Dyskinetic cerebral palsy. I. Clinical categories, associated neurological abnormalities and incidences

An unselected series of 116 dyskinetic cerebral palsy cases born 1959-70 was delineated and subgrouped according to neurological criteria into 35 hyperkinetic (30%) and 81 dystonic (70%) cases. Of the hyperkinetics, 80% had a mild motor disability, while 90% of the dystonics had moderate or severe disability. Subordinated spastic signs were found in 9% of the hyperkinetic and in 44% of the dystonic cases. IQ was greater than 90 in 69% of the hyperkinetics and 25% of the dystonics and less than 50 in 11% and 41%, respectively. Two or more additional neurological abnormalities (spasticity, mental retardation, epilepsy, anarthria, dysarthria, hearing deficit) were detected in 46% hyperkinetic and 81% dystonic cases. A heavy multihandicap complex was present predominantly in the dystonic subgroup. The 5-19 year mortality rate was 6% and was confined to the most severely handicapped dystonic cases. The twin rate was 5%. A total of 9% had birth weights less than or equal to 1500 g, and 31% had less than or equal to 2500 g. The weight- and age-specific incidences increased rapidly with decreasing birth weights and gestational ages. The crude incidence of hyperkinetic cerebral palsy was 0.07 and dystonic cerebral palsy 0.17 per thousand live births.