Palsy Children Research Articles

Prevalence and temporal trends of cerebral palsy in children born from 2002 to 2017 in Ontario, Canada: Population-based cohort study.

To examine the prevalence and temporal trends of cerebral palsy (CP) overall and by population characteristics. We identified 2 110 177 live births born in the province of Ontario, Canada, between 2002 and 2017 using administrative health data and estimated CP prevalence in children aged 0 to 16 years overall and by specific population characteristics. We also examined temporal trends in CP rates-overall and by characteristics-in young children (0-4 years) by their year of birth between 2002 and 2013 (n=1 587 087 live births) to allow for an equal follow-up time (4 years and 364 days) for all children. Overall CP prevalence among children aged 0 to 16 years was 2.52 (95% confidence interval 2.45-2.59) per 1000 live births. CP rates in ages 0 to 4 years peaked at 2.86 in 2007 births, but steadily declined afterwards to 1.94 per 1000 live births in 2013. CP rates were higher in children born preterm, small for gestational age, males, multiples, children with congenital malformations, and in children of young (<20 years), old (≥40 years), primiparous, or grand multiparous (≥4) mothers; differences by these characteristics decreased over time. We observed socioeconomic disparities in CP rates that persisted over time. Despite the decreasing trend of CP rates overall, CP rates varied by the child and maternal characteristics over time. Overall cerebral palsy (CP) prevalence was 2.5 per 1000 live births among children born from 2002 to 2017. CP prevalence peaked in children born in 2007 then steadily decreased between 2007 and 2013. Changes in CP rates varied over time by child and maternal characteristics. Socioeconomic inequalities in CP persisted and remained stable over the study period.

Conducting public health surveillance in areas of armed conflict and restricted population access: a qualitative case study of polio surveillance in conflict-affected areas of Borno State, Nigeria

This study examined the impact of armed conflict on public health surveillance systems, the limitations of traditional surveillance in this context, and innovative strategies to overcome these limitations. A qualitative case study was conducted to examine the factors affecting the functioning of poliovirus surveillance in conflict-affected areas of Borno state, Nigeria using semi-structured interviews of a purposeful sample of participants. The main inhibitors of surveillance were inaccessibility, the destroyed health infrastructure, and the destroyed communication network. These three challenges created a situation in which the traditional polio surveillance system could not function. Three strategies to overcome these challenges were viewed by respondents as the most impactful. First, local community informants were recruited to conduct surveillance for acute flaccid paralysis in children in the inaccessible areas. Second, the informants engaged in local-level negotiation with the insurgency groups to bring children with paralysis to accessible areas for investigation and sample collection. Third, GIS technology was used to track the places reached for surveillance and vaccination and to estimate the size and location of the inaccessible population. A modified monitoring system tracked tailored indicators including the number of places reached for surveillance and the number of acute flaccid paralysis cases detected and investigated, and utilized GIS technology to map the reach of the program. The surveillance strategies used in Borno were successful in increasing surveillance sensitivity in an area of protracted conflict and inaccessibility. This approach and some of the specific strategies may be useful in other areas of armed conflict.

Botulinum Injection Into the Proximal Intestinal Wall of Diet-Induced Obese Mice Leads to Weight Loss and Improves Glucose and Fat Tolerance.

Botulinum neurotoxin (available commercially as BOTOX) has been used successfully for treatment of several neuromuscular disorders, including blepharospasm, dystonia, spasticity, and cerebral palsy in children. Our data demonstrate that injection of Botox into the proximal intestinal wall of diet-induced obese (DIO) mice induces weight loss and reduces food intake. This was associated with amelioration of hyperglycemia, hyperlipidemia, and significant improvement of glucose tolerance without alteration of energy expenditure. We also observed accelerated gastrointestinal transit and significant reductions in glucose and lipid absorption, which may account, at least in part, for the observed weight loss and robust metabolic benefits, although possible systemic effects occurring as a consequence of central and/or peripheral signaling cannot be ignored. The observed metabolic benefits were found to be largely independent of weight loss, as demonstrated by pair-feeding experiments. Effects lasted ∼8 weeks, for as long as the half-life of Botox as reported in prior rodent studies. These results have valuable clinical implications. If the observed effects are translatable in humans, this approach could lay the foundation for therapeutic approaches geared toward robust and sustained weight loss, mimicking some of the benefits of bariatric operations without its cost and complications.

