Common Type Of Cerebral Palsy Research Articles

Clinical Phenotypes and Etiological Risk Factors in Children with Cerebral Palsy: A Retrospective Study

Background: Cerebral palsy is a motor impairment syndrome that arises from a lesion in the developing brain. The condition varies based on the timing of the lesion, as well as differences in clinical presentation, location, and severity. Objectives: The aim of this study is to determine the clinical features of patients with cerebral palsy, identify the associated risk factors, and analyze cranial MRI findings in relation to the different types of cerebral palsy. Methods: This study retrospectively evaluated the medical records of children diagnosed with cerebral palsy. Data collected included demographic information, details of potential relevant abnormalities during pregnancy, birth, and the neonatal period, comorbidities, types of cerebral palsy, cranial MRI findings, and classifications of motor impairments. Results: The mean age of the 202 patients with cerebral palsy in the study was 8.02 years, with a male predominance (60.4%). The most common type of cerebral palsy observed was spastic cerebral palsy, accounting for 81.6% of the cases. The most frequent cranial MRI finding was white matter damage of immaturity, present in 36.1% of the patients, while 8.4% of the cases had normal cranial MRI results. Epilepsy was the most common comorbidity, affecting 50.5% of the patients. White matter damage of immaturity was most commonly associated with spastic diparesis, and the identified risk factors for these patients included prematurity, low birth weight, oligohydramnios, multiple pregnancy, and neonatal sepsis/meningitis. Spastic tetraparesis was most frequently linked to miscellaneous MRI findings, with risk factors such as term birth, normal birth weight, polyhydramnios, asphyxia/resuscitation, and a history of neonatal convulsions. Focal infarction/hemorrhage was most often associated with spastic hemiparesis, while basal ganglia-thalamus damage was frequently seen in patients with choreoathetotic and dystonic cerebral palsy. In patients with dystonic cerebral palsy, vaginal delivery and a history of hyperbilirubinemia were identified as common risk factors. Cerebellar damage and malformations were most frequently associated with ataxic cerebral palsy. Conclusions: In this study, it was determined that MRI findings can serve as a valuable guide for identifying different types of cerebral palsy. Additionally, the risk factors, disease severity, and accompanying comorbidities were found to vary according to the specific type of cerebral palsy.

Assessment of the Quality of Life and Relationship of Mental Status Among Parents with Cerebral Palsy Children in a Single Centre Study

Introduction: Children with cerebral palsy (CP) in Bangladesh suffer immensely, with no means or hope for a decent life and a public system lacking basic facilities.This study aims to analyze the quality of life (QoL) and depression status of parents among children with CP, as well as the relationship between these factors and their demographic profile. Materials and Methods: This is a descriptive cross-sectional study in which data were collected from the Pediatric Department of Centre for the Rehabilitation of the Paralysed (CRP) in Savar. The participants included 150 children with CP between January 2018 and December 2020. Results: The mean age of the mothers (29.86±6.14) was between 25 and 29 years (32.7%). The most common type of CP was spastic CP among 100 mothers (66.7%). A significant relationship was observed between the mother’s age during marriage and World Health Organization quality of life (WHOQoL-BREF), physical health (P<0.01), psychological health (P<0.01), and the age group of 31-35 years had the lowest scores (Mean±SD 62.00±5.16, 51±0.683) in both domains. A strong correlation (P<0.001) was observed between QoL, physical health (r=0.319), psychological (r=0.365), social (r=0.390) and environmental (r=0.388). From the box plot, QoL showed that spastic CP posed good QoL for mild depression while all other types had neither poor nor good QoL. Conclusion: A hidden issue in every parent is that CP children are the misfortune of their fate that increases their level of depression and consequently decreases their QoL.

