Keywords : cerebral palsy


Patterns and Prognosis of Epileptic seizures in Children with Cerebral Palsy

Kawes O.Zangana; Muhi Kadhem Al-Janabi; Abdulla F. Ahmad; Zaher T. Gardi

Iraqi Postgraduate Medical Journal, 2017, Volume 16, Issue 1, Pages 64-71

ABSTRACT:
BACKGROUND:
Cerebral palsy (CP) is the result of non-progressive damage to the developing brain and consists of a number of clinical neurological syndromes of heterogeneous etiology. Epilepsy is known to have a higher association with cerebral palsy; 15–60% of children with cerebral palsy have been reported to have epilepsy.
OBJECTIVE:
This study was performed to determine and assess the characteristics of cerebral palsy and explore the relationship between type of cerebral palsy and patterns of epileptic seizures and to determine the associated factors, nature and prognosis of epilepsy in children with cerebral palsy.
PATIENTS AND METHODS:
Design:A prospective, hospital-based, case-control study.
Setting: RaparinPediatric Teaching Hospital, Rizgary Teaching Hospital-Neurology Department and Helina Handicap Care Centre during the period of January 2013- July 2015, Erbil, KRG, Iraq.
PATIENTS:
One hundred and twelve children had CP and seizures were studied (group1). Two control groups included 70 children had CP without seizures (group2), and 50 children had seizures without CP (group3).
The following data were ascertained: Type of CP, pattern of seizures, age, gender, age at onset of seizures, mode of delivery, history of hypoxic ischemic encephalopathy in the neonatal period, neonatal seizures, history of status epilepticus, family history of seizures, developmental delay, EEG data, image findings, use of anti-epileptic drugs, seizures control and seizures outcome. Children with febrile convulsion were excluded from this study.
RESULTS:
Spastic tetraplegia wasthe most common type of CP (29.46%, 35.71%) in group 1 and 2 respectively.Generalized tonic, clonic or tonic clonic seizures were the most common types of seizures in both groups. Unlike those who had epilepsy without CP,themajority; 57(50.89%) of patients who had epilepsy and CPdeveloped seizures in the first year of life. Twenty eight percent of caseswith epilepsy and cerebral palsy, and 88% of cases with epilepsies alone showed good seizure control by antiepileptic therapy. Children who had epilepsy and CPhad a higher frequency of; neonatal seizures44 (39.28%), developmental delay98 (87.5), abnormal brain CT scan 91(81.25%) and family history of seizures47 (41.69%). Large number of patients who had epilepsy and CP 81(72.32%) needed poly therapy while majority ofthose who had epilepsy without CP needed single therapy 60(90%).
CONCLUSION:
Cerebral palsy is associated with a higher incidence of seizure disorders, whichin a majority has its onset in the first year life.Brain imaging showed abnormal pathology in most affected children and needed poly therapy and even difficult to control.

Risk Factors & Clinical Patterns of Cerebral Palsy in Children Welfare Teaching Hospital in Baghdad

Mahjoob N. AL-Naddawi; Nebal Waill Saadi; Aseel Rasheed Abid

Iraqi Postgraduate Medical Journal, 2011, Volume 10, Issue 3, Pages 284-292

ABSTRACT:
BACKGROUND:
Cerebral palsy (CP) is a disorder of posture , movement & tone due to a static encephalopathy acquired during brain growth in fetal life, infancy or early childhood.
OBJECTIVE:
To identify the risk factors of CP & its clinical patterns.
PATIENTS AND METHODS:
This case control study was done from the 1st of January 2009 to the end of September 2009, on 100 patients with CP who attended the neurology clinic or have been admitted to the neurology ward in Children Welfare Teaching Hospital in Medical City complex, Baghdad. For comparative purposes,100 control individuals matched for sex & age were selected. Some of those patients were referred to pediatric clinic & registered with a diagnosis of CP & some of them were brought by the parents or caregivers without referral for various complaints, then we reviewed their full history & examination ( mainly neurological ) to confirm the diagnosis of CP. A specially designed questionnaire form was used .
RESULTS:
Out of 100 patients with cerebral palsy, male:female ratio was (1.3:1), 89% of the patients were born at term whereas 11% were preterm. Those patients were found to have history of normal vaginal delivery in 70%, with one patient only delivered by assisted delivery, while 29% of them delivered by caesarean section mode of delivery. History of intrauterine growth retardation found in 21% patients, 4% were twin. The mothers of those patients had history of pre-eclampsia in 8% of the cases, regular antenatal care in 65%, history of antipartum haemorrhage in 4%, premature rupture of membrane in 13%. Abnormal presentation was found in 8%, cord prolapse in 4%, neonatal jaundice in 62%, neonatal seizure in 8%, history of head trauma in 4% & history of central nervous system infection in 20%. Spastic CP was the commonest type (67%), while mixed and atonic CP were the least type (1% for each). Quadriplegic CP was the commonest topographical subtype (56%). Delayed social milestone was found in 46% , speech difficulty in 94% , deafness in 2% , ocular problem in 29% , seizure in 58% & all of them had delayed milestone & weakness.
CONCLUSION:
Neonatal convulsion, neonatal jaundice, neonatal infection, antepartum hemorrhage & head trauma are significant risk factors for cerebral palsy while precipitate labour, caesarean section, twins, toxemia, breech delivery, low birth weight & cord prolapse were not found to be significantly associated with cerebral palsy. The most common clinical pattern of CP was spastic quadriplegic CP

Psychological Burden of a Child with Cerebral Palsy Upon Caregiver in Erbil Governorate.

ala; Eqbal A.Mu

Iraqi Postgraduate Medical Journal, 2008, Volume 7, Issue 2, Pages 129-134

ABSTRACT:
BACKGROUND:
A with disabled child have a great burden on caregiver is, they are under the risk of having depression, anger, and can be under great stress. Caregivers have stroking emotional and behavioural changes such as forgetfulness, depression, dependence, lack of motivation, often felt confined, and fatigue from their responsibilities.
OBJECTIVES:
To assess the psychological burden of child with Cerebral Palsy (CP) upon his/ her caregivers.
METHODOLOGY:
A descriptive study was conducted in the Helena Center (HC) in Erbil Governorate for handicapped children from 15th February to 15th March 2005; Data were analyzed by using frequencies, percentages, mean of scores, comparative significant, Pearson's correlation, and multi regression analysis.
RESULTS:
Of the study indicate that (85%) of caregivers are child's mothers (68%) their age between (25–38) years, (60%) are illiterate, (79%) come from low Socio Economic Status (SES), (46%) live in crowded situations, (50%) of CP at preschool age, (54%) were males, (58%) of CP children diagnosed at infant stage. (80%) of CP is spastic type, (34.4%) of CP children have mutism, and (33.7%) has Mental Retardation (MR) accompanying CP.
CONCLUSION:
There is a highly significant association between the psychological burden and the age of caregiver, crowding index, complications like mutism, MR and epilepsy.