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Published on: January 11, 2016
Clinical presentation, associated disorders and aetiological moments in Cerebral Palsy: a Dutch population-based
M J Wichers1, E Odding, H J Stam
1Department of Child Rehabilitation, Leijpark Rehabilitation Centre, Tilburg, The Netherlands. mjwich@knmg.nl
Insights
Quantitative data on cerebral palsy (CP) in the Netherlands was scarce. Clinical patterns and associated disorders in Dutch children with CP remained consistent over time, despite a noted prevalence rise.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) presents with diverse clinical features, associated conditions, and causes.
- Quantitative data and trend analysis for CP in the Netherlands were previously limited.
Purpose of the Study:
- To provide quantitative data on the prevalence, presentation, and associated disorders of cerebral palsy in Dutch children.
- To investigate trends in CP clinical patterns and etiological factors over time.
Main Methods:
- A population-based study involving Dutch children born between 1977-1988 with CP.
- Data collection included individual history taking, clinical examination, and medical record review by experienced clinicians.
- Analysis compared clinical subtypes, motor disability, co-morbidities (mental retardation, visual disability, epilepsy), and etiological factors between earlier and later birth years.
Main Results:
- Over 90% of CP cases were spastic subtypes, with bilateral spastic cerebral palsy being the most common group and spastic hemiplegia the largest individual subtype.
- Epilepsy and mental retardation were frequently observed co-morbidities.
- Clinical patterns and associated disorders remained relatively constant across birth years, despite a prevalence increase.
Conclusions:
- Early diagnosis of cerebral palsy can be challenging.
- General clinical patterns and associated disorders in CP remained stable over the study period.
- No specific factor emerged as a clear explanation for the observed rise in CP prevalence.
Purpose:
Cerebral Palsy (CP) contains varying clinical presentations, associated disorders and aetiological moments. Quantitative data and trends on these aspects were lacking in The Netherlands.
Method:
Within a population-based study on prevalence, presentation and functioning of Dutch children with CP born in the years 1977-1988, individual history taking, examination and medical file checking was done by experienced clinicians. Clinical subtypes, motor disability, important co-morbidity (mental retardation, visual disability and epilepsy) were recorded, aetiological moments identified if possible. By comparing the four most recent years with the earlier years possible trends were studied.
Results:
A quarter of children beforehand recorded as CP did not meet inclusion criteria after individual examination. Spastic subtypes accounted for over 90% of all CP cases: bilateral spastic cerebral palsy as a group are the majority although spastic hemiplegia is percentage-wise the largest individual clinical subtype. Epilepsy and mental retardation are common. Clinical patterns and associated disorders remained rather constant comparing earlier to more recent birth years.
Conclusions:
An early diagnosis of CP may be challenged. General clinical patterns remained rather constant in following years, as did most studied items. Even if this study revealed a prevalence rise, no aspect stood out as a possible explanation for this prevalence rise. Comparable studies performed elsewhere showed similar findings.
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