Research Article
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Serebral palsi’li hastalarda demografik ve klinik özellikler: Retrospektif tek merkezli gözlemsel çalışma

Year 2018, Volume: 2 Issue: 3, 233 - 235, 01.09.2018
https://doi.org/10.28982/josam.418229

Abstract

Amaç: Serebral palsi (CP) genellikle doğumdan önce, olgunlaşmamış, gelişmekte olan beyinde meydana gelen hasarın neden olduğu bir hareket, kas tonusu veya postür bozukluğudur. Hastalığın iyi bir tanımlanması erken teşhis ve tedavi için yardımcı olacaktır. Burada CP tanısı ile takipli hastaların sosyodemografik, klinik ve radyolojik özelliklerinin değerlendirilmesini amaçladık.

Yöntemler: Çalışmamız retrospektif, kesitsel, tanımlayıcı olarak dizayn edildi. CP tanılı 46 hasta çalışmaya dahil edildi. Hasta dosyalarındaki yaş, cinsiyet, CP türü, eşlik eden klinik bulgular, mental retardasyon varlığı ve kraniyal magnetik rezonans görüntüleme (MRI) bulguları kayıt edildi. 

Bulgular: CP tiplerinden 12 hasta (%26.1) spastik hemiparezik, 9 hasta (%19,6) spastik paraparezik, 17 hasta (%37.0, en sık) spastik tetraparezik, 3 hasta (%6,5) ataksik, 1 hasta (%2,2) hipotonik, 2 hasta (%4,4) ekstrapiramidal, 2 hasta (%4,4) mikst tipte idi. MRI bulgularından araknoid kist 4 hastada (%11.4), bazal ganglion intensitesi 8 hastada (%20,2), ensefalomalazik alan 8 hastada (%20,2), frontogliotik alan 30 hastada (%80,7, en sık), kortikal atrofi 6 hastada (%17,1), megasisterna 5 hastada (%14.3), sentrum semiovale hiperintensitesi 8 hastada (%20,2), ensefalomalazi 8 hastada (%20,2) gözlendi. Hipoksik iskemik beyin hasarı bulguları hastaların 32 (%91.4)’ünde saptandı.

Sonuç: CP tanısı güç koyulabilen fakat erken tanı konulması durumunda daha faydalı olunabilen bir grup hastalık olduğundan özellikle riskli doğan çocuklar yakın takip edilmeli, aileleri uyarılmalı, gerekli görülürse erken dönemde nörogörüntüleme tetkikleri istenmelidir. İleri dönem takip sürecinde hem epilepsi gibi eşlik eden durumların takibi hem de rehabilitasyon açısından hastanın maksimum fiziksel kapasitesine ulaşması için multidisipliner bir ekip tarafından tedavi ve takibinin yapılması gerekmektedir.

References

  • 1. Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014;383(9924):1240-9. doi: 10.1016/S0140-6736(13)61835-8.
  • 2. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am Jour Obst Gynecol. 2015; 213(6):779-88.
  • 3. Richards CL, Malouin F. Cerebral palsy: definition, assessment and rehabilitation. Handb Clin Neurol. 2013;111:183-95.
  • 4. Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, et al. Cerebral palsy. Nat Rev Dis Primers. 2016;2:15082. doi: 10.1038/nrdp.2015.82.
  • 5. Winter L, Colditz PB, Sanders MR, Boyd RN, Pritchard M, Gray PH, et al. Depression, posttraumatic stress and relationship distress in parents of very preterm infants. Arch Womens Ment Health. 2018 Mar 3. doi: 10.1007/s00737-018-0821-6.
  • 6. Yöneyman F, Gürvit G, Yusuf M. Ro-CODEC Screening of the frequency of chronic diseases in children 1997;83-84.
  • 7. Umphred DA. Neurological Rehabilitation. Mosby Inc. 2001;259-86.
  • 8. Sigurdardottir S, Thorkelsson T, Halldorsdottir M, Thorarensen O, Vik T. Trends in prevalence and characteristics of cerebral palsy among Icelandic children born 1990 to 2003. Dev Med Child Neurol. 2009;51(5):356-63.
  • 9. Pereira A, Lopes S, Magalhães P, Sampaio A, Chaleta E, Rosário P. How Executive Functions Are Evaluated in Children and Adolescents with Cerebral Palsy? A Systematic Review. Frontiers in Psychology. 2018;9:21.
  • 10. O’Callaghan ME, MacLennan AH, Gibson CS, et al. Epidemiologic associations with cerebral palsy. Obstet Gynecol. 2011;118:576-82.
  • 11. Oğuz H, Dursun E, Dursun N. Medical Rehabilitation. Istanbul, Nobel Medicine Publisher 2004;957-74.
  • 12. Weir FW, Hatch JL, McRackan TR, Wallace SA, Meyer TA. Hearing loss in pediatric patients with cerebral palsy. Oto & Neur. 2018;39(1):59-64.
  • 13. Yalçın S, Özaras N, Dormans J. Cerebral Palsy Treatment and Rehabilitation. Mas Printing. 2000;13-31:51-6.
  • 14. Downs J, Blackmore AM, Epstein A, Skoss R, Langdon K, Jacoby P at al. The prevalence of mental health disorders and symptoms in children and adolescents with cerebral palsy: a systematic review and meta‐analysis. Develop Med & Child Neur. 2018;60(1):30-8.
  • 15. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D at al. Dev Med Child Neurol Suppl. 2007;109:8-14.
  • 16. Reid SM, Dagia CD, Ditchfield MR, Carlin JB, Reddihough DS. Population‐based studies of brain imaging patterns in cerebral palsy. Develop Med & Child Neur. 2014;56(3):222-32.
  • 17. Piovesana AM, De Moura-Ribeiro MV, Zanardi VA, Gonçalves VM. Hemiparetic cerebral palsy etiological risk factors and neuroimaging. Arq Neuropsiquiatr 2001;59:29-34.