Helicobacter pylori Infection in Children With Cerebral Palsy: A Cross-Sectional Study

BackgroundChildren with cerebral palsy (CP) frequently have associated disorders and complications, including gastrointestinal problems. Helicobacter pylori is a common infection worldwide, frequently associated with gastrointestinal manifestations. MethodsTo estimate the prevalence of H. pylori infection in children with CP, a cross-sectional study over an eight-month period was performed in the pediatric neurology outpatient clinic of Tanta University Hospital. The study included 100 patients with CP aged two to 17 years. All patients were tested for H. pylori antigen in stool by enzyme-linked immunosorbent assay. ResultsThe mean age of studied children with CP was 7.03 ± 4.1 years; there were 57 males and 43 females. Spastic quadriplegic CP was the most common type of CP (34%). Forty-five children with CP were positive for H. pylori antigen in stool. Intellectual disability (ID), low sociodemographic scoring system, semisolid diet, and Eating and Drinking Ability Classification System (EDACS) levels 4 and 5 were significant predictors of H. pylori infection (odds ratio of 1.86, 2.63, 12, and 1.77, respectively, P < 0.05). Vomiting, abdominal pain, and gastrointestinal tract bleeding were significantly more frequent in H. pylori-infected children with CP than noninfected children with CP (P value < 0.05) ConclusionH. pylori is a relatively common infection among children with CP. The main risk factors for H. pylori infection were low socioeconomic level, ID, semisolid diet, and EDACS levels 4 and 5.

Brain Magnetic Resonance Imaging in Indonesian Patients with Cerebral Palsy

Purpose: Cerebral palsy (CP) is a neurological health problem that affects children around the world and warrants particular attention. Magnetic resonance imaging (MRI) can be used to visualize brain disorders, as it provides a clear view of the brain’s anatomy, including the location of any damage or structural abnormalities. The objective of this study was to obtain a detailed MRI representation of patients with CP. Methods: This study employed a retrospective design involving the examination of medical records. It included CP patients aged between 1 and 16 years who had undergone brain MRI examinations. The Gross Motor Function Classification System scale was used to classify limitations in functional motor ability among these patients. The brain MRI results were categorized as either normal or abnormal. Results: Of 60 CP cases, 50% were classified as severe, with the remaining cases considered mild to moderate. Epilepsy was present in 66.7% of patients with severe CP. The most common type of CP, among both mild-to-moderate and severe cases, was quadriplegia. Gray matter lesions on brain MRI were more common in severe than mild-to-moderate cases, while vascular insult lesions and brain malformations were less frequent. A significant difference was observed in the severity of CP when a gray matter lesion was present on MRI. Conclusion: Most children with CP exhibited abnormal results on brain MRI. Lesions of the white and gray matter were the most frequently observed. MRI plays a crucial role in understanding the underlying pathological brain abnormalities in CP.

Cerebellar deep brain stimulation for the treatment of movement disorders in cerebral palsy.

Cerebral palsy (CP) represents the most common childhood physical disability that encompasses disorders of movement and posture attributed to nonprogressive disturbances that occurred in the developmental fetal or infant brain. Dyskinetic CP (DCP), the second most common type of CP after spastic forms, refers to a subset of patients in whom dystonia and choreoathetosis are the predominant motor manifestations. Most children with CP have abnormal brain MRI studies indicative of cortical and deep gray matter damage consistent with hypoxic ischemic encephalopathy, which may preclude or suggest decreased efficacy of standard deep brain stimulation (DBS) targets. The cerebellum has been posited as an attractive target for treatment of DCP because it is frequently spared from hypoxic ischemic damage and has shown promise in alleviating patient symptoms both in early work in the 1970s and in more recent case series with DBS. The authors performed bilateral cerebellar DBS implantation, targeting the dentate nucleus (DN) and cerebellar outflow pathway, in 3 patients with DCP. Leads were connected to a pulse generator that senses local field potentials during chronic continuous DBS. The authors report their surgical methods, examples of chronic cerebellar local field potential recordings, and preliminary clinical outcomes. Motor outcomes were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale. Three patients 14-22 years old with DCP and MRI evidence of structural damage to the basal ganglia were offered cerebellar stimulation targeting the DN. All patients tolerated the procedure well and demonstrated improvement in subjective motor function as well as objective improvement in the Burke-Fahn-Marsden Dystonia Rating Scale movement subscale, although the range of responses was variable (19%-40%). Patients experienced subjective improvement in motor function including ease of hand movements and coordination, gait, head control, speech, decreased overflow, and diminished muscle tightness. DBS of the dentate nuclei in patients with DCP appears to be safe and shows preliminary evidence of clinical benefit. New chronic sensing technology may allow for determination of in vivo mechanisms of network disruption in DCP and allow for further understanding of the effects of neuromodulation on brain physiology. Larger studies with long-term follow up will be required to further elucidate the clinical benefits of this therapy. This report addresses a gap in the literature regarding the technical approach to image-based stereotactic targeting and chronic neural recording in the DN.