Risk factors of cerebral palsy in children: a systematic review and meta-analysis.

This study aimed to explore the main risk factors for cerebral palsy in children by meta-analysis of the literature on the risk factors of cerebral palsy. We performed a literature search of the PubMed, EMBASE, Medline, and CENTRAL databases using the following search terms: ("cerebrl plsy" or "cerebrl plsis" or "infantile cerebral palsy") and ("risk factors"). Case-control or cohort studies of children with cerebral palsy and healthy children were included for meta-analysis. The Newcastle-Ottawa Scale (NOS) of case-control studies was used to evaluate the quality of the included studies. The Chi-square test was used to test the heterogeneity of the literature. This study used subgroup analysis and sensitivity analysis to identify sources of heterogeneity. If subgroup analyses and sensitivity analyses could not identify the source of heterogeneity, no pooling between study results was performed, and only individual study results were described. In this study, Egger's test was used to test for publication bias. The random-effects model was used when heterogeneity existed, and the fixed-effect model was applied when heterogeneity did not exist. A total of 1,836 related articles were retrieved. After screening, 13 articles were included in the analysis, involving a total of 2,489 children with cerebral palsy and 4,782 children without cerebral palsy. None of the included articles achieved a NOS score of 9, four articles scored 8, eight articles scored 7, and one article scored 6. Meta-analysis showed that maternal hypertension during pregnancy, premature rupture of membranes, premature delivery and emergency cesarean section were risk factors for cerebral palsy in children, and there was no heterogeneity among the literatures and no publication bias. This study identified gestational hypertension, preterm birth, premature rupture of membranes, and emergency cesarean section as risk factors for cerebral palsy in children through meta-analysis, providing a reference for risk monitoring and clinical intervention.

Risk factors of cerebral palsy in children, patterns and associated troubles

Introduction: Cerebral palsy is the most common neurological disorder seen in childhood, and part of chronic diseases at this stage, which poses a great social and economic challenge at the family level, medical staff and rehabilitation centers. To assess the actual needs for patient management in various fields, it was necessary to study the problem at the local level. The main objectives: To study the risk factors associated with cerebral palsy in children attending the Neurological Clinic in Tishreen University Hospital. Materials and methods: The study included all children diagnosed with cerebral palsy up to the age of 14 who attended the Neurology Clinic at Tishreen University Hospital during the study period from May 2020 to June 2021. Data were analyzed according to: gender distribution, age of the injured, method of delivery, and the age at which the child first attended the clinic. In addition to studying potential risk factors during pregnancy, and causes in the perinatal and postpartum period. Cerebral palsy was stereotyped and the degree of disability was determined based on the clinical examination and the need for aids. The accompanying disorders and the various complaints that these children were referred to were recorded and included in categories. The diagnosis was based on clinical examination, pathological history, radiological investigations and available laboratory analyzes. Results: The sample included 163 children with a male preponderance of 68%. In the research sample, there was a relationship between the parents of 40 children at a rate of 24.5%. The risk factors that were found in the mothers of the children were sepsis during pregnancy, diabetes and preeclampsia. The form of perinatal asphyxia was the most dangerous perinatal factor seen and there was no differences in the method of delivery. The most causative factor after birth is the need for oxygen or a ventilator. Delayed milestone, speech delay, and convulsions constituted the most associated troubles. The spastic pattern is the most frequently seen pattern. As for the applied procedures, the most common was CT scan with 71.8.

The main risk factors for the development of cerebral palsy in children

Introduction. Currently, worldwide the formation of cerebral palsy (CP) makes a great contribution to the gain in childhood disability prevalence. The goal is to conduct a comparative analysis of risk factors and the main causes of the development of CP in children living in the Belgorod region for the period from 2020 to 2021. Materials and methods. There were analyzed histories of two hundred two CP children aged from four months to seven years. Results. Spastic forms of the disease predominated in the structure of infantile CP. Significantly more often this pathology occurred in premature babies at an early age and children residing in urban areas. The most frequent risk factors for the onset of the disease were such pathology of pregnancy as chronic fetoplacental insufficiency and chronic intrauterine fetal hypoxia. Delayed psycho-speech development had a leading place among all manifestations of the central nervous system in CP patients is beyond doubt. An analysis of the causes leading to the onset of the disease showed that in most cases it is not possible to discriminate one of them, since a combination of several unfavourable factors is often noted during pregnancy and parturition. CP children require constant care from relatives, long courses of complex drug and rehabilitation treatment.