The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study

Year 2018, Volume: 2 Issue: 3, 233 - 235, 01.09.2018
https://doi.org/10.28982/josam.418229

Abstract

Aim: Cerebral palsy (CP) is a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth. 

A good definition of the disease will help for early diagnosis and treatment. The aim of this study was to evaluate the sociodemographic, clinical and radiologic characteristics of patients who were followed up as CP diagnosis.

Methods: Our study was designed as a retrospective, cross-sectional and descriptive. Forty-six patients with CP were included in the study. The age, sex, type of CP, accompanying clinical findings, presence of mental retardation, and cranial magnetic resonance imaging (MRI) data were recorded in the patient files.

Results: The types of CP were determined as spastic hemiparesis in 12 (26.1%) patients, spastic paraparesis in 9 (19.6%), spastic tetraparesis in 17 (37.0%, most frequently)), ataxic in 3 (6.5%), hypotonic in 1 (2.2%), extrapyramidal in 2 (4.4%) and mixed type in 2 (4.4%). In the MRI findings, arachnoid cyst was observed in 4 (11.4%) patients, basal ganglion intensity in 8 (20.2%), encephalomalacia in 8 (20.2%), frontogliotic area in 30 (80.7%, mostly frequently), cortical atrophy in 6 (17.1%), megacisterna in 5 (14.3%), and centrum semiovale hyperintensity in 8 (20.2%). Findings of hypoxic ischaemic brain injury were determined in 32 (91.4%) patients.

Conclusion: As CP is a group of diseases for which diagnosis may be difficult but early diagnosis can be beneficial, children at high-risk from birth must be closely monitored, the families must be warned, and if necessary early neuro-imaging tests should be requested. In the long-term follow-up process, in respect of both rehabilitation and the follow-up of comorbidities such as epilepsy, the treatment and follow-up of patients must be applied by a multidisciplinary team to be able to reach maximum physical capacity.