Cerebral Palsy among Children Visiting the Outpatient Department of Pediatric Orthopaedics in a Tertiary Care Centre.

Cerebral palsy is a group of neurological disorders that appear in infancy or early childhood and occur as a result of anomalies in the developing brain that impair the brain's capacity to regulate movement, maintain posture, and maintain balance. Healthcare professionals can better predict the need for the medical, rehabilitative, and support services needed by people with cerebral palsy by using accurate prevalence statistics. The aim of the study was to find out the prevalence of cerebral palsy among children visiting the Outpatient Department of Pediatric Orthopaedics in a tertiary care centre. A descriptive cross-sectional study was conducted among patients visiting the Outpatient Department of Pediatric Orthopaedics in a tertiary care centre. Data from 1 January 2018 to 31 December 2019 was collected between 25 April 2023 to 5 May 2023 from medical records after obtaining ethical approval from the Institutional Review Committee. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 6984 children, the prevalence of cerebral palsy was 545 (7.80%) (7.17-8.43, 95% Confidence Interval). The most common type of cerebral palsy was found to be spastic diplegia 219 (40.18%). The prevalence of cerebral palsy among children visiting the Outpatient Department of Pediatric Orthopaedic was found to be higher than in other studies done in similar settings. cerebral palsy; prevalence; spastic diplegia.

Computed Tomographic Findings in Children with Cerebral Palsy in a Developing Country

Background: Cerebral palsy (CP) is one of the most common causes of chronic childhood disability. To know the aetiopathogenesis, severity and prognosis of CP, neuroimaging is an important modality of investigation. Objective: This study was done to observe the findings in CT scan of brain in children with CP. Materials and Methods: This is a cross-sectional descriptive study. One hundred and ten patients who were clinically diagnosed as cerebral palsy were enrolled in the study. After selection of the subjects, demographic and clinical characteristics were recorded. All other comorbidities including visual and hearing impairments were identified. CT scan of brain was done in all children and reporting had been done by a single qualified radiologist. Results: The mean age of the studied children was 2.6±2.2 years (1 to 14 years). Seven types of CP were found in the study group. Among them quadriplegic CP were the most common (39.1%). History of perinatal asphyxia was found in 81.8% children. Cognitive delay was found in 90% children, speech delay was found in 88.2% children, visual impairment was found in 35.5% children and hearing impairment in 31.8% cases. Epilepsy was found in 44.4% among studied subjects. Most common finding on CT scan of brain was cerebral atrophy (62.7%), followed by encephalomalacia (15.5%), calcification (13.6%), and brain malformations (11.8%). Abnormal CT scan findings were found in 88.2% of study population. Conclusion: This study showed that most common type of CP was quadriplegic CP. Maximum children had abnormal CT scan findings. Most common CT scan finding was cerebral atrophy. J Enam Med Col 2021; 11(1): 18-23

The relationship between the use of orthotics and foot deformity in cerebral palsy