Acute Facial Nerve Palsy in Children: Gold Standard Management.

Facial nerve palsy (FNP) is a common illness in the paediatric emergency department. Missed or delayed diagnosis can have a serious impact on a patient’s quality of life. The aim of this article is to give a recent overview of this pathology in terms of the causes, diagnosis, red flag symptoms, complementary examinations, treatments and follow-up in the child population. In cases of acquired, acute onset and isolated FNP, Bell’s palsy can be assumed, and no further investigation is required. In any other scenario, complementary examinations are required. Treatment depends on the aetiology. Corticosteroids, in addition to antiviral medication, are recommended to treat Bell’s palsy whenever a viral infection is suspected. However, the lack of randomised control trials in the paediatric population does not allow us to comment on the effectiveness of these treatments. In all cases, treated or not, children have a very good recovery rate. This review emphasises the necessity of randomised control trials concerning this frequent neurological pathology in order to better treat these children.

Hypertension Presenting As Bell's Palsy In Children

Hypertension Presenting As Bell's Palsy In Children

Research progress of Chinese and Western medicine on spastic cerebral palsy in children in recent ten years

Research progress of Chinese and Western medicine on spastic cerebral palsy in children in recent ten years

Peripheral facial nerve palsy in children during the COVID-19 pandemic.

During the COVID-19 pandemic, an increased frequency of peripheral facial nerve palsy has been described in adults and children. The etiology of the disease during this time remains unclear, since most cases occurred in patients who tested negative for SARS-CoV-2 infection. Retrospective study of pediatric cases of facial nerve palsy treated during the first year of the pandemic in the emergency department of a children´s hospital located in one of the areas with the highest prevalence of COVID-19 in Spain. Data from this period are compared with cases from the previous three years. Twenty-nine patients with Bell's palsy were included. Over the previous three years combined, 24 patients presented with the same condition, a more than threefold increase. No clinical differences were found between the groups apart from the fact that fewer patients received corticosteroids during the pandemic (13.8% vs 41.6%; p = 0.022). Fourteen children underwent microbiologic testing for active SARS-CoV-2 infection (12 polymerase chain reaction, two rapid antigen test); all were negative. Thirteen patients received serologic testing, two with a positive IgG (15.3%). A substantial increase in hospital presentations for facial nerve palsy was observed among children and adolescents during the first year of the pandemic, though findings of microbiologic testing cannot confirm a direct link with SARS-CoV-2 infection in most cases. Patient characteristics did not change between the two time periods. Difficulty accessing primary-care facilities during the pandemic in Spain may have played a role in this increase.

Speech by children with cerebral palsy in an education cluster mechanisms of work on

This article provides information about what is cerebral palsy, its causes, their speech and speech motor skills, the mechanism of work with cerebral palsy in children there is a hyperkinetic form associated with the destruction of the sub cortical centers.

Chuna Manual Therapy for Cerebral Palsy in Children: A Systematic Review and Meta-analysis

Objectives This study was aimed to evaluate the effects of Chuna manual therapy (CMT) for the treatment of cerebral palsy. Methods The randomized controlled trials (RCTs) on the treatment of CMT for cerebral palsy in children were selected among the literature published until January 2021 in seven databases. The quality of the literature was evaluated using the Cochrane s risk of bias tool, and RevMan 5.3 was used for the synthesis of results. Results Total 801 pediatric patient with cerebral palsy incontinence were finally selected from twelve RCTs. The total effective rate of the combined treatment general rehabilitation and CMT is statistically significantly higher (P<0.0001) than that of general rehabilitation alone. Conclusions This study suggests that general rehabilitation combined with CMT for cerebral palsy in children might be more effective in improving symptoms than general rehabilitation alone. As the number and quality of the literature included in the meta-analysis was insufficient, high-quality clinical studies on CMT for cerebral palsy would be required.

Declining prevalence of cerebral palsy in children born at term in Denmark.

