Neurocognitive and sensory impairments in cerebral palsy

Abstract

Although cerebral palsy (CP) is primarily a motor disorder, a significant proportion of individuals with CP have associated neurocognitive and sensory impairments that adversely affect the prognosis of the disease. This study was undertaken to determine the pattern and burden of associated neurocognitive and sensory deficits in Nigerian children with CP. All c onsecutive cases of CP seen at the Pediatric Neurology clinic of the University College Hospital, Ibadan, Nigeria over a period of 3 years were evaluated for severity of motor impairment and any accompanying neurocognitive and sensory deficits. A total of 303 children, 187 males and 116 females were studied. Severe perinatal asphyxia (42.2%), bilirubin encephalopathy (23.4%) and intracranial infections (15.8%) were the leading risk fact ors for CP. Associated neurocognitive/sensory impairments were present in 269 (88.8%) of the cases. The most frequent deficits, which are associated with day to day functioning, were epilepsy (40.3%), hearing impairment (33.0%), visual impairment (32.0%), growth impairment (29.0%) and speech disorders (24.8%). Cognitive impairment was present in 30 (83.3%) of the 36 children aged 6 years and above. Deficits were multiple in 51.5% of the cases. The study showed a statistically increased risk of multiple neurocognitive and sensory deficits with presence of spastic quadriparesis (P < 0.001, odds ratio 2.553, 95% confidence interval 1.55-4.25) and microcephaly (P < 0.001, odds ratio 3.83, 95% confidence interval 2.38-6.18). Neurocognitive and sen sory impairments are common in Nigerian children with CP. These can further compromise the quality of life and increase the burden of care on affected children and their families.