Aim: Foot deformities are seen in more than 50% of children with cerebral palsy (CP). These deformities may cause gait deviations and mobility disorders over time. We aimed to examine the relationship between orthosis use, gait disturbances, and foot deformities in patients with cerebral palsy. Here, we aimed to analyze the relationship between orthosis use and foot deformities. &#x0D; Materials and Methods: The study was designed as cross-sectional, descriptive. One hundred and two patients who were admitted to Physical Medicine and Rehabilitation Health Care Committee were included. All patients were questioned about their age, birth history, maternal education level, orthosis use, surgery, and botulism toxin application. &#x0D; Detailed neurological examination of all participants (including walking analysis and spasticity) was performed by the same experienced physiatrist.&#x0D; &#x0D; Results: A total of 102 patients (41 males/61 females; mean age 10.1 ± 6.8 years) were included in the study. The most common type of CP was spastic tetraparesis (37.3%). Most commonly, crouch gait was observed in 23.5% of the patients. &#x0D; The rate of orthosis use in the lower extremity was 21.6%. The median duration of the use was 60 min/day, and the most frequent orthosis type was knee ankle foot orthosis (6.9%). Foot deformities were found in 84.3% of the patients (29.4%), and the most common foot deformity type was equinovarus. Also, 15.7% of the patients had botulism toxin application, and 9.8% had surgery. Foot deformity was observed less frequently in orthosis users (P= 0.042). Foot deformity was observed in 54.5% (n = 12) of the patients using orthosis. A negative correlation was found between spasticity score and ambulation (P= 0.00).&#x0D; &#x0D; Conclusion: Foot deformities were found high in non daily orthosis use group. With the widespread use of orthosis in children with CP, the development of foot deformities can be prevented.

Magnetic resonance imaging findings and the clinical characteristics of children with cerebral palsy at a public sector hospital in Gauteng Province, South Africa

Background. Cerebral palsy (CP) is a common cause of physical impairment in children. Brain magnetic resonance imaging (MRI) can define different neuropathological patterns of brain injury in CP. There are limited data available on MRI findings of children with CP in Africa. &#x0D; Objective. To describe the clinical characteristics, risk factors and MRI findings of children with CP attending a developmental clinic at a tertiary hospital in South Africa; and to assess possible associations between the clinical characteristics and pathogenic neuro-imaging patterns. &#x0D; Methods. This was a retrospective cross-sectional study. The cohort of 112 children was identified from the clinic’s REDcap database. Clinical information was obtained from existing medical records of the patients. Findings from brain MRI reports were classified according to the MRI classification system (MRICS) for CP. The MRI reports were rated independently by two study investigators. A descriptive analysis was conducted. &#x0D; Results. A total of 112 patient files and MRI brain reports were reviewed. Spastic CP was the most common type of CP (n=75%). The most common perinatal risk factors included prematurity (31%) and low birthweight (28%). Nineteen (17%) children acquired CP after the neonatal period. CP sub-type showed a significant association with functional motor impairment classified as per the gross motor function classification system (GMFCS), p&lt;0.001. Predominant grey matter injury (PGMI) was the most common pathogenic MRI pattern identified (30%). The radiological findings (per MRICS) had a significant association with both the CP sub-type (p&lt;0.005) and functional impairment according to the GMFCS (p&lt;0.001). &#x0D; Conclusion. Standardised classification of neuro-imaging findings can assist in defining the pathogenesis and clinical manifestations of CP.

Functional characterization of patients with cerebral palsy living in the Magallanes region and the Chilean Antarctic

To functionally characterize patients with Cerebral Palsy (CP) living in the Magallanes Re gion and the Chilean Antarctic. Descriptive-retrospective observational study of patients with cerebral palsy, registered in the Outpatient Rehabilitation Program of the Corporación de Rehabilitación Club de Leones Cruz del Sur de Punta Arenas between 1986 and 2018. Patients with CP were clinically categorized and then functionally characterized according to gross motor skills (GMFCS), manual ability (MACS), feeding ability (EDACS), and communication function (CFCS). 106 patients were included. Regarding the clinical classification, the most common type of CP was bilateral spastic paralysis, with the highest percentage of functional involvement in each of the evaluated areas, followed by unilateral spastic paralysis, while cases of dystonic CP and other non-classifiable types presented were less frequent. According to the clinical subclassification, spastic diplegia was more frequent, especially affecting manual and communication skills level I compared with hemiplegia, while cases of mixed and unclassifiable quadriplegia were less frequent with greater overall involvement of level I feeding skills. The observed results of CP in the Magalla nes Region and the Chilean Antarctic are similar to studies available in the literature. The complete evaluation and classification of patients with CP enable a better understanding of the pathology for future studies.