To investigate reasons for the declining prevalence of cerebral palsy (CP) in children born at term in Denmark by evaluating obstetric and neonatal factors associated with CP, and their changes over time. In this cohort study, we included 987 495 children (504 600 [51.1%] males and 482 895 [48.9%] females) born after 37 completed gestational weeks during birth years 1997 to 2013. Risk ratios of CP for each factor were calculated with log-binominal regression analyses. Significant factors were evaluated concerning their development in prevalence over time. In the antenatal period, there were significant associations with an increased risk of CP and high maternal body mass index (BMI), smoking during pregnancy, nulliparity, male sex, gestational age, and low birthweight. In the study period, fewer females smoked during pregnancy and fewer children were born post-term, dropping from 22.6% to 11.4% and 9.4% to 2.5% respectively. Conversely, the proportion of females with high BMI increased. Most significant risk factors were found in the neonatal period, with an increase in children with diagnosed birth defects and children admitted to neonatal care. Reasons for the declining prevalence of CP appear to be multifactorial and likely include the decline in maternal smoking and children born post-term along with centralization and advances in neonatal treatment.

Cost analysis of botulinum therapy of spastic forms of cerebral palsy in Ukraine

Cerebral palsy (CP) represents a group of disorders of the mechanisms of movement and body position, causing limitations of activity, which are caused by non-progressive damage to the developing brain, fetus or child. About 80% of cases are spastic forms of cerebral palsy. Along with motor rehabilitation, the use of botulinum toxin type A (BoNT-A) is considered one of the main methods of treatment of choice for focal spastic and dystonic syndromes, regardless of their etiology. At present, there are no studies in Ukraine on the analysis of the costs of using drugs based on BoNT-A, taking into account the recommended dose and frequency of administration.&#x0D; The aim of the work. Carrying out an analysis of minimizing the cost of botulinum therapy for spastic forms of cerebral palsy in patients aged two years and older.&#x0D; The annual dosage and frequency of administration of abobotulotoxin and onabotolutoxin for the treatment of dynamic equinus deformity of the foot caused by focal spasticity due to cerebral palsy in children over two years of age were obtained from the instructions for use. The cost of abobotulotoxin and onabotolutoxin was obtained from the Register of Wholesale Prices of the Ministry of Health of Ukraine.&#x0D; Cost analysis for a model cohort of children in different weight categories showed that abobotulotoxin 500 U will be the least expensive treatment technology in the weight category of 21–33 kg at a dosage of 15 U/kg in the treatment of diplegia. Abobotulotoxin 300 U is most rationally used in weight categories 10–20 kg and 34–40 kg with a dosage of 15 U/kg in the treatment of hemiplegia and in the weight category 17–20 kg with a dosage of 30 U/kg in the treatment of diplegia. Weight categories were identified in which the costs of using abobotulotoxin 300 U and abobotulotoxin 500 U were equal to and less than the costs of onabotolutoxin treatment.&#x0D; The study was the first to analyze the cost of botulinum therapy, which identified the benefits of abobotulotoxin in the symptomatic treatment of hemiplegia and diplegia in cerebral palsy in the focus of different weight groups of children. Possible variability in the dosage and frequency of administration of onabotolutoxin per year indicates the relevance of collecting additional information on the application in real clinical practice and further pharmacoeconomic studies.

Effect of etiological factors on treatment success of pediatric facial paralysis: Success of facial paralysis in children.

Facial paralysis is a clinical condition that causes anxiety in the family and is one of the reasons for urgent admission to the hospital. The purpose of this article is to evaluate to reveal the relationship between etiology and treatment results in childhood facial paralysis.Thirty-three patients who presented with facial paralysis between May 2018 and May 2020, had adequate follow-up were included in the study. Data were reviewed age, gender, side, etiology, features of family, treatment, results, and recurrences.The ages of the cases ranged from 21 months to 17 years, with the mean age was 13.1 years. Ten of the cases were male (30.3%), 23 of them were female (69.7%). It was observed that 15 (45.4%) of the paralysis were on the right half of the face, 17 (51.5%) were on the left side of the face, and 1 (3.1%) had bilateral involvement. However, it was learned from the story that 3 cases had recurrence. Thirty-two (96.9%) of the cases were peripheral and 1 (3.1%) had central facial paralysis. No cause could be found in the etiology of other peripheral paralysis cases and it was considered as Bell Paralysis. According to the House Brackmann Stage at the time of admission of 30 patients who were given steroid treatment, 10 patients were evaluated as stage 6, 15 patients as stage 5, and 5 patients as stage 4. After 6 months of follow-up, 27 patients were evaluated as stage 1 and 2 patients as stage 2. Recurrence was not observed in any of the patients who recovered.It was concluded that etiology determines the success of treatment in facial paralysis.

