Children with dyskinetic cerebral palsy are severely affected as compared to bilateral spastic cerebral palsy

Acta Paediatr. 2019 Oct;108(10):1850-1856. doi: 10.1111/apa.14806. Epub 2019 Apr 21.

Abstract

Aim: We aimed at describing clinical findings in children with dyskinetic as compared to bilateral spastic cerebral palsy (CP).

Methods: Data were extracted from the Danish nationwide CP register. Participants were born in 1999-2007 and were 5-6 years at ascertainment.

Results: The total number of CP cases was 1165 of which 92 had dyskinetic and 540 bilateral spastic CP. Prevalence of dyskinetic CP was 0.16 per 1000 live births. In participants with dyskinetic compared to bilateral spastic CP, there was more frequently an Apgar level less than five at five minutes (22.7% vs. 11.2%) and neonatal seizures (43.5% vs. 28.5%), but less respiratory deficiency, hyperbilirubinaemia and sepsis. Impairment based on gross motor function classification was more severe in dyskinetic CP (level III-V 90.0% vs. 66.0%). In dyskinetic CP, there was a high rate of reduced developmental quotient (68.1%), visual impairment (39.3%) and epilepsy (51.6%). Basal ganglia lesions were more prevalent in dyskinetic compared to bilateral spastic CP (27.7% vs. 12.8%).

Conclusion: Cases of dyskinetic CP had overlapping clinical features with cases of bilateral spastic CP, but differed significantly in several perinatal risk factors. The children with dyskinetic CP had experienced more peri- or neonatal adverse events, and neurodevelopmental impairment was severe.

Keywords: Cerebral palsy; Dyskinetic; Paediatric; Prevalence; Spasticity.

Publication types

  • Comparative Study

MeSH terms

  • Cerebral Palsy / complications
  • Cerebral Palsy / diagnostic imaging
  • Cerebral Palsy / epidemiology*
  • Child
  • Child, Preschool
  • Denmark / epidemiology
  • Epilepsy / etiology
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Neuroimaging
  • Pregnancy
  • Prevalence
  • Registries*