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Etiological factors in cerebral palsy: an historical review
Insights
Cerebral palsy causes have shifted over time, with prematurity now a leading factor. While athetosis has declined, spasticity and atonic cerebral palsy have increased, alongside factors like hydrocephalus and multiple births.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a group of movement disorders due to early brain damage.
- Understanding etiological factors and trends is crucial for prevention and intervention.
Purpose of the Study:
- To analyze the etiological factors and trends in cerebral palsy cases over several decades.
- To identify changes in the incidence of specific CP types and contributing factors.
Main Methods:
- Retrospective analysis of 1503 cerebral palsy patient records from 1947 onwards.
- Categorization of etiological factors into prenatal, natal, and postnatal origins.
- Tracking of patient numbers and CP subtype prevalence over time.
Main Results:
- Prematurity is the most prominent etiological factor (27.8%).
- Causes are predominantly natal (46.3%), followed by prenatal (38.5%) and postnatal (15.2%).
- Increasing trends observed in spasticity (especially paraplegia/quadriplegia), atonic CP, hydrocephalus, prematurity, trauma, and multiple births.
- Dramatic decrease in athetosis (38% to 3%) and erythroblastosis (to nil).
Conclusions:
- Etiological landscape of cerebral palsy has evolved significantly since 1947.
- Shifting trends necessitate updated prevention and management strategies.
- Increased incidence of certain factors like prematurity and multiple births warrants further investigation and targeted interventions.
Abstract:
The etiological factors in 1503 patients with cerebral palsy seen since 1947 are listed. Prematurity was the most prominent factor, being present in 27.8 per cent of cases. 38.5 per cent of the causes were prenatal in origin, 46.3 per cent natal, and 15.2 per cent postnatal. Since 1947, the number of patients seen rose to a maximum in the 1950s and has fallen since. A steadily increasing percentage of the patient population has been children with spasticity, especially paraplegia and quadriplegia. Although small, the atonic group has shown a marked increase, from 0.8 per cent in the 1950s to 3.4 per cent in the 1970s. There has been a dramatic decrease in the incidence of athetosis, from 38 per cent to about 3 per cent, and a slight decrease in the rigidities. The incidence of some of the etiological factors has increased, such as hydrocephalus, prematurity, trauma and multiple birth. There has been a striking decrease in the incidence of erythroblastosis as a factor, which dropped to nil in the 1970s. There have been lesser decreases in encephalitis, dystocia and idiopathic factors.