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Published on: January 12, 2019
Beyond motor dysfunction: comorbidities in children with cerebral palsy: a retrospective observational study from a
Lana Talo1, Kerat Hanspal1, Besher Alnukari1
1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates.
Insights
Children with cerebral palsy (CP) experience significant comorbidities, especially in severe cases. Optimizing perinatal care and enhancing rehabilitation access are crucial for improving outcomes in children with CP.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a complex condition with diverse motor, cognitive, and sensory impairments.
- The burden and spectrum of comorbidities in CP can vary based on disease severity, perinatal factors, and healthcare access.
Purpose of the Study:
- To assess comorbidities, functional limitations, and rehabilitation utilization in children with CP at a UAE tertiary hospital.
- To compare these findings with international data on cerebral palsy.
Main Methods:
- A retrospective observational study of 179 children (1 month to 18 years) diagnosed with cerebral palsy.
- Data extracted from electronic medical records included demographics, aetiologies, comorbidities, and rehabilitation engagement.
- Exploratory chi-square tests were used for categorical variable comparisons.
Main Results:
- Spastic quadriplegia was the most frequent subtype (40.2%). Common aetiologies included perinatal asphyxia (26.3%) and hypoxic-ischaemic encephalopathy (14.5%).
- Global developmental delay (78.6%) and drug-resistant epilepsy (63.7%) were the most prevalent comorbidities.
- Higher comorbidity burden, including feeding difficulties, was observed in spastic quadriplegia. Rehabilitation access was 64.8%, predominantly physiotherapy.
Conclusions:
- Children with CP in the UAE exhibit a substantial comorbidity burden, particularly those with severe CP subtypes.
- Findings underscore the need for improved perinatal care and expanded access to rehabilitation services for children with cerebral palsy.
- Further prospective research is recommended to establish causal links and inform interventions.
Background:
Cerebral palsy (CP) is associated with comorbidities affecting motor, cognitive, and sensory function, which may be present at various levels in different patients, across regions, or within the same region. The comorbidity burden and the range of comorbidities in children with CP may vary according to disease severity, perinatal factors, and access to healthcare services.
Objectives:
To evaluate comorbidities, functional limitations, and rehabilitation use in children with CP in a tertiary hospital in the UAE and compare findings with international data.
Methods:
This retrospective observational study analysed 179 children with CP aged 1 month to 18 years, categorized into spastic quadriplegic, diplegic, hemiplegic, and unspecified subtypes. Data from electronic medical records were used to assess demographic characteristics, aetiologies, comorbidities, and rehabilitation engagement. Categorical variables were compared using chi-square tests. P-values were calculated for all comorbidities; no formal correction for multiple comparisons (e.g., Bonferroni or false discovery rate adjustment) was applied, and these analyses are considered exploratory and should be interpreted appropriately.
Results:
The cohort included 40.2% spastic quadriplegia, 34.6% spastic diplegia, 13.4% spastic hemiplegia, and 11.8% unspecified cases. Most children (58.1%) were born at term, with perinatal asphyxia (26.3%), hypoxic-ischaemic encephalopathy (14.5%), and neonatal jaundice (14.0%) being the most common aetiologies. Global developmental delay was the most prevalent comorbidity (78.6%), followed by drug-resistant epilepsy (63.7%). Visual impairments (43.6%), gait abnormalities (44.1%), and speech impairments (41.3%) were also common. A higher observed burden of comorbidities was noted in SQ compared with other subtypes, including feeding difficulties (43.1%) and musculoskeletal abnormalities (37.5%). Rehabilitation services were accessed by 64.8% of the cohort, primarily physiotherapy. Comparisons with international studies revealed similar trends in CP subtypes and comorbidities but highlighted disparities in aetiological patterns and access to rehabilitation.
Conclusions:
Children with CP in the UAE have a high comorbidity burden, particularly in severe subtypes. These findings support the importance of optimizing perinatal care and improving access to rehabilitation services, though prospective studies are needed to establish causal relationships.