Sixth Nerve Palsy in Children Etiology, Long-Term Course, and a Diagnostic Algorithm.

Acute onset strabismus is worrisome for parents and physicians. This condition is sometimes attributed to sixth cranial nerve palsy, which may be secondary to various etiologies. Debate still exists about the appropriate diagnostic approach. The objective of this study was to describe the common etiologies of sixth nerve palsy in our pediatric population and to suggest a clear, implementable diagnostic algorithm. The authors conducted an electronic medical review of files of patients admitted to the pediatric department at Emek Medical Center between January 2014 and April 2020. They reviewed the medical records from the study period of patients with the following diagnoses according to the International Classification of Diseases 9: sixth nerve palsy, acute infective polyneuritis, Guillain-Barré syndrome, benign intracranial hypertension, malignant neoplasm of the brain, strabismus, myasthenia gravis, and multiple sclerosis. The authors extracted information regarding clinical presentation, previous history, and diagnostic work-up, including serological testing, cerebrospinal fluid testing, and neuroimaging. Final diagnosis and clinical follow-up were assessed. Seventeen patients with sixth nerve palsy were identified. The most common etiologies were increased intracranial hypertension and anti-GQ1B syndrome (3 patients each). This is a retrospective study of patients diagnosed in one medical center. The suggested algorithm was not validated on a prospective study. The etiologies of sixth nerve palsy in children are variable. The authors suggest performing neuroimaging in all patients and considering serum and cerebrospinal fluid testing in selected patients. Initial neuroimaging combined with laboratory testing is useful and provides rational tools for proper diagnosis.

Cerebral palsy in children: subtypes, motor function and associated impairments in Addis Ababa, Ethiopia

BackgroundAlthough, there is no population-level data in Ethiopia, a previous retrospective hospital-based study identified CP as the most common developmental disability in children. The overall aim of this study is to describe the clinical spectrum of CP in Tikur Anbessa Specialized Hospital in Addis Ababa, including CP subtype, gross and fine motor function, presence and pattern of associated impairments, and possible risk factors in children aged 2 to 18 years.MethodsA hospital-based descriptive cross-sectional study conducted- July – September of 2018 among 207 children with suspected motor symptoms. The Surveillance of CP in Europe (SCPE) decision tree was used as a guideline for inclusion and evaluation was by standardized questionnaire and clinical examination. Descriptive, bivariate and multivariate statistical analyses, Chi-square test, crudes association and adjusted odds ratio with 95% confidence interval employed.ResultOne hundred seventy four children who fulfilled the clinical criteria were included. Half (50.6%) were under the age of 5 years with a mean age of 5.6 (SD 3.6) years; 55.2 were male. The majority had bilateral spastic CP (60.4%) followed by unilateral spastic CP 21.8%, dyskinetic CP 10.4%, and ataxic CP 3.4%; 4% were unclassifiable. Of the children, 95.4% had speech difficulty, 87.4% learning disabilities, 60.9% epilepsy, 24.7% visual impairment and 8.6% hearing impairment. On gross motor function (GMFCS) and manual ability (MACS) classification systems, 75.3% of the children had level IV and V functional impairment. More than 80% of the mothers had complications during delivery Half of the neonates did not cry immediately after birth,44% were resuscitated with bag mask ventilation at birth and 64% immediately admitted to NICU. During the first month of life, 50% had infection, 62% had trouble feeding, 49.4% had difficulty breathing, 35% had seizure and 13.8% had jaundice.ConclusionThe severe forms of CP predominate; most children are dependent on their parents for routine activities of daily living and cannot communicate well. Multidisciplinary care approaches and focused functional habilitation services are needed. Causal relationships cannot be drawn from these data but findings make a strong argument for improving maternal and child health care.

