Causes, functional outcomes and healthcare utilisation of people with cerebral palsy in Singapore.

INTRODUCTION: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. METHODS: People with CP born after 1994 were recruited through KK Women's and Children's Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records. RESULTS: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV-V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year). CONCLUSION: Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation.

Pediatric epilepsy and first afebrile seizure in Singapore: epidemiology and investigation yield at presentation.

The authors studied pediatric epilepsy and first afebrile seizure at presentation in Singapore. A total of 211 participants aged 1 month to 15 years with first presentation for afebrile seizures were recruited from November 2002 to May 2004; 108 with ≥2 prior afebrile seizures (newly diagnosed epilepsy) and 103 with first afebrile seizures. A χ(2) analysis of demographics, risk factors, examination, and investigation findings showed significant differences in development (normal in 87% [newly diagnosed epilepsy] and 93% [first afebrile seizure], P = .046), neurological examination (normal in 92% [newly diagnosed epilepsy] and 98% [first afebrile seizure], P = .016), and electroencephalogram findings (abnormal in 75% [newly diagnosed epilepsy] and 36.9% [first afebrile seizure], P < .005). Pediatric epilepsy incidence at our institution is 24 per 100 000 person-years and is highest in early childhood. Focal epilepsy is more common than generalized epilepsy. Patients with first afebrile seizure and abnormal development, neurological examination, and electroencephalogram findings should be monitored for future development of epilepsy. Population-based studies are recommended.