Cerebral Palsy in Children Reprot Summary

Definition and Characteristics

• Cerebral palsy (CP) is a disorder characterized by abnormal tone, posture, and movement. It is clinically classified based on the predominant motor syndrome, including spastic hemiplegia, spastic diplegia, spastic quadriplegia, and extrapyramidal or dyskinetic.
• The incidence of CP is 2–3 per 1,000 live births.

Risk Factors

• Prematurity and low birthweight are significant risk factors for CP.
• Other associated risk factors include maternal infections, multiple gestation, maternal-fetal infections, in utero or perinatal stroke, kernicterus, neonatal seizures, neonatal sepsis or meningitis, and more.

Pathology

• In most cases of CP, the initial injury to the brain occurs during early fetal brain development.
• Intracerebral hemorrhage and periventricular leukomalacia are the primary pathologic findings in preterm infants who develop CP.

Diagnosis

• The diagnosis of CP is primarily based on clinical findings.
• Early diagnosis is possible through a combination of clinical history, standardized neuromotor assessment, and findings on magnetic resonance imaging (MRI).
• In most clinical settings, CP is more reliably recognized by 2 years of age.

Management

• CP is associated with multiple associated and secondary medical conditions, requiring a multidisciplinary team approach for its management.
• Most children with CP grow up to be productive adults.

Introduction

• CP is primarily a neuromotor disorder affecting the development of movement, muscle tone, and posture.
• The underlying pathophysiology is an injury to the developing brain in the prenatal through the neonatal period.
• CP is characterized by heterogeneity in risk factors, clinical features, severity of functional limitations, treatment options, and the evolution of the condition over the individual’s lifespan.

Prevalence

• The prevalence of CP for all live births ranges from 1.5 to 3 per 1,000 live births. The prevalence varies between high-income and low to middle-income countries and by geographic region.

Clinical Findings

• The neurologic impairment of the motor system in children with CP is characterized by spasticity, dyskinesia, hypotonia, and ataxia. Mixed presentations are also common.