Clinical patterns of cerebral palsy with complications and neurodisabilities associated with cerebral palsy

Cerebral palsy was a primary neuromotor disorder that affects the development of movement, muscular tone and posture due to injury to the developing brain in prenatal, natal, or post-natal period. cp is non progressive disease but it is changeable features with period. The objective of this study is to identify clinical types of cerebral palsy and neuro-disabilities associated with cerebral palsy patient. Data (2019-2020) on 100 children of cerebral palsy in central teaching hospital in Baghdad analysis include clinical patterns of cerebral palsy and topographic classification of spastic cerebral palsy. also, the complication and neurological disabilities associated with cerebral palsy. In this analysis found most of cerebral palsy patients (84%) were spastic according to topographic classification, (47%) of spastic cerebral palsy was diplegic type. (29%) quadriplegic cerebral palsy and (8%) of hemiplegic cerebral palsy. About neurological complication and disabilities associated with cerebral palsy, (79%) of cerebral palsy patients had speech disturbance. (53%) had epilepsy, (43%) Micro acephaly, (32%) of patients had growth retardation, (29 %) had ocular problems, and (15%) of cerebral palsy patients had mental retardation. In conclusions; the most common type of cerebral palsy was spastic cerebral palsy &amp; according to a topographic classification diplegic spastic cerebral palsy was the most common type of Spastic cerebral palsy. About neurodisabilities associated with cerebral palsy, the most common disabilities were speech disturbance and epilepsy.

Correlation of Postural Asymmetries with Gross Motor Functional Classification among Cerebral Palsy Children

Background: Motor control and posture disorders are responsible in the development of cerebral palsy (CP). Spastic CP, the most common type of CP is associated with postural asymmetries resulting in functional limitation among children and compromising their quality of life. Therefore, the study aimed to describe the severity of postural asymmetries among special school going children with spastic cerebral palsy in correlation with Gross Motor Function Classification System levels (GMFCS). Methods: Thirty-four subjects from Lahore who were special school going children diagnosed with spastic CP for more than 6 months and less than 1 year were recruited. Children with uncontrolled seizures, hearing and visual impairment, surgery scheduled and other types of cerebral palsy were excluded. The scale used for the assessment of postural asymmetries was Posture and Postural Ability Scale with the reliability of 0.99. ANOVA test was applied with p&lt;0.05 considered as statistically significant. Results: Severe asymmetries were found in standing position with 5.9% (n=2) in frontal and 20.6% (n=7) in sagittal plane. There were mild asymmetries in supine position, 55.9% (n=19) in frontal and 50% (n=17) in sagittal plane. In prone position, reported asymmetries were 55.9% (n=19) in frontal and 44.1% (n=15) in sagittal plane. In sitting position 76.5% (n=26) accounted for both frontal and sagittal plane asymmetries. p&lt;0.05 showed significant distribution of postural asymmetries. Conclusion: Severe postural asymmetries were found in standing position (p&lt;0.05). However, high frequency of pain, scoliosis and hip dislocation were observed at level III of GMFCS among special school going children diagnosed with spastic cerebral palsy. Keywords: Cerebral Palsy; Children; Spastic; Muscle Spasticity.

