Severity of Cerebral Palsy-The Impact of Associated Impairments
Veronka Horber1, Asma Fares2, Mary Jane Platt3
1Department of Paediatric Neurology, University Children's Hospital, Tübingen, Germany.
Insights
This study found that 30% of children with cerebral palsy (CP) can walk and have normal intellect. CP severity is linked to subtype, not birth weight or gestational age.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) is a group of movement disorders due to abnormal brain development.
- Associated impairments significantly impact a child's functional abilities and quality of life.
Purpose of the Study:
- To describe the associated impairments in children with cerebral palsy (CP) and its subtypes.
- To analyze the relationship between CP subtypes and the severity of associated impairments.
Main Methods:
- Analysis of 11,015 children diagnosed with CP between 1990-2006 from the Surveillance of Cerebral Palsy in Europe database.
- Development and application of an "impairment index" to quantify the severity and combinations of impairments.
Main Results:
- 56% of children could walk unaided, and 54% had normal/near-normal intellect (IQ ≥ 70).
- A low impairment index (able to walk, normal intellect) was observed in 30% of all children, varying by subtype (e.g., 54% in unilateral spastic CP, 7% in dyskinetic CP).
- Higher impairment index (inability to walk and/or severe intellectual impairment) was most frequent in dyskinetic (77%) and bilateral spastic CP (54%). Severity was weakly associated with birth weight or gestational age.
Conclusions:
- Thirty percent of children with CP exhibit a low impairment index, characterized by unaided walking and normal/near-normal intellect.
- CP severity is strongly associated with the specific subtype of CP, with less correlation to birth weight or gestational age.
Objective:
This article describes associated impairments in children with cerebral palsy (CP) and its subtypes.
Method:
Children born between 1990 and 2006 recorded in the Surveillance of Cerebral Palsy in Europe common database were studied. An "impairment index" characterized severity of impairments and their combinations.
Results:
Amongst the 11,015 children analyzed, 56% (n = 5,968) could walk unaided, 54% (4,972) had normal or near-normal intellect (intelligence quotient ≥ 70). Except for ataxic CP, associated impairments were less frequent when walking ability was preserved. The impairment index was low (walking unaided and normal or near-normal intellect) in 30% of cases; 54% (n = 1,637) in unilateral spastic, 24% (n = 79) in ataxic, 18% (n = 913) in bilateral spastic, and 7% (n = 50) in dyskinetic CP. Around 40% had a high impairment index (inability to walk and/or severe intellectual impairment ± additional impairments)-highest in dyskinetic (77%, n = 549) and bilateral spastic CP (54%, n = 2,680). The impairment index varied little in birth weight and gestational age groups. However, significantly fewer cases in the birth weight group ≤ 1,000 g or gestational age group ≤ 27 weeks had a low impairment index compared to the other birth weight and gestational age groups (23 and 24% vs. between 27 and 32%).
Conclusion:
Thirty percent of the children with CP had a low impairment index (they were able to walk unaided and had a normal or near-normal intellect). Severity in CP was strongly associated to subtype, whereas the association was weak with birth weight or gestational age.
Related Concept Videos
01:29Intellectual Disability
01:14Role of Cerebellum and Prefrontal Cortex in Memory
01:27Language and Cognition
01:25Learning Disabilities
Dyslexia
Dyslexia is a...
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:15Parkinson's Disease: Overview