Cerebral Palsy in Birmingham

Abstract

SUMMARY Of the 441 children born in Birmingham between Jan. I, 1948 and Dec. 31, 1963 and registered with the Midland Spastic Association as suffering from cerebral palsy, 401 are included in this study. The annual incidence per 1,000 live births varied between 1 ‐3 and 1 ‐9. The incidence in children of school age in two five‐year birth periods, 1950–1954 and 1955–1959, showed a slight fall from 1 ‐7 to 1–5 per 1,000. The figures for children under five years of age were incomplété but there was no evidence of a significant fall in the number of cases during the period under review. The classification of cerebral palsy by type is discussed and the incidence of the different types in two five‐year periods is considered. Some possible precipitating causes are investigated and particular attention is paid to prematurity, asphyxia, birth injury and jaundice and their relative importance in the production of the various types of cerebral palsy. The intelligence and educability of children suffering from the different types of cerebral palsy is surveyed; the educational placement of children born in two five‐year periods, 1950–1954 and 1955–1959, is compared and the implications of these results for future educational planning is considered. It is concluded that there is no evidence that the disappearance of cerebral palsy as a medical and social problem is imminent, and that simplification of nomenclature and classification is a possible method of clarifying the problems of causation. RÉSUMÉ Palsie cérébrale à Birmingham Cette étude intéresse 401 enfants parmi les 441 enfants nés à Birmingham entre le ler Janvier 1948 et le 31 Décembre 1963 et inscrits à la ‘Midland Spastic Association’ comme atteints de palsie cérébrale. L'incidence annuelle pour 1.000 naissance en vie varie entre 1,3 et 1,9. L'incidence chez les enfants d'âge scolaire pendant deux périodes de naissance de cinq ans, 1950–1954 et 1955–1959, a montré une légère chute de 1,7 à 1,5 pour 1.000. Les chiffres pour les enfants de moins de cinq ans sont incomplés, mais il n'y avait aucune évidence d'une chute appréciable dans le nombre des cas pendant la période étudiée. La classification de la palsie cérébrale par type est discutée et l'incidence des différents types au cours des deux périodes de cinq ans est considérée. Quelques causes précipitantes possibles sont recherchées et une attention particulière est portée sur les facteurs de prématurité, asphyxie, accident de naissance et jaunisse et sur leur importance relative dans la production des divers types de palsie cérébrale. Une enquête est faite sur l'intelligence et l'éducabilité des enfants souffrant des differents types de palsie cérébrale; le placement éducationnel des enfants nés au cours des deux périodes de cinq ans, 1950–1954 et 1955–1959, est comparé et les implications de ces résultats pour l'établissement d'un plan d'éducation pour le futur sont considérées. En conclusion, il n'y a aucune évidence que la disparition de la palsie cérébrale en tant que problème médical et social soit émminent...

Motor Handicapped Children: A Study from a Swedish County

“…The incidence of cerebral palsy in this investigation (0.18 per cent) is in accordance with earlier surveys (Herlitz et al 1955, d'Avignon et al 1958, Hansen 1960, Ingram 1964, Griffiths et al 1967, Tuuteri et al 1967 and others). The proportional distribution of different types of cerebral palsy seems to correspond with other surveys (Andersen 1957, d'Avignon et al 1958, Hansen 1960, Ingram 1964).…”

An Epidemiological Study of Cerebral Palsy in Western Australia, 1956–1975. II: Spastic Cerebral Palsy and Perinatal Factors

“…The association between preterm gestational age, low birthweight and spastic cerebral palsy has been reported by many authors (Alberman 1963, Griffiths and Barrett 1967, Scherzer and Mike 1974, Davies and Tizard 1975, McManus et al 1977, Mayer and Wingate 1978, and has also proved to be highly significant in the present study. While this risk has been well documented, some authors have found that the number of low-birthweight infants contributing to their spastic populations, particularly for diplegia, has decreased recently, and they attribute this to improved obstetric, and especially, neonatal care (Hagberg et al 1975a, Franco andAndrews 1977).…”

Association of Apolipoprotein E Genotype and Cerebral Palsy in Children

“…The prevalence of mental retardation in our study is lower than that reported in population-based studies (range: 31%-75%). 29 The association of quadriplegia/triplegia both with APOE genotype and with seizures, cognitive problems, and vision problems could be taken to indicate a similar association of carriage of the 4 or 2 allele with these comorbid conditions in children with CP. The lack of any statistically significant association between carriage of either the 4 or 2 allele and these coconditions in the present study does not rule out an effect of APOE genotype.…”