Effect of a combined rehabilitation program with botulinum toxin type A injections on gross motor function scores in children with spastic cerebral palsy; a systematic review

Cerebral palsy (CP) is primarily a disease of movement and posture. Spastic CP is the most common type of CP and is characterized by muscle spasticity. The management of CP aims to improve the function of the patients. Botulinum toxin type A (BTX-A) is one of the most effective therapies for focal spasticity for children with CP. Rehabilitation is also effective for CP when applied to children aged younger than 6 years. The study aimed to assess the effect of the combination of a rehabilitation program and BTX-A on spastic CP among children by reviewing the previous studies conducted on this subject. PubMed and Google Scholar databases were used for searching purposes to obtain articles related to the subjects of interest. The included searching terms were rehabilitation, physiotherapy, CP, children, spasticity, effect, combination, and BTX-A, which were used in several combinations to obtain all possible articles related to the current subject. A total of 340 articles were obtained; only six articles were eligible for the inclusion criteria. The six studies included 368 patients, and the longest duration of assessment was up to 13 months. The collected data from the included studies were summarized in one table. The combination of BTX-A therapy and rehabilitation for spastic CP children resulted in significant improvements in function, reduction in spasticity, improving strength compared to using BTX-A alone.

Study on the Efficacy of Hydrotherapy Exercise Prescription on Walking Ability of Patients with Spastic Cerebral Palsy

Objective: Spastic cerebral palsy is the most common type of cerebral palsy and is characterized by increased skeletal muscle tone throughout the body, especially in the lower extremities. Long-term muscle spasticity and muscle strength imbalance can cause different degrees of fixed deformities in the lower extremities of cerebral palsy patients, which can seriously affect their walking ability and even their daily life. In this study, we will conduct hydrotherapy exercise prescription rehabilitation training for patients with spastic cerebral palsy aged 20-40 years old and analyze the effect of hydrotherapy exercise prescription on patients' walking ability using gait analysis system to provide a new idea of treatment for improving walking ability of cerebral palsy patients. Methods: Thirty-two patients with spastic cerebral palsy admitted to our hospital from January 2017 to February 2018 were selected as the experimental group, and a walking tank manufactured by HYDRO PHYSIO, UK, was used to maintain the water temperature at 34-40°C. 32 patients were rehabilitated with hydrotherapy exercise prescription for 8 weeks, 1 time/day, 20-30 min/time. In the experimental group, gait data were collected in Vicon 3D gait analysis system after 8 weeks. The gait data of 32 normal subjects in the control group and the gait data of the experimental group before and after treatment were compared and analyzed to study the effect of hydrotherapy exercise prescription on the walking ability of patients with spastic cerebral palsy aged 20-40 years. Results: After 8 weeks of treatment, the patients' gait data in frequency, stride length, stride speed, single support and double support were significantly improved (p < 0.05). Conclusion Hydrotherapy exercise prescription is effective in the treatment of walking ability in patients with spastic cerebral palsy and helps patients' lower limb balance and stability, which is worthy of application and promotion.

The Effect of Cerebral Palsy Disease Severity, Socioeconomic Status, and Educational Background on Selective Percutaneous Myofascial Lengthening Reoperation Rates.

Cerebral palsy (CP) is a neuro-developmental disorder. Spastic CP is the most common type of CP and is characterized by contractures of the extremities. Selective Percutaneous Myofascial Lengthening (SPML) is a minimally invasive procedure practiced by a handful of physicians in the US, and it decreases contractures and increases the range of motion in individuals with spastic CP. This study wanted to examine if there was an association between CP severity, socioeconomic status, and reoperation rates. This study used electronic medical records (EMR) to include 626 patients with spastic CP who had surgeries between January 2006 and December 2012. The zip codes from the EMR were used to determine the inflation-adjusted mean income and educational qualification (a high school education or higher) of the community via the US Census Bureau. Disease severity before the initial surgery was determined by using the functional mobility scale in the EMR to compute the Gross Motor Function Classification System (GMFCS) level. Then the data was graphed and averages were taken for the reoperation versus the no-reoperation populations, and Student's t-tests were run to determine statistical significance. The data showed that communities with higher education and income tended to reoperate more often. The higher number of reoperations in affluent communities could mean that either more affluent communities are better educated and know the benefits of bringing their children back for reoperation or that they require further education about physical therapy after the initial surgery to decrease the incidence of reoperation. This retrospective study is a level 2 study looking at the socioeconomic and educational backgrounds and disease severity and their association with reoperation rates.

