Early Diagnosis and Classification of Cerebral Palsy: An Historical Perspective and Barriers to an Early Diagnosis

Velde, Anna te; Morgan, Catherine; Novak, Iona; Tantsis, Esther; Badawi, Nadia

doi:10.3390/jcm8101599

Cited by 96 publications

(95 citation statements)

References 88 publications

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“…Medium-term neurological outcomes such as CP and DQ were evaluated at approximately 36 months of chronological age. CP was defined as permanent disorders of development of movement and posture caused by non-progressive disturbances of the fetal or infant brain 20 . However, the subtype and severity of CP were not documented in the NRNJ database.…”

Section: Methodsmentioning

confidence: 99%

Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

Nakamura

Ushida

Nakatochi

et al. 2021

Sci Rep

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To evaluate the impact of maternal hypertensive disorders of pregnancy (HDP) on mortality and neurological outcomes in extremely and very preterm infants using a nationwide neonatal database in Japan. This population-based retrospective study was based on an analysis of data collected by the Neonatal Research Network of Japan from 2003 to 2015 of neonates weighing 1,500 g or less at birth, between 22 and 31 weeks’ gestation. A total of 21,659 infants were randomly divided into two groups, HDP (n = 4,584) and non-HDP (n = 4,584), at a ratio of 1:1 after stratification by four factors including maternal age, parity, weeks of gestation, and year of delivery. Short-term (neonatal period) and medium-term (3 years of age) mortality and neurological outcomes were compared between the two groups by logistic regression analyses. In univariate analysis, HDP was associated with an increased risk for in-hospital death (crude odds ratio [OR], 1.31; 95% confidence interval, 1.04–1.63) and a decreased risk for severe intraventricular haemorrhage (0.68; 0.53–0.87) and periventricular leukomalacia (0.60; 0.48–0.77). In multivariate analysis, HDP was significantly associated with a lower risk for in-hospital death (adjusted OR, 0.61; 0.47–0.80), severe intraventricular haemorrhage (0.47; 0.35–0.63), periventricular leukomalacia (0.59; 0.45–0.78), neonatal seizures (0.40; 0.28–0.57) and cerebral palsy (0.70; 0.52–0.95) at 3 years after adjustment for covariates including birth weight. These results were consistent with those of additional analyses, which excluded cases with histological chorioamnionitis and which divided the infants into two subgroups (22–27 gestational weeks and 28–31 gestational weeks). Maternal HDP was associated with an increased risk for in-hospital death without adjusting for covariates, but it was also associated with a lower risk for mortality and adverse neurological outcomes in extremely and very preterm infants if all covariates except HDP were identical.

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Section: Methodsmentioning

confidence: 99%

Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

Nakamura

Ushida

Nakatochi

et al. 2021

Sci Rep

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“…The complex manifestations of the disorder led to an extension of the term CP to cerebral palsy spectrum disorder. The incidence of CP ranges from 1/500 live births [ 6 ] to 2–3/1000 live births [ 7 ], while the prevalence in Australia has been reported to be 1.4 (95% CI, 1.3–1.5) per live births [ 2 ]. Prematurity and low birth weight are the main risk factors for CP.…”

Section: Introductionmentioning

confidence: 99%

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

et al. 2020

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Cerebral palsy (CP) is a frequent cause of childhood disability often associated with a complex group of disorders, including epilepsy, which is reported to impact approximately 40% of affected individuals. This retrospective study involved a group of children affected by CP, some of whom also had comorbid epilepsy. The aim of this study was to report our experience of analyzing, in particular, (a) some of the clinical aspects of the different type of CP, and (b) the relationship between the clinical data of children affected by CP plus epilepsy and each type of CP. Methods: This retrospective single-center study was performed with 93 children admitted to the Pediatric Department of the University of Catania, Italy, affected by CP and distinguished according to the type of motor clinical presentation, with 46 showing epileptic seizures, compared to a control group of 136 children affected by epilepsy without other neurologic disorders. Results: Among the 93 CP children, 25 (27%) had spastic quadriplegia (plus one patient with dystonic quadriplegia), 39 (42%) had spastic hemiplegia, 11 (12%) had spastic diplegia (plus two with ataxia and one with dyskinetic CP), and 14 (15%) did not have a well-defined type of CP. The frequency of epilepsy was higher in affected CP children who showed major motor dysfunction (GMFCS IV–V types). As regards the 46 children with CP plus epilepsy, compared to the group of the control, the age of epilepsy onset was found to be statistically significant: 21 ± 35.1 months vs. 67 ± 39.7. Conclusions: Epilepsy represents one of the most frequent comorbidities of cerebral palsy. In children with CP, particular attention should be paid to the early identification and treatment of comorbid epilepsy.

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“…The Gross Motor Function Classification System (GMFCS) [17] and Ashworth classification were used to classify the severity of the disease [18]. The Learning Accomplishment Profile-Diagnostic (LAP-D) test were used to evaluates fine locomotor skills, cognitive skills, and speech skills [19].…”

Section: Methodsmentioning

confidence: 99%

Cerebral palsy treatment with autologous bone marrow aspirate concentrate challenges for the future

Maric¹,

Radomir²,

Milankov³

et al. 2020

Preprint

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Background Cerebral Palsy (CP) is a heterogeneous group of conditions that results in permanent motor disability. Recent studies have suggested that cellular transplantation may have functional efficacy in the treatment of CP. We conducted a pilot study of the intrathecal transplantation of autologous bone marrow aspirate (BMAC) concentrate in children with CP to assess the safety of the procedure as well as its potential efficacy in motor and cognitive functions. Materials and methods Twenty-four patients with CP received BMAC and were evaluated 12 months. The treatment procedure involves three intrathecal BMAC applications along with neurorehabilitation. We assessed potential efficacy by using Gross motor functional classification system, Ashworth scale, Learning accomplishment profile-diagnostic scale, brain magnetic resonance imaging and electroencephalogram. Results The study enrolled 24 CP patients with chronological age from 1-12 years but the current developmental age was from 6 -10 months. After BMAC therapy, immediate improvements were noted within first 7 days, decreased muscle tone, and decreased involuntary limb movements, better head control and decreased salivation. After treatment, 83% patients developed relaxation of the extremities. The cognitive function assessment also revealed significant improvement in 40% patients. The average developmental age of the CP patients after the intervention was 22 months in the field of cognition and, 20 months in the field of locomotor skills, 21 months in the field of speech skills. Conclusion Autologous BMAC transplantation seems to be safe and feasible, and can help reduce the degree of impairment of CP patients and, improve the quality of life. The combination of cell therapy and neurorehabilitation can lead to functional restoration that reduces disability in CP.

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Early Diagnosis and Classification of Cerebral Palsy: An Historical Perspective and Barriers to an Early Diagnosis

Cited by 96 publications

References 88 publications

Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

Mortality and neurological outcomes in extremely and very preterm infants born to mothers with hypertensive disorders of pregnancy

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

Cerebral palsy treatment with autologous bone marrow aspirate concentrate challenges for the future

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