Erum Afzal, Muhammad Waqar Rabbani, Tanveer Ahmad, Imran Iqbal.
Association of Perinatal Adverse Events Withthe Type of Cerebral Palsy.
Pak Paed J Jan ;38(3):179-83.

Objective: To determine the relationship of different types of cerebral palsy (CP) with perinatal adverse events in CP patients presenting to the Children’s Hospital &the Institute of Child Health Multan. Study Design: Cross-sectional study Methodology: This study was conducted at Rehabilitation services unit, The Children’s Hospital & the Institute of Child Health Multan from June 2010 to March 2012.Patients (1 to 12 years of age)with abnormalities of tone, movement and posture and diagnosed as cerebral palsy, were included in the study. Details of perinatal adverse events were recorded by detailed history and available perinatal record and type of cerebral palsy was ascertained in each case by clinical examination. All the information was recorded on a predesigned Performa for final analysis. Results: Out of 178 cerebral palsy patients, 39.9%(n=71) were spastic quadriplegic, 30.9%(n=55)spasticdiplegic,22.5% (n=40) spastic hemiplegic, 3.4%(n=6) chorioathetoid,1.7%(n=3) hypotonic and 1.7%(n=3)were mixed type. Spastic quadriplegic type was mainly associated with birth asphyxia whereas spastic diplegia with prematurity and low birth weight. Sepsis, meningitis and intracranial bleed were the main events responsible for spastic hemiplegia. Chorioethetoid type was related to kernicteris whereas hypotonic type to CNS bleed and malformations. In mixed type there was history of birth asphyxia in most of the patients. In 8.5%( n=15)patients no definite factor could be determined. Conclusion: Most common presentation of cerebral palsy is spastic quadriplegia, mainly caused by birth asphyxia.

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