USE OF BOTULINUM TOXIN A AND SUBSEQUENT REHABILITATION IN AMBULATORY CHILDREN WITH SPASTIC CEREBRAL PALSY – EFFECTS AND DILEMMAS

The definition of cerebral palsy (CP) includes a group of permanent developmental disorders of movement and posture that cause activity limitation due to non-progressive lesions in the developing fetal or newborn infant brain. The most common type of CP is spastic cerebral palsy (SCP). One of the primary aims in treating children with SCP is to enable them to perform functional activities, to stimulate effective movement, to prevent deformities of bone and joint system, and to reduce pain. Limb deformities are the most prominent manifestation in children with SCP, greatly preventing them from performing activities of daily living. The reduction of spasticity and prevention of contractures, the development of performing functional activities in the full potential, as well as delays in performing surgical intervention, have dramatically increased the use of botulinum toxin type A (BTA) in treating children with CP lately. It is known as the most potent neurotoxin found in nature that reduces spasticity after application and results in irreversible denervation at the neuromuscular junction, while functional recovery is time limited. In that time period it is necessary to evaluate the functional motor status of a child, clearly and realistically define aims in cooperation with parents, and apply adequate rehabilitation protocol. The international consensus statement in 2010 defined the protocol, dosage, the site of application, and rehabilitation protocol. After being used for two and a half decades, certain dilemmas arose, particularly those regarding rehabilitation effects after BTA application.

Pattern of Cerebral Palsy Among Sudanese Children Less Than 15 Years of Age.

Background: Cerebral palsy (CP) is a non-progressive, everlasting neurological disorder of movement, posture, and physical activities, with a prevalence of 2.2-3.3/1,000. CP is a condition that occurs globally, with a similar prevalence in both developed and undeveloped countries. However, the etiology differs according to the socioeconomic status of the countries. The objective is to determine the pattern and the contributing factors of CP among Sudanese children.Methods: This was a retrospective hospital-based study conducted over a period of three years in a pediatric referral hospital in Khartoum, Sudan. One hundred and eight patients of CP were enrolled, of whom 59 (54.6%) were males and 49 (45.4%) were females.Results: Spastic quadriplegic CP was the most common type. Most cases were from lower social classes. Prenatal, antenatal, and unclassified CP were found in 45 (41.7%), 31 (28.7.%), 23 (21.3%), and 9 (8.3%) cases, respectively. Birth asphyxia, neonatal jaundice, Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus infections (TORCH), and sepsis (acquired) were the main causative factors.Conclusion: Spastic quadriplegia is the most common type of CP. Most of the cases had a direct positive relationship with socioeconomic status. The prenatal period was the most common period for the development of CP.

Characteristics and predisposing factors for cerebral palsy in children in Medina, Saudi Arabia

Background: Cerebral palsy (CP) is a heterogeneous disease with different causes and clinical types. It is the leading condition that causes life-long disability in children worldwide. The current study aimed at identifying the prevalence, most common risk factors, and types of CP among infants and children in the city of Medina over 10 years (2009-2018). Methodology: This retrospective descriptive study screened all medical files of children diagnosed with CP at the main neurological center of Medina (Maternity and Children Hospital). Results: The current study showed that the prevalence of CP among children in Medina is 3.5 per 1,000 live births. The most common age of CP diagnosis was between 12 and 24 months, with a percentage of 38.3%. The most common type of CP among children in Medina was spastic (82.05%), followed by ataxic (9.83%), and dyskinetic (8.12%). Regarding the risk factors for CP, mixed risk factors were the most common (38.2%), followed by perinatal (34.3%) and postnatal (17.6%) factors; whereas, antenatal (7.3%) and unknown (2.6%) risk factors were less common. Conclusion: The prevalence of CP in Medina is 3.5 per 1,000 live births. Regarding risk factors, mixed risk factors were most common, followed by perinatal, postnatal, and antenatal factors. The most common type of CP in Medina children was spastic, followed by ataxic and dyskinetic.

