RESUMO
Cerebral palsy (CP) is a form chronic motor disability in children. It is a non-progressive disorder of posture and movement, often associated with epilepsy and abnormalities of speech, vision and intellect. It results from a defect or lesion of growing brain before or during birth or in postnatal period. The damage to brain is permanent and cannot be cured but the consequences can be minimized. Cerebral palsy (CP) is a disorder of development in which abnormalities of motor function are the main characteristic features. Severity varies from mild to severe. Cerebral palsy is a very challenging disability for parents and professionals. Cerebral palsy is a heterogeneous group of disorders caused by intrapartum asphyxia and exposure to maternal infection such as chorioamnionitis, sepsis, urinary tract infection, and prematurity. The incidence of Cerebral Palsy is 2 to 2.5 per 1000 live births. During the past twenty years, there have been increases in the incidence and prevalence of CP that may be associated to enhanced records of cases, advances in neonatal health care and other factors.METHODSThis cross-sectional study was conducted in the Department of Paediatrics, Darbhanga Medical College & Hospital, Laheriasarai, Darbhanga, Bihar, from October 2018 to September 2019. A total of 100 Cerebral Palsy cases coming from various districts to inpatient and outpatient department of hospital were selected.RESULTSIn this study a total 100 CP children up to 12 years of age was included. 60% were boys and 40% were girls. The causes of CP included birth asphyxia (47%), prematurity (22%), pyogenic meningitis (8%), genetic (7%), neonatal sepsis (6%), intracranial bleed (5%), and idiopathic (5%). Among these cases, spastic type (65%), ataxic (15%), dyskinetic (10%) and mixed (10%) varieties were found. Among spastic, quadriplegic subtype was seen in 69%, diplegia in 23%, and hemiplegia in 8%. Comorbidities associated with CP patients were speech problem (80%), pain (75%), cognitive disability (50%), hip displacement (30%), seizure (25%), behavioural disorders (25%), sleep disturbances (20%), visual impairment (19%) and hearing impairment (4%).CONCLUSIONSPerinatal asphyxia is a leading and preventable cause of cerebral palsy. Spastic type was the most common type and in spastic type, quadriplegic subtype was most common. Mental retardation, speech problems, pain, cognitive disability, hip displacement and seizure were the major co-morbidities in children with cerebral palsy. Early diagnosis and appropriate management are important in such children to limit morbidity.
RESUMO
Background: Cerebral palsy (CP) is one of the leading causes of childhood disability worldwide with the greatest burdenfound in developing countries. Motor impairments are the hallmarks of CP, but in many individuals, other impairments suchas vision, hearing, speech, cognition, behavior, and epilepsy may at times produce even greater activity limitation in daily life.Early diagnosis and comprehensive management with a multidisciplinary approach are required for satisfactory managementof a child with CP. In low- and middle-income countries, there are gaps in knowledge especially in spheres of epidemiologicalresearch, intervention, and service utilization.Materials and Methods: This cross-sectional observational study was conducted among the children coming to the inpatientand outpatient Department of Paediatrics SMGS Hospital, Government Medical College Jammu.Aims and Objectives: The aim of the study was to study the clinical pattern and etiological factors of CP and to determine the prevalenceof associated disabilities or handicaps in CP. Our study population included 100 cases of diagnosed CP up to 18 years of age.Results: A total of 100 children of CP were evaluated of which 59% were boys and 41% were girls. CP patients belonged tovarious age groups as, <2 years (46%), 2–4 years (30%), 4–6 years (12%), 6–12 years (10%), and 12–18 years (2%). CP patientscoming to our hospital belonged to various districts such as Jammu (27%), Rajouri (20%), Doda (17%), Reasi (11%), Udhampur(8%), Kathua (7%), Poonch (5%), and Samba (5%). The most common etiological factors were birth asphyxia (48%). The spastictype was the most common (65%), followed by ataxic (15%), dyskinetic (10%), and mixed (10%). Among the spastic quadriplegic,subtype was seen in 69%, diplegia in 23%, and hemiplegia in 8%. Speech delay was the most common associated problem(80%), followed by seizures (56%), feeding difficulty (46%), and contractures and deformities (20%). Formal vision assessmenthad been done in only 48% of the patients, among them, 30% had normal vision, 9% had refractive error, 7% were havingstrabismus, and 2% were blind. Spectacles were being used by only three patients. A mere 30% of the patients had undergonehearing assessment; among them, 6% were having moderate to profound hearing loss. Hearing aid was being used by twopatients. Physiotherapy services were being availed by 47% of patients. Early intervention and appropriate rehabilitation servicesshould be provided to such children to limit the disability. Medical college hospitals of India, where a number of these childrenreport with their various problems, can play an important role as nodal centers for evaluation and registration of such patients.