Survey on children with cerebral palsy in Tochigi Prefecture, Japan

Abstract

Background The incidence of cerebral palsy (CP) is influenced by perinatal medicine and regional medical systems. We investigated the recent incidence of CP and the current problems of children with CP in living at home under an advanced perinatal medical system in Tochigi Prefecture, Japan. Methods A clinical datasheet survey was performed among 13 hospitals and six rehabilitation facilities treating children with CP born in Tochigi Prefecture to estimate the incidence of CP among children born between 2009 and 2013. The severity of motor and intellectual impairment, presumed causal factors, complications, and provided medical interventions were investigated and compared between preterm and term‐born children with CP. Results The incidence of CP was 1.6 per 1000 live births. Shorter gestation period and lower birthweight were associated with a higher incidence of CP. Fifty‐one percent of children with CP were non‐ambulatory and 55% had severe to profound intellectual impairment. Episodes of neonatal asphyxia and periventricular leukomalacia were the most frequent causal factors; both were significantly more frequent in preterm than in term‐born children. Approximately 30% of children with CP had respiratory disorders, dysphagia, or epilepsy; 62% received medical interventions, including medication, mechanical ventilation, oxygen therapy, tube feeding, and intraoral/intranasal suction. Conclusion We found the incidence of CP to be lower in comparison to previous Japanese studies. However, the motor and intellectual impairments were severe, and many children with CP and their families were burdened by daily medical care. Public support systems should be developed, as well as the perinatal medical system.

Prevalence and characteristics of children with cerebral palsy according to socioeconomic status of areas of residence in a French department

“…The hypotheses put forward for these differences between preterm and term-born children with the same (spastic) forms are notably that of a different cerebral vulnerability [ 32 ] and brain’s ability to compensate better when it is less well developed [ 34 ]. However, some studies have shown inconclusive [ 37 ] or contradictory results [ 25 ]. Other studies focused on children with the same type of brain lesions [ 38 , 39 ] have shown clinical differences between preterm and term born children with a greater severity of motor impairment in preterm children, leading the authors to suggest that "despite a common radiologic pattern, these are different clinicopathologic entities."…”

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis

“…Many patients with severe neurological impairment have difficulty feeding [23,24]. Their energy consumption is usually too high, and their intake is deficient.…”

The anatomical and functional rationale for conducting dysphagia rehabilitation

“…2 Dysphagia is a common but critical problem in severely impaired motor and intellectual disabilities (SMID). According to a systematic review, in Japan, the prevalence of dysphagia is 28% in children with cerebral palsy 3 and around 50% across the lifespan of cerebral palsy. 4 Dysphagia is classified into oropharyngeal and esophageal dysphagia, according to anatomical site.…”