Evaluation of the pediatric cerebral palsy patients: warning signs, complications, risc factors

Evaluation of the Pediatric Cerebral Palsy Patients: Warning Signs, Complications, Risc Factors Aim: This study was conducted between January 2019 and December 2020 to evaluate complications and comorbidities in cerebral palsy patients, relations among them and other risk factors. Material and Method: 66 patients with cerebral palsy who followed-up in the Pediatric Norology Department of the Çukurova University Medical Faculty Hospital between January 2019 and December 2020 were recruited for this study. Data regarding to demographics, birth weight, gestational age at birth, prenatal, natal and neonatal history, walking age, complications and other factors were collected through detailed family anamnesis. Cerebral palsy etiology, clinical type, motor and mental deficit severity were identified. All the data were registered using detailed questionnaire forms. Before recruitment informed consent was obtained from each patient's family. Results: Total 66 patients: 29 (43,9%) girls and 37 (56,1%) boys were recruited for the study. The age of the patients were between 2,25-17,9 years (8±4.1). 23 of the recruited patients (34,8%) had history of gestational complications, 39 (59,1%) had perinatal anoxia, 48 (72,7%) had history of NICU treatment, 34 (51,5%) had neonatal history of mechanical ventilation, 24 (36,4%) had neonatal history of seizures, 25 (37,9%) had neonatal history of hyperbilirubinemia and 25 (37,9%) had neonatal history of infection. 57 (86,3%) of patients had spastic type (22 (33,3%) with hemiplegia, 7 (10,6%) with diplegia, 28 (42,4%) with tetraplegia), 5 (7,6%) had dyskinetic type and 4 (6,1%) mixed type CP. 3 patients (4,5%) were reported to walk before the age of 2, 18 (27,3%) between 2-5 years, 7 (10,6%) after the age of , 38 patients (57,6%) couldn't walk at the moment of evaluation. Pathologic reflexes were positive in 29 patients (43,9%) and negative in 37 of them (56,1%). 13 (19,7%) of all patients weren't evaluated for parachute reflex because of the body weight and sever motor impairment, of those who were evaluated 27 (40,9%) had positive parachute reflex. In terms of GMFCS all patients were distributed as following: 11 (16,7%) with level I, 14 (21,2%) with level II, 5 (7,6%) with level III, 9 (13,6%) with level IV and 27 (40,9%) with level V. The most common complication/comorbidity of CP in recruited patients was mental retardation (n=51, 77,3%), followed by epilepsy (n=49, 74,2%) and speech impairment (n=48, 72,7%). 14 patients (21,2%) had behavioral disorders, 16 patients (24,2%) had GERD and 23 (48,5%) had malnutrition. Other common complications were chronic lung disease (n=12, 18,2%) and orthopedic complications (n=16, 24,2%). Conclusion: Depending on the results of our study we conclude that; CP is a multifactorial disease, genetic factors play a significant role in the development of CP, more than half of all patients has history of term birth, most common clinical type of CP is spastic type, most common complications/comorbidities of CP are mental retardation, epilepsy and speech impairment, there are significant causal relations between the complications/comorbidities of CP. Key Words: Behavioral disorders, cerebral palsy, epilepsy, GMFCS, hearing impairment, malnurtrition, mental retardation, visual impairment.