Cerebral palsy in southern Sweden I. Prevalence and clinical features

Background Varus osteotomy of the proximal femur (VOPF) is one treatment option to prevent hip dislocation in children with cerebral palsy (CP). It is questioned whether the osteotomy should be performed in the displaced hip only, or if it should be performed bilaterally to prevent later displacement of the contralateral hip. CPUP is a register and healthcare programme for children with CP that was initiated in 1994 in southern Sweden. In the programme, range-of-motion and radiographic examination of the hips is performed regularly. These data have been analysed preoperatively and for 5 years postoperatively in children treated with unilateral VOPF. Methods Children with CP living in the counties of Skåne and Blekinge in the south of Sweden, who were treated with unilateral VOPF at least 5 years ago, were included in the study. The degree of hip displacement and the range of hip motion were analysed preoperatively and after 5 years. Repeat hip operations after the index operation were recorded. Results Twenty-four children fulfilled the inclusion criteria. Mean age at index operation was 7.6 (2.8-13.2) years. No child died within 5 years postoperatively, and no child was lost from follow-up. At follow-up after 5 years, 2 of the 24 children had been operated on with VOPF in the contralateral hip. The range of motion in both hips decreased, but the difference between the index hip and the contralateral hip did not change significantly. Conclusion Children with CP and unilateral hip displacement have a low risk of later contralateral displacement after being operated on with unilateral VOPF. This supports healthcare programmes that advocate unilateral VOPF in children with unilateral hip displacement.

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“…The number of children with CP in the area corresponds to a prevalence of 2.4-2.6 per 1,000 living births [9,10].…”

Section: Methodsmentioning

confidence: 99%

Unilateral varus osteotomy of the proximal femur in children with cerebral palsy: A five-year follow-up of the development of both hips

Larsson

Hägglund

Wagner

2012

Journal of Children's Orthopaedics

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“…All children with CP in the study area in southern Sweden, with a population of 1.3 million, were identified and offered participation in the prevention programme [8]. In this study, radiographs of the children born 1992-1998 were analysed.…”

Section: Methodsmentioning

confidence: 99%

Radiographic threshold values for hip screening in cerebral palsy

Hägglund

Lauge-Pedersen

Persson

2007

Journal of Children's Orthopaedics

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Purpose To analyse the consequences of using different radiographic measurements and different threshold values for hip screening in children with cerebral palsy (CP).Methods In a total sample of children with CP a standardised radiological follow-up of the hips was carried out as a part of a hip prevention programme. Acetabular index (AI) and migration percentage (MP) were measured on all radiographs. In this study, 1,067 radiographs of 272 children born 1992-1998 were analysed. Results Lateral displacement of the femoral head was common without acetabular dysplasia, and acetabular dysplasia occurred at a later stage than femoral head lateralisation. Hip dysplasia without lateral displacement of the femoral head was rare. In 16 of the 56 hips (29%) with AI ‡ 27°and in 23 of the 71 (32%) hips with MP ‡ 33% the values decreased below the threshold value without operative treatment. In hips with AI ‡ 30°only 2 of 31 hips (6%) and in hips with MP ‡ 40% only 5 of 44 hips (11%) decreased below the threshold values without operative treatment. Conclusions Radiographic follow-up with only measurement of the MP seems sufficient in screening for dislocation in children with CP. MP ‡ 33% is recommended as threshold for reaction or intensified observation. In children with MP ‡ 40%, the lateral displacement increased over time in most hips, thus indicating the need for operative intervention. In children with MP 33-40%, treatment should be based on other clinical signs and the progression of MP over time.

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“…The majority of international studies indicates that the prevalence of the cerebral palsy is about 2-2,5 cases per 1000 born, although there are some reports about lower and higher prevalence rates (Nordmark, Hagglund & Lagergren, 2001). …”

Section: Prevalence and Causesmentioning

confidence: 99%

“…In particular, due to the high risk of interventricular haemorrhage and periventricular leukomalacia, an www.intechopen.com According to the time of influence, causes of cerebral palsy can be divided to prenatal (from conception until beginning of the delivery), perinatal (beginning of the delivery until age of 28 days) and postnatal (from 29 th day of age until two years of age). The majority of international studies indicates that the prevalence of the cerebral palsy is about 2-2,5 cases per 1000 born, although there are some reports about lower and higher prevalence rates (Nordmark, Hagglund & Lagergren, 2001). …”

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confidence: 99%

Children with Cerebral Palsy and Epilepsy

Švraka¹

2012

Epilepsy - Histological, Electroencephalographic and Psychological Aspects

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Before the 1992, medical rehabilitation in Bosnia and Herzegovina had been provided at the level of institutions, usually after the hospital or ambulant treatments. As a concept of rehabilitation, community-based rehabilitation (CBR) was included in the strategic plan of reform of health care in Bosnia and Herzegovina. CBR is strategy for rehabilitation, equal possibilities and social integration of all persons with disabilities.Priority problems for the families of children and adolescents with intellectual disabilities in Bosnia and Herzegovina are: lack of Register for developmental and intellectual disabilities,  lack of continuous preventive measures for disability manifestation, www.intechopen.comEpilepsy -Histological, Electroencephalographic and Psychological Aspects 252  lack of continuous education for the professionals in multiprofessional team for work with families of children with intellectual and development disabilities,  lack of continuous education of teachers in general schools for work with children in program