Cerebral Palsy: Prevalence, Predictability, and Parental Counseling

Abstract

Cerebral palsy (CP) is the most common cause of severe physical disability in childhood, occurring in approximately 2 in 1,000 liveborn infants. Although the prevalence of CP appears to have stabilized in the past 2 decades, recent studies suggest that severe CP may be decreasing. Neuroimaging studies help identify abnormal neuroanatomic findings, which are found in most affected children. Neuropathology identified by magnetic resonance imaging (MRI) corresponds well to clinical descriptions of motor impairment in children who have CP. Clinical risk factors, combined with imaging studies, can help identify a subpopulation of infants who are at high risk for poor neurodevelopmental outcome. Counseling caregivers on future adverse developmental risks can be challenging for the clinician in the neonatal intensive care unit (NICU), especially because the cause of CP remains unexplained in most cases and is typically diagnosed outside the neonatal period. Early counseling of families of at-risk neonates may function as the starting point for parental adaptation to a lifelong condition that requires ongoing services and adjustments to promote the overall health and well-being of their child.