Clinical Spectrum of Cerebral Palsy and Associated Disability in South Egypt: A Local Survey Study

Abstract

BACKGROUND:Cerebral palsy is the most common cause of motor disability in children with a prevalence of 2-10/1,000 live births in the developing areas.AIM:The epidemiology, clinical picture, and associated comorbidities in CP have been extensively studied in high-resource countries, but in low-resource areas, including Africa, those studies are still lacking.METHODS:Cerebral palsy cases were prospectively recruited from every physiotherapy centre in Bani-Mazar city, Egypt, in a cross-sectional study from May 2015 to November 2015.RESULTS:Two hundred cases were enrolled with a prevalence of 1 per 1000 live births. Within the study population, 72.5% were the spastic type, 16% were dyskinetic, 7% were ataxic, and 4.5% were hypotonic. The most common comorbidities were cognitive impairment and epilepsy affecting 77% and 38%, respectively.CONCLUSION:Cerebral palsy in developing countries has a higher prevalence and different clinical profile regarding severity and associated disability. The perinatal and high-quality neonatal care together with physical therapy and rehabilitation programs is still lacking in developing countries.

Aetiology and comorbidities of cerebral palsy in a developing country

“…which is high compared to previously obtained values in this environment and other parts of some developing countries. [11][12][13] The high rate of patients with CP due to birth asphyxia in this study is due to poor obstetrics care occasioned by increasing number of deliveries conducted at home, churches and TBAs where they are unsupervised or attended by untrained midwives.…”

“…Central nervous system infection (meningitis and viral encephalitis) accounted for about a third of the case of CP in this study, a frequency comparable to that previously reported in this environment 4 and other parts of Nigeria and the developing countries in contrast CNS infection contributes a negligible percentage to CP in developed countries. [11][12][13] Congenital malformations of the brain and vascular abnormalities such as cerebral artery occlusion are important causes of cerebral palsy in developed countries, these however, are uncommon aetiologies in developing countries. [10][11][12]14,15 This probably may be related to the unavailability of facilities in some centers of the developing countries where these studies were carried out.…”

“…[11][12][13] Congenital malformations of the brain and vascular abnormalities such as cerebral artery occlusion are important causes of cerebral palsy in developed countries, these however, are uncommon aetiologies in developing countries. [10][11][12]14,15 This probably may be related to the unavailability of facilities in some centers of the developing countries where these studies were carried out.…”

Cerebral Palsy In Children: Subtypes, Motor Function And Associated Impairments; Addis Ababa, Ethiopia

“…In our cohort, we found few children with mild impairments (GMFCS level I-II, which was prevalent particularly among the older children in the Ugandan cohort. The high proportion of children with severe impairments are more in par with other clinical cohorts from Uganda, Egypt 4,5,13,14,15 , North India 16 . Many of the children suffered from seizures (61%), and had probably been identified when seeking to get anti-convulsing drugs.…”

“…1 One reason for this omission, is probably the lack of robust population based studies in Africa and other LMIC. Until recently there were only studies on clinical samples suggesting a wide range of prevalence estimates from 2-10 cases per 1000 children [2][3][4][5] . During recent years, a couple of rigorous population based studies have been published from Uganda 6 and Bangladesh 7 revealing large discrepancies compared with prevalence data from HIC 8 .…”