Computer-Aided Diagnosis of Children with Cerebral Palsy under Deep Learning Convolutional Neural Network Image Segmentation Model Combined with Three-Dimensional Cranial Magnetic Resonance Imaging.

In this paper, we analyzed the application value and effect of deep learn-based image segmentation model of convolutional neural network (CNN) algorithm combined with 3D brain magnetic resonance imaging (MRI) in diagnosis of cerebral palsy in children. 3D brain model was segmented based on CNN algorithm to obtain the segmented MRI images of brain tissue, and the validity was verified. Then, 70 children with cerebral palsy were rolled into the observation group (n = 35), which received MRI for diagnosis after segmentation of brain tissue, and control group (n = 35), which were diagnosed by computed tomography (CT). The diagnosis results of the two groups were compared. The validity experiment verified that the image segmentation method based on CNN algorithm can obtain effective style graphics. In clinical trials, the diagnostic accuracy of 88.6% in the observation group was evidently superior to that of 80% in the control group (P < 0.05). In the observation group, one patient was diagnosed as normal, four patients had white matter lesions, 17 patients had corpus callosum lesions, and five patients had basal ganglia softening foci. In the control group, two patients were diagnosed as normal, two patients had white matter lesions, 19 patients had corpus callosum lesions, and four patients had basal ganglia softening foci. No notable difference was found between the two groups (P > 0.05). According to the research results, in the diagnosis of cerebral palsy in children, the image segmentation of brain 3D model based on CNN to obtain the MRI image of segmented brain tissue can effectively improve the detection accuracy. Moreover, the specific symptoms can be diagnosed clearly. It can provide the corresponding diagnostic basis for clinical diagnosis and treatment and was worthy of clinical promotion.

Оценка уровня эндотелиального фактора роста сосудов и моноцитарного хемоаттрактанта при детском церебральном параличе

Objective. The aim of this article is to assess the role of vascular endothelial growth factor and monocytic chemoattractant in the development of cerebral palsy in children. Materials and methods. Examination of 77 children with different clinical forms of infantile cerebral palsy in the age group from 1 to 16 years was carried out. The content of monocyte chemoattractant (MCP) and vascular growth factor (VEGF) was determined in different forms of cerebral palsy. The obtained data were processed statistically. Results. The analysis of the obtained data revealed a significant increase in the indicators of monocytic chemoattractant and vascular growth factor in children with infantile cerebral palsy compared with healthy children. There were no significant differences between the indicators of MCP and VEGF in children with cerebral palsy and comorbid pathology and children with cerebral palsy without concomitant pathology. Conclusion. The authors of the presented analysis conclude that the determination of monocytic chemoattractant and vascular growth factor has a high diagnostic value for identifying a predisposition to the development of cerebral palsy. Timely detection of an increase in the level of these factors provides a broader prospective for early diagnosis of the disease and for the early implementation of rehabilitation measures accordingly.

Impact of social support for mothers as caregivers of cerebral palsy children in Japan

PurposeSocial supports are critical to alleviate the psychological and physical burden of primary caregivers of children with disabilities. This study aims to (1) clarify how cerebral palsy in children affects caregiving burden of the mother, and (2) identify the social supports that can effectively reduce that burden. Design and methodsThis is a cross-sectional study in which mothers of children with cerebral palsy completed questionnaires and provided data regarding their child's condition, family support, social support usage, degree of satisfaction with supports, and caregiving burden. ResultsWe analyzed responses from 1190 mothers. Support usage, particularly of home-visit nursing, home care, home-visit rehabilitation, and mobility support, was higher in severely burdened groups. However, the proportion of satisfaction with social support in groups with light or no burden were higher, particularly in home care, home-visit rehabilitation, training/treatment, and short stays. Mothers whose children have an intellectual disability and gross exercise ≥1 in addition to tube feeding or intravenous nutrition especially felt a strong sense of burden. The most effective measure in reducing mother's sense of burden was short stays. ConclusionsMothers with children who can move and have an intellectual disability felt more burden compared with mothers of bedridden children. The findings clarify that supports, such as home care and short stays, have a significant impact on reducing the mother's sense of burden. Practice implicationsDue to the large sample size, we believe that the results can inform efforts to increase social support for caregivers.