References

  • 1. Colver A, Fairhurst C, Pharoah PO. Cerebral palsy. Lancet. 2014;383(9924):1240-9. doi: 10.1016/S0140-6736(13)61835-8.
  • 2. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: causes, pathways, and the role of genetic variants. Am Jour Obst Gynecol. 2015; 213(6):779-88.
  • 3. Richards CL, Malouin F. Cerebral palsy: definition, assessment and rehabilitation. Handb Clin Neurol. 2013;111:183-95.
  • 4. Graham HK, Rosenbaum P, Paneth N, Dan B, Lin JP, Damiano DL, et al. Cerebral palsy. Nat Rev Dis Primers. 2016;2:15082. doi: 10.1038/nrdp.2015.82.
  • 5. Winter L, Colditz PB, Sanders MR, Boyd RN, Pritchard M, Gray PH, et al. Depression, posttraumatic stress and relationship distress in parents of very preterm infants. Arch Womens Ment Health. 2018 Mar 3. doi: 10.1007/s00737-018-0821-6.
  • 6. Yöneyman F, Gürvit G, Yusuf M. Ro-CODEC Screening of the frequency of chronic diseases in children 1997;83-84.
  • 7. Umphred DA. Neurological Rehabilitation. Mosby Inc. 2001;259-86.
  • 8. Sigurdardottir S, Thorkelsson T, Halldorsdottir M, Thorarensen O, Vik T. Trends in prevalence and characteristics of cerebral palsy among Icelandic children born 1990 to 2003. Dev Med Child Neurol. 2009;51(5):356-63.
  • 9. Pereira A, Lopes S, Magalhães P, Sampaio A, Chaleta E, Rosário P. How Executive Functions Are Evaluated in Children and Adolescents with Cerebral Palsy? A Systematic Review. Frontiers in Psychology. 2018;9:21.
  • 10. O’Callaghan ME, MacLennan AH, Gibson CS, et al. Epidemiologic associations with cerebral palsy. Obstet Gynecol. 2011;118:576-82.
  • 11. Oğuz H, Dursun E, Dursun N. Medical Rehabilitation. Istanbul, Nobel Medicine Publisher 2004;957-74.
  • 12. Weir FW, Hatch JL, McRackan TR, Wallace SA, Meyer TA. Hearing loss in pediatric patients with cerebral palsy. Oto & Neur. 2018;39(1):59-64.
  • 13. Yalçın S, Özaras N, Dormans J. Cerebral Palsy Treatment and Rehabilitation. Mas Printing. 2000;13-31:51-6.
  • 14. Downs J, Blackmore AM, Epstein A, Skoss R, Langdon K, Jacoby P at al. The prevalence of mental health disorders and symptoms in children and adolescents with cerebral palsy: a systematic review and meta‐analysis. Develop Med & Child Neur. 2018;60(1):30-8.
  • 15. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D at al. Dev Med Child Neurol Suppl. 2007;109:8-14.
  • 16. Reid SM, Dagia CD, Ditchfield MR, Carlin JB, Reddihough DS. Population‐based studies of brain imaging patterns in cerebral palsy. Develop Med & Child Neur. 2014;56(3):222-32.
  • 17. Piovesana AM, De Moura-Ribeiro MV, Zanardi VA, Gonçalves VM. Hemiparetic cerebral palsy etiological risk factors and neuroimaging. Arq Neuropsiquiatr 2001;59:29-34.
There are 17 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research article
Authors

Yılmaz İnanç 0000-0002-0423-0941

Tuba Tülay Koca 0000-0002-4596-858X

Publication Date September 1, 2018
Published in Issue Year 2018 Volume: 2 Issue: 3

Cite

APA İnanç, Y., & Koca, T. T. (2018). The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study. Journal of Surgery and Medicine, 2(3), 233-235. https://doi.org/10.28982/josam.418229
AMA İnanç Y, Koca TT. The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study. J Surg Med. September 2018;2(3):233-235. doi:10.28982/josam.418229
Chicago İnanç, Yılmaz, and Tuba Tülay Koca. “The Demographic and Clinical Characteristics of Patients With Cerebral Palsy: A Retrospective, Single Center, Observational Study”. Journal of Surgery and Medicine 2, no. 3 (September 2018): 233-35. https://doi.org/10.28982/josam.418229.
EndNote İnanç Y, Koca TT (September 1, 2018) The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study. Journal of Surgery and Medicine 2 3 233–235.
IEEE Y. İnanç and T. T. Koca, “The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study”, J Surg Med, vol. 2, no. 3, pp. 233–235, 2018, doi: 10.28982/josam.418229.
ISNAD İnanç, Yılmaz - Koca, Tuba Tülay. “The Demographic and Clinical Characteristics of Patients With Cerebral Palsy: A Retrospective, Single Center, Observational Study”. Journal of Surgery and Medicine 2/3 (September 2018), 233-235. https://doi.org/10.28982/josam.418229.
JAMA İnanç Y, Koca TT. The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study. J Surg Med. 2018;2:233–235.
MLA İnanç, Yılmaz and Tuba Tülay Koca. “The Demographic and Clinical Characteristics of Patients With Cerebral Palsy: A Retrospective, Single Center, Observational Study”. Journal of Surgery and Medicine, vol. 2, no. 3, 2018, pp. 233-5, doi:10.28982/josam.418229.
Vancouver İnanç Y, Koca TT. The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study. J Surg Med. 2018;2(3):233-5.