental Vulnerability and Resilience in extremely preterm infants. JAMA. 2004;292:2399-401.

Johnson A. Prevalance and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44:633-40.

Kavcic A and Perat MV. Prevalence of cerebral palsy in Slovenia: birth years 1981 to 1990. Dev Med Child Neurol. 1998;40: 459-63.

Reid SM, Meehan E, McIntyre S, Goldsmith S, Badawi N, Reddihough DS, et al. Temporal trends in cerebral palsy by impairment severity and birth gestation. Dev Med Child Neurol. 2016;58(2):25-35.

Reddy B. A study of clinical spectrum and risk factors of cerebral palsy in children. IOSR-JDMS;2018:17(1):9-52.

Das N, Bezboruah G, Das I. Study on the clinical profile of patients with cerebral palsy. IOSR J Dental Med Sci. 2016;15(7):54-8.

Fidan F, Baysal O. Epidemiologic characteristics of patients with cerebral palsy. Open J Therapy Rehab.2014;2:126-32.

Hagglund G, Lauge-Pedersen H, Wagner P. Characteristics of children with hip displacement in cerebral palsy. BMC Musculoskelet Disord. 2007;8:101.

Pountney T, Green EM. Hip dislocation in cerebral palsy. BMJ. 2006;332(7544):772-75.