Prenatal determinants of motor disorders

Cerebral palsies (CP) are the commonest childhood motor disorders, originating in early childhood as a result of interference in the developing brain. Identifying prenatal factors in CP is a challenge because there is a considerable period of time (years) between the causal event(s) and diagnosis. Four fascinating "natural" situations provided a unique opportunity to identify and measure prenatal exposures in relation to motor disorders, thus establishing the unequivocal role of some factors. However, the majority of studies determining adverse reproductive effects of environmental factors require a retrospective case-control approach, which present considerable problems. Studies based on the Western Australian CP register suggest that prenatal factors singly or in complex sequences are more common as causes than those occurring perinatally or postnatally. In future, better diagnosis of motor disorders, use of sophisticated scientific techniques to identify markers of neuronal development and the accurate linkage of these findings to clinical patterns of motor dysfunction are required.