Demographic data and clinical characteristics of 202 cerebral palsy cases/Serebral palsili 202 olgunun demografik verileri ve klinik ozellikler

• Published in: Türkiye fiziksel tip ve rehabilitasyon dergisi p. 94
• Main Authors: Eriman, Esme Ocal, Icagasioglu, Afitap, Demirhan, Esma, Kolukisa, Seyma, Aras, Huriye, Haliloglu, Sema, Baklacioglu, Hatice Sule
• Format: Journal Article
• Language: Turkish
• Published: Galenos Yayinevi Tic. Ltd 01.09.2009
• Subjects: Care and treatment; Cerebral palsy; Diagnosis; Health aspects; Medicine, Physical; Risk factors; Turkey
• ISSN: 1302-0234

Objective: The aim of this study is to determine the demographic and clinical characteristics of children with cerebral palsy (CP) who applied to physical medicine and rehabilitation outpatient clinic. Materials and Methods: Data of the 202 cases who had reffered to our outpatient clinic between December 2005 and June 2007 was evaluated retrospectively. Results: Ninety-four of the cases were girls and 108 were boys. Their mean age was 6.98 years (1-33 years). The distribution of cerebral palsy types was as follows: diplegia 34% (n:69), tetraplegia 32% (n:66), hemiplegia 26% (n:53), monoplegia 4.5% (n:9), dyskinetic %1 (n:2) and mixed type 1.4% (n:3). CP severity, assessed with the Gross Motor Functional Classification System (GMFCS), was distributed as follows: level 1 (9.9%), level 2 (17.8%), level 3 (20.8%), level 4 (22.8%), level 5 (8.7%). The most frequently encountered prenatal risk factor was consanguineous marriage--25% (n=51), perinatal risk factors were low birth weight--37.1% (n=75) and premature birth--35% (n=72), natal risk factor was forced birth--14.9% (n=30), postnatal risk factor was convulsion--9.9% (n=20), and 14.9% (n=30) were unclassified. 55.4% of the children had speech disorder, 50.4% had mental retardation, 35.6% had visual impairment, 5.9% had epilepsy. Eighty-six of the cases who applied to the clinic were using orthesis. New orthesis were prescribed to 74 patients, botulinum toxin-A injection were performed in 11 cases and 12 of them were referred for surgery. Conclusion: Perinatal risk factors were the most frequently seen when assessing the etiologic factors in CP. Better health conditions will decrease the prevalence of CP by minimizing prenatal, perinatal, and postnatal damage. Prenatal care should be improved, high-risk babies should be followed up closely and the number of neonatal intensive care units should be increased. Key Words: Cerebral palsy, demographic data, etiologic factors Amac: Bu calisma hastanemiz Fizik Tedavi ve Rehabilitasyon poliklinigine basvuran serebral palsili (SP) cocuklarin demografik ve klinik ozelliklerinin tanimlanmasi amaciyla yapilmistir. Gerec ve Yontem: Poliklinigimize Aralik 2005-Haziran 2007 tarihleri arasi nda basvuran 202 olgunun verileri retrospektif olarak incelendi. Bulgular: Toplam 202 olgunun 94'u kiz, 108'i erkekti. Olgularin yas ortalamasi 6,98 yildi (dagilim: 1-33 yas). SP norolojik tiplemesine gore 69 olgu spastik dipleji (%34), 66 olgu spastik tetrapleji (%32), 53 olgu spastik hemipleji (%26), 9 olgu spastik monopleji (%4,5), 2 olgu diskinetik (%1) ve 3 olgu mikstti (%1,4). Kaba motor fonksiyonel sinisama sistemine gore olgularin %9,9'u seviye 1, %17,8'i seviye 2, %20,8'i seviye 3, %22,8'i seviye 4, %28,7'si seviye 5 idi. Etiyolojik faktorlerden prenatal donemde en sik akraba evliligi %25 (n=51), perinatal donemde dusuk dogum agirligi %37,1 (75) ve prematur dogum %35 (n=72), natal donemde zor dogum %14,9 (30), postnatal donemde konvulsiyon %9,9 (n=20) ve nedeni belirlenemeyen de %14,9 (n=30) olarak bulundu. Olgularin %55,4'unde konusma bozuklugu, %50,4'unde zeka geriligi, %35,6'sinda gorme bozuklugu, %5,9'unda epilepsi vardi. Basvuran 86 olgu cihaz kullanmakta idi, 74 olguya ise yeni cihaz yazildi, 11 cocuga botulinum toxin-A enjeksiyonu yapildi, 12 cocuk cerrahi icin yonlendirildi. Sonuc: SP'de etiyolojik faktorler incelendiginde perinatal nedenler en sikti. Iyi saglik kosullari prenatal, natal ve postnatal hasari azaltarak SP prevalansini dusurecektir. Bunun icin dogum oncesi bakim hizmetleri gelistirilmeli, yuksek riskli bebekler yakin takibe alinmali ve neonatal yogun bakim servislerinin sayisi arttirilmalidir. Anahtar Kelimeler: Serebral palsi, demografik veriler, etiyolojik faktorler