The Epidemiology of Cerebral Palsy: New Perspectives From a Canadian Registry

Abstract

Cerebral palsy (CP)wasfirst recognized as a distinct clinical entity in the mid-19th century. Since then, our conceptualization of this neurodevelopmental disability has evolved with reification of its case definition. Presently, the most widely accepted consensus definition utilized for both clinical and research purposes is the one put forward by Rosenbaum et al in 2007, “cerebral palsy describes a group of permanent disorders of movement and posture, causing activity limitations, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbance of sensation, perception, cognition, communication and behavior, by epilepsy and by musculo-skeletal problems.” This consensus definition ably captures the inherent heterogeneity of CP. This heterogeneity is manifest in all its aspects: clinical presentation, neuromotor impairment evident, etiology, pathogenesis, comorbidities experienced, and natural history. Indeed CP appears never to be the same disorder twice. There is also an explicit recognition in the consensus definition that although the core feature is an objective early onset of neuromotor impairment that leads to activity