Demographic and clinical characteristics and bone-mineral metabolism of pediatric cerebral palsy patients

Aim: The aim of the study is to evaluate clinic and demographic properties, detect bone mineral metabolism problems and raise awareness for these problems of cerebral palsy (CP) patients who were followed up in Çukurova University Pediatric Neurology Department. Material and Methods: 102 patients aged 2-18 years who are regularly followed up in Çukurova University Pediatric Neurology Department, between January 2014-January 2015 are involved in this study. Demographic characteristics, etiologies, clinic and laboratory findings and associated problems of these patients were evaluated. Results: Mean age of patients were 96.83 ± 53.54 months (24-207 months), male/female ratio was 1,2. Fifty one percents of patients'mothers were graduated from elementary school and 18.6% were illiterate. 23.5% of the percents were born term and 50% patients' birth weight was above 2500 gr. spastic Quadriplegia was the most frequent type (38.2%). Most frequent etiologic factor was natal factors (56.9%). In detailed etiologic evaluation, asphyxia (49%) and low birth weight (28.4%) were must seen. Most frequent serebral MRI abnormality was periventricular leukomalacia (25%). Other accompanying problems were mental retardation 88.2%, speech problems (72.5%), malnutrition (67.6%), epilepsy (46.4%), visual problems (28.4%). Antiepileptic drug (AED) evaluation was done; 60.7% patients were on monotherapy, 37,5% were on multiple drug therapy. In epileptic patients; convulsion neonatal seizure, spastic tetraparesic type CP, abnormal MRI findings, mental retardation were risk factors for epilepsy (p≤0,05). No statistical relationship was found between usage of Calcium-vitamin D supplements and levels of osteocalcin, cystatin C and 25(OH)D3 (p>0.05). Levels of osteocalcin, IGF-1, IGFBP-3 and PTH were better in patients who were on regular physiotherapy (p<0.05). Serum 25(OH)D3 levels were significantly lower in patients who are on multiple AED treatment in comparison to patients on monotherapy. Serum 25(OH)D3 levels were correlated with sun exposure (p > 0.05). Conclusıon: In pedeiatric cerebral palsy patients, bone metabolism disorders are more frequent. In long term follow-up, early diagnosis and treatment of these disorders are important to improve quality of life. Enough and correct sun exposure and regular, dynamic physiotherapy may improve bone health. Perinatal asphyxia was the most important etiologic factor in patients with cerebral palsy. For this reason, regular follow-up of neuromotor development in patients with complicated birth and perinatal asphyxia may prevent delayed diagnosis and treatment. Keywords: Cerebral palsy, asphyxia, bone mineral metabolism disorder