One hundred and two children with severe cerebral palsy (CP), referred to us during the period 1980 to 1983, were analysed for aetiology and clinical features. Ninety-one children were under the age of two years. Male to female ratio was 3:2. The causes of CP were prenatal in 23.5%, perinatal in 48%, and postnatal in 28.4% of cases. All the clinical types were represented and the study revealed the well-established high frequency of associated neurological deficits. Cerebral palsy was considered medically preventable in at least 30% of the cases, through improvements in obstetric and neonatal care services and control of infection. There is need, also, to establish integrated interdisciplinary teams for the effective diagnosis and complete habilitation of CP patients.
The CT findings in 120 cerebral palsied children are analysed. The 72.5% positive findings are correlated with the clinical types, as well as the aetiological basis for the cerebral palsy. The spastic type, 83.3% of the total number of children, had the highest positive findings. The yield was increased in children with seizures (91.3%) and those in the postnatal group (90%), as well as those with birth trauma and neonatal asphyxia (94%). The findings were those of atrophy in 30.8%, hydrocephalus, in 10%, infarct in 11.6%, porencephaly in 8.3% and others. The atropic changes and their patterns are explained. Treatable lesions, such as tumour, hydrocephalus, subdural haematoma, porencephaly and hygroma were identified in 22.5% of cases. It is concluded that CT scan is definitely efficacious in the management of cerebral palsied children.
CT scan imaging of the brain was done in eight children with Werdnig-Hoffmann Disease. Seven of them showed generalized cerebral cortical atrophy and one had low attenuated, non-enhancing areas in the white matter involving both frontal lobes. These changes could be due to repeated episodes of hypoxic injury.
The case records of 10 children with osteopetrosis are reviewed. The mean age at presentation was 4 years. Parental consanguinity was noted in all the families. Growth retardation was the commonest presenting complaint. All the children had severe dental caries. Routine metabolic studies for calcium, phosphorus and alkaline phosphatase were unremarkable. The literature on the management of this entity is briefly discussed.
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