The evaluation of children with cerebral palsy admitted to the pediatric neurology outpatient department

Abstract

Objective: Cerebral palsy (CP) is a neurological condition that occurs as a result of non-progressive damage in the immature brain and is characterized by impairment of muscle tone and posture. This study aims to evaluate the risk factors and imaging findings of patients with CP. Material and Methods: Medical records of patients with CP at the Pediatric Neurology Clinic of Cerrahpasa Medical School were evaluated retrospectively. Demographic and clinical characteristics were collected from medical records: Gestational age, birth weight, intrauterine growth retardation (IUGR), delivery mode, type of CP, risk factors, accompanying diseases, computed tomography (CT), magnetic resonance imaging (MRI), and electroencephalography findings were recorded. Results: A total of 169 patients were enrolled in the study. The mean age at diagnosis was 27.3±26.1 months. One hundred eight (66.2%) patients were term and 55 (33.7%) were preterm. The delivery mode was vaginal in 99 (58.6%) cases and cesarean section in 70 (40.4%) cases. Ninety-six cases (56.8%) were male and 73 (43.2%) were female. Birth weights were <2500 g in 59 cases (34.9%) and 2500–4500 g in 110 cases (65%). The types of CP were spastic (n=144, 86%), dyskinetic (n=13, 7.7%), mixed (n=6, 3.6%) and ataxic-hypotonic type (n=5, 3%). In subgroup analysis, 65 (38.5%) cases were quadriparetic, 43 (25.6%) cases were diplegic, 35 (20.7%) cases were hemiparetic, and 2 (1.2%) cases were monoparetic. The reasons for CP were asphyxia (n=99, 58.9%), low birth weight (n=61, 36.1%), prematurity (n=55, 32.5%), hyperbilirubinemia (n=16, 9.5%), meningitis (n=7, 4.1%), intracranial vascular processes (n=7, 4.2%), sepsis (n=6, 3.6%), hydrocephalus (n=5, 3%), genetic anomalies (n=5, 3%), and hypoglycemia (n=1, 0.6%). No risk factors could be determined in eight (4.7%) cases. Imaging techniques (CT and/or MRI) showed encephalomalacia, which was considered as the main finding of hypoxic-ischemic encephalopathy, in 45 (26.6%) cases. Imaging results of 15 (8.9%) patients were normal. Conclusion: This study results showed that asphyxia, low birth weight, and prematurity are the main reasons for the development of CP. Encephalomalacia is the most common imaging finding, but imaging may be also normal in some patients with CP.