Cerebral Palsy

last authored:

Introduction

Cerebral palsy (CP) is more a syndrome than a disease. It is characterized by central motor impairment due to an event or an anomaly of CNS development. There is a variable degree of intellectual impairment.

Incidence is 1.5-2.5 per 1,000 live births.

The Case of...

a simple case introducing clincial presentation and calling for a differential diagnosis. To get students thinking.

return to top

Causes and Risk Factors

Causes are often obscure. A third of cases are idiopathic.

Only 10% are due to intrapartum asphyxia. A further 10% develop the condition following birth due to infection, asphyxia, or intraventricular hemmorhage of prematurity.

There is an association with low birth-weight babies.

Other causes include:

prematurity
IUGR
developmental abnormalities
metabolic conditions
autoimmune disorders
coagulopathy
infection
multiple gestation
truma
asphyxia
substance use and smoking
maternal medical conditions
placental abnormalities

Criteria for assessing intrapartum hypoxemia sufficent to cause CP:

pH <7.00 and base deficit >12 mmol/L
early onset...
...
...
sentinel hypoxic event occurring immediately before or during labour
sudden, sustained bradycardia or absence of variability and persistent, late, or variable decels
...
...

return to top