Changes in the clinical spectrum of cerebral palsy over two decades in North India--an analysis of 1212 cases

J Trop Pediatr. 2013 Dec;59(6):434-40. doi: 10.1093/tropej/fmt035. Epub 2013 Jun 19.

Abstract

Background: Clinical spectrum of cerebral palsy (CP) is different in developing and developed countries. We evaluated the clinical profile, etiological factors and co-morbidities of children with CP in North India, and compared with our previous study.

Methods: 1212 children with CP registered in last 10 years in our rehabilitation center were compared with our previous study of 1000 children from same center.

Results: Spastic quadriplegia is the commonest type of CP (51.5%) although lesser than previous decade (61%). Birth asphyxia remains the main (51.98%) etiological factor as earlier (45.3%). CP due to CNS infections decreased from 63.5% to 57.4%, due to bilirubin-encephalopathy remained same (∼30%). Speech problems (83.7%), microcephaly (64.27%), seizures (44.5%) and intellectual disability (38.61%) are common co-morbidities. Common neuroimaging findings include hypoxic-ischemic changes and periventricular leucomalacia.

Conclusion: The spectrum of CP is evolving in the developing countries with an increase in diplegic and a decrease in quadriplegic CP.

Keywords: asphyxia; cerebral palsy; intellectual disability; quadriplegia; seizures.

MeSH terms

  • Adolescent
  • Asphyxia Neonatorum / complications*
  • Asphyxia Neonatorum / epidemiology
  • Cerebral Palsy / epidemiology
  • Cerebral Palsy / etiology
  • Cerebral Palsy / pathology*
  • Child
  • Child, Preschool
  • Comorbidity
  • Electroencephalography
  • Female
  • Humans
  • India / epidemiology
  • Infant
  • Intellectual Disability / epidemiology
  • Intellectual Disability / etiology*
  • Magnetic Resonance Imaging
  • Male
  • Muscle Spasticity / epidemiology
  • Muscle Spasticity / etiology
  • Muscle Spasticity / pathology*
  • Pregnancy
  • Prevalence
  • Quadriplegia / etiology*
  • Rehabilitation Centers
  • Retrospective Studies
  • Risk Factors
  • Socioeconomic Factors