The Children with Cerebral Palsy: Clinical Features and Causes

Abstract

Background: Cerebral palsy (CP) is a heterogenous permanent neurological disorder that is caused by a non-progressive damage to the developing brain. In this disorder, injury or malformation occurs in the growing central nervous system which eventually will affect the development of motor function and body posture before, during, or shortly after birth.

Objective: To estimate and highlight the status of demographic and clinical characteristics of cerebral palsy in children at Sulaymaniyah province which has significant walking disorders. Patients and Methods: In this study (118) ambulatory patients with cerebral palsy who attended the health care and consultation clinic at Children Rehabilitation Center (CRC) in Sulaymaniyah province. The primary data were studied according to: gender distribution, patient age, types of delivery, and age of presentation of the CP disorder. Additionally, the conditions at birth such as asphyxia, kernicterus, types of cerebral palsy, full-term, and pre-term were studied. Finally, the Gross Motor Function Classification System (GMFCS) of cerebral palsied children was identified.

Results: Our data showed that females tend to be more affected by CP than males with a ratio of (65:53). The range of ages was between half a year and 12 years (mean of 7.5 years). The highest range appearance of cerebral palsy was between the ages of (12-24) months with a percentage of (58.47%). A delayed milestone was the most common presenting among CP types (41.53%). In comparison to the other CP types, the spastic type was the most common (59.32%). The most prevalent subtype of CP was the spastic hemiplegia (40%). 66.10% of patients were born with vaginal delivery. The majority of the patients were born with asphyxia (31.36%) followed by kernicterus direct antepartum. Sixty-seven (56.78%) mothers were using medications during pregnancy. Forty-eight of parents were consanguine marriage. According to the GMFCS results, most of the CP patients were in the level III and level IV with 27.12%, 25.42% respectively; the major motor disability in children with spastic hemiplegia varied from level I to III.

Conclusion: We deduced that it is difficult to estimate and clarify the exact cause and risk factors associated with the cerebral palsy disorder. However; we found spastic hemiplegia is the most common clinical pattern of CP due to its high prevalence of birth asphyxia. Using medicine during pregnancy will increase a chance of CP to occurs, for further investigation, the case-control study should be employed within the cohort study.