A descriptive study of children with cerebral palsy at Chris Hani Baragwanath Academic Hospital
Background. Cerebral palsy (CP) is a motor disability owing to a non-progressive insult to the developing motor brain. To contribute to the paucity of CP data in South Africa, we undertook a retrospective study to describe new cases of CP presenting at the CP clinic at Chris Hani Baragwanath Academic Hospital (CHBAH) in Soweto, Johannesburg.
Objective. To determine the age at presentation, the common types of CP that are seen at the clinic, and imaging abnormalities detected; and to assess the level of functional capabilities of patients using the Gross Motor Function Classification Scale (GMFCS). We assessed the association between the GMFCS level of patients with the type of imaging abnormalities, type of CP, gestational age, and comorbidities. Methods. All CP patients who presented for the first time to the CP clinic in 2012 were screened for enrolment. A total of 145 patients from the 201 new cases of CP presenting to the CP clinic during the study period were included in the study. Demographic data, radiology reports of imaging abnormalities (if imaging had been performed), GMFCS scores and perinatal history were extracted from the clinical files.
Results. The mean (standard deviation) age at presentation of the patients was 34.7 (35) months. Two-thirds of the patients were male. Forty-eight percent of CP patients were diagnosed with neonatal encephalopathy. Mixed CP (39%) was the predominant type of CP. Cranial ultrasound, computed tomography (CT) scanning and magnetic resonance imaging (MRI) of the brain were performed in 60% of the patients. These scanned patients (54%) had periventricular white matter lesions (PWML). More than a third of cases had a level III GMFCS score. Intellectual impairment was the most frequent comorbidity.
Conclusion. In our cohort of patients, PWML were frequently reported on imaging results, DGML (deep grey matter lesions) were infrequently described, and some patients had normal imaging reports. Most of our patients functioned at GMFCS level III with a higher GMFCS level correlating with the type of CP, intellectual impairment and orthopaedic complications. Most CP patients had been diagnosed with neonatal encephalopathy. This information will aid in the management of patients with CP at CHBAH.
N Mahlaba, Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
F L Nakwa, Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
J R Rodda, Department of Paediatrics, Chris Hani Baragwanath Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Date published: 2020-04-23
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