Socio-clinical issues in cerebral palsy in Sagamu, Nigeria

Abstract

of CP at the paediatric neurology clinic was 50.3%. Most subjects were aged 1 - 3 years (77.2%), were malnourished (80.4%) and belonged to the lower socio-economic groups (70.6%). The clinical types of CP were spastic (80.4%), hypotonic (12.0%), extrapyramidal (4.3%) and mixed (3.3%). Quadriplegia was the commonest type of spastic CP (66.2%). Asphyxia (57.6%), kernicterus (36.9%) and CNS infections (21.7%) were the leading identified causes. Co-morbidities such as seizures, microcephaly and speech and auditory deficits were present in 90.2% of the subjects. Seizures and microcephaly were commoner among CP cases associated with asphyxia than those associated with kernicterus (p=0.026 and p=0.005, respectively). Limitations. The rarity of prenatal causes of CP in this study may reflect our inability to investigate high-risk pregnancies adequately, particularly for intra-uterine infections. This also emphasises the inability of retrospective studies to adequately identify risk factors. Conclusion. Most patients with CP in this study were of low socio-economic status and had had perinatal problems. Improved perinatal care may reduce the burden of CP. Continuing training of health workers and traditional birth attendants is essential. It is hoped that this study will stimulate well-designed prospective studies.