Known Risk Factors and Comorbidities in 100 Cases of Cerebral Palsy : in a Neurology f , ' ollow up Clinic

Abstract: Background: Cerebral palsy (CP) is a major cause of crippling in children. Several antenatal, natal and post natal factors for CP like birth asphyxia and preterm & LBW deliveries were identified. Objective: To see the presence of known risk factors of CP and co-morbidities in our setting. Methods: In this study 100 cases of cerebral palsy attending the child neurology out-patient department Bangabandhu Sheikh Mujib Medical University (BSMMU) were evaluated with special attention to risk factors of CP. Full evaluation was done to find out co-morbidities. Results: Birth asphyxia (49%) was the most common risk factor. Mental retardation; speech problem and seizure were common co-morbidities. Conclusion: As birth asphyxia is common risk factor of cerebral palsy, it may be reduced by improving perinatal care.


Introduction:
known risk factor and co-morbidities of cerebral palsy in Cerebral palsy is a diagnostic term used to describe u this center' group of permanent disorders of movement and posture Methods: causing activity limitation that are atkibuted to nonprogressive disturbances in the developing fetal or infant This cross sectional study was done at the out-patient brain.The incidence of cerebral palsy varies between l-6 service of Paediatric Neurology, Department of Pediat- per thousand live births r.In the recent past this figure is rics, BSMMU, Dhaka, Bangladesh.Consecutive one changed with a slight increase hend that coincide with the hundred children aged 1-10 years suffering from cerebral increased survival rate of infants with very low birth palsy were selected for this study.Children who were weight.2In third world countries like Bangladesh, cerebral suspected neurodegenerative disease and neurometabolic palsy (CP) is becoming a major cause of disability.About disorders were excluded.After -fulfill initial criteria, 32Yo patient attended in the Child Neurology unit of detailedhistorywastakenwithspecialattentiontoantena- Bangababdhu Sheikh Mujib Medical University were tal, natal and postnatal risk factors and associated diagnosed as cerebral palsy.3 As there is no cure for problems.Thorough physical examination, development cerebral palsy, it is necessary to prevent the disease with assessment and neurological examination were done.identiffing risk factors .Several studies in developed Cerebral palsy cases were classified using topographical countries was carried out to identif,i the risk factors of CP. and physiological as well as using gross motor function They found birth asphyxia, preterm, low birth weight, scale.Psychological assessment was done in all cases by neonatal jaundice, post natal infection were common a,'.appropriate tools.Ophthalmological and hearing assess- This study was aimed to observe the frequency of those ment was done in all cases but EEG was done for selected Address for Correspondence: orMohammedMahbubullslam cases.All findings were recorded in structured question- Consultant,DepartmentofPediatricsGastroenterology&Nutrition naire fOr analySiS.EVery Child WaS managed With bOth BSMMU' ce'' Phone No-01711-310493' Email: mahbub25somc@gmail com pharmacologicar and developmental therapy.

Results:
A total 100 cases of CP were included in this study.Three quarter of the studied cases (7 4%) were in the 1-5 years age range and male preponderance were found (Table I).

Vo1
Issue I Jan 2013 Birth asphyxia was found as risk factor in all types of CP Neonatal hyperbilirubenimia was found in maximum with the highest frequency in spastic tetraplegia (38.8%).frequency with dyskinetic CP.Birth asphyxia, prolonged Preterm birth was found in next higher frequency among labor, preterm & LBW was found in much high frequency risk factors and mostly with spastic diplegia (55.9).spastic diplegia and spastic tetraplegia (Table III).Low vision (9) Feeding difficulty (7) Hearing impairment (5)   20(60 %) ts{s7  IV.Mental retardation as the commonest associated problem and mostly were with spastic tetraplegia (60%).Rest were equally distributed in other type.Speech and language delay was cofirmonly associated with spastic tetraplegia (57.7%) but was present in all the varieties of CP in lower frequency.

Table-IV
Seizure was also present in all types of CP but was highest in spastic tetraplegia (56.5%).Hearing impairment and feeding difficulty was highest in diskinetic variety (71.4%).Low vision was commoner in spastic tetraplegia (55.6%).About 50% of spastic tetraplegia had some form of associated problems and many of those cases had more than one problem.
Riskfoctors observed in spectfic type of cerebral palsy Associated  Problems in dffirent Qpes of Cerebral Palsy (n:100)

Table - I
Demographic and delivery characteristics of cerebral

Table - II
Distribution of known risk factors among cerebral palsy