Characteristics of Epilepsy in Children with Cerebral Palsy

Cerebral palsy is a disorder of movement and posture due to disruption of the immature motoric cells in central nervous systems. It is characterized by various neurological abnormalities, one of them is epilepsy. Epilepsy is difficult to control, as it is able to aggravate motor disorders and disrupt cognitive function, ultimately worsening the long-term outcome. This research aims to determine the characteristics of epilepsy in children with cerebral palsy. A cross-sectional study was done based on medical records data Pediatric Outpatient Department and Medical Rehabilitation Installation Sanglah Hospital from January 2016 until June 2018. Eighty-four samples were included. Most of the samples were female (53.6%) with mean of age was 64 months and onset of epilepsy was 21 months. Regarding to nutritional status, most of them with undernutrition (44%). Based on birth history, 66.7% of them was born by spontaneous delivery, 34.5% with asphyxia and 82.1% were normal birth weight. Generalized seizure was the most common type of seizure (81%). Most types of cerebral palsy were spastic type (94%). History of seizures at <1 year of age was 63.1%. History of central nervous system infection was 15.5%. The most brain abnormalities was microcephaly (34.5%). Abnormal EEG results were about 91.7%, with family history of seizures was 1.2%. Frequency of polytherapy with anti-epileptic drugs was 69%. The most common type of cerebral palsy in this research was spastic type. Generalized seizure was the most common type of seizure in epilepsy children with cerebral palsy. Most of them have abnormal EEG results and need more than one anti-epileptic therapy.

A Case Study on the Ayurvedic Managment of Spastic Cerebral Palsy Due to Birth Asphyxia

Background: Cerebral palsy is a disorder of motor control due to a static lesion of the developing brain. It was described almost 150 years ago. Global incidence of Cerebral Palsy is 2 to 2.5/1000 children but in Indian scenario, incidence is 03.8% of population. In India about twenty-five Lakh children are suffering from cerebral palsy. Most common type of cerebral palsy is spastic which cover 70% to 75% of overall. There is no exact correlation found for cerebral palsy in Ayurvedic literature but may be the result of Shiromarmabhighata (injury to brain) and can be considered as Vata Vikara or Vata Vyadhi (neurological disorders). Aim: To assess the effect of certain oral medication with Purvakarma (preparatory procedures) and Panchakarma procedures (Five-fold measures of Bio-cleansing) in the management of Cerebral Palsy (CP). Material and Method: In this case study, one case of Spastic cerebral palsy was registered and treated with multiple Ayurvedic treatment modalities. Total period of treatment was 93 days in which 5 days of Abhyanga (Massage) with Nadi swedana (steam kettle Sudation), 5 days of Abhyanga (Massage) with Shashti Shali Pinda Swedana (a type of Sudation) and then 7 days of Matra Vasti (Enema by Medicated oil in small dose) by Ksheera Bala Taila; this schedule of treatment was given three times with a gap of 14 days. Vacha mula (Root of Acorus calamus ) and Samvardhana Ghrita was given as internal medication during the total course of treatment. Results were assessed by progress in delayed milestone, anthropometrical measurement, modified Ashworth scale, muscle power grading and Manual Ability Classification System (MACS) scale. Result: Treatment protocol of oral medication with Panchkarma delivered better result in CP patient, especially improving anthropometric data (weight, height, chest circumference), delaying milestone (walking and language), reducing spasticity and improved Quality of Life (QOL). Conclusion: Cerebral palsy is a disorder of motor function. The cause originates from the brain sometime during its developmental period. Internal medication along with Purvakarma (preparatory procedures) and Panchakarma (Five-fold measures of Bio-cleansing) give significant improvement in all the facets of spastic CP.