Cerebral palsy: a study in IPGMR, Dhaka

Abstract

This prospective study was carried out on 60 children attending follow-up clinic of Paediatric Neurology and Child Development in the out-patient department of Institute of Post Graduate Medicine and Research (IPGM & R), Dhaka, from May 1995 to April 1996. The present study was conducted to find out various etiological factors responsible for cerebral palsy. Evaluation of 60 cases of cerebral palsy was made by taking detailed history and physical examination. In history, special attention was given to find out antenatal, natal & postnatal factors which predispose to or is directly responsible for the occurence of cerebral palsy. Of these 60 cases, 38 (63.33%) patients were male and 22 (36.36%) female children . 75% of the cases were of spastic type of cerebral palsy. Hypotonic cerebral palsy was observed in 11.66%; ataxic type in 5%; athetoid in 3.33%; mixed spastic and ataxic in 3.33%, and dyskinetic type of cerebral palsy in one case. History of consanguinity of marriage was found in 23.33% cases. Natal and prenatal factors were most common etiological factors. Among the natal factors birth, asphyxia was found in 55%; prematurity in 6.66%, and sepsis in 5%. Antenatal maternal illness was found in 50% cases including toxemia in 10%; intrauterine infection in 10%, prolonged and obstructed labour in 28.32%. Postnatal factors were found in 30% of cases including hyperbilirubinemia. The results of this study emphasize the need to reinforce the existing antenatal, natal, obstetric and neonatal services for early and proper management of these conditions and to reduce the incidence and severity of cerebral palsy.