P6 – 2654: Clinical spectrum of cerebral palsy in Durban, South Africa

Abstract

Objective To evaluate the clinical spectrum of cerebral palsy children in South Africa and their need. Methods The study was done in a tertiary children's outpatient hospital from July 2013 to December 2014. This was a retrospective, descriptive chart review of cerebral palsy patients. Background Few comprehensive studies have been done in South Africa. Results 30 children were analyzed. The average age was 5.8 years. The range was 2 to 13.5 years. The male to female ratio was 1.5:1. Children were classified according to the type of cerebral palsy. A paediatric neurologist, occupational therapist, physiotherapist, speech therapist, dietitian and psychologist examined them. 53% had bilateral spastic, 26.7% unilateral spastic, 13% dyskinetic, one ataxic and one mixed cerebral palsy. Common comorbidities (average 4 per child) were epilepsy, cognitive impairment, contractures, reflux, constipation, drooling and behaviour problems. Two had fractures and two precocious puberty. Twenty children (66%) had Epilepsy and twelve (40%) abnormal EEGs. There were 13 MRI brains done. The number of children with abnormal radiology, which included Ct brain, was 25 (83%). Two were unrecorded. Aetiology ranged from perinatal hypoxic ischaemic encephalopathy (43%), 13% brain malformations, 16.7% prematurity related complications, 23% post natal complications, including TB meningitis and jaundice, and one patient with no identified cause. Only nine children (30%) could walk. There was a high degree of disability with the GMFCS above 4 in 63%. The children were on an average of 4 medications and none were on Botulin toxin injections. Only 6 were in special schools. Conclusion The number of bilateral spastic cerebral palsy is still very high. The aetiology includes high number of preventable causes. There is a very high degree of comorbidity in children with cerebral palsy in South Africa and a high need for other therapy like botulin toxin, anti-drooling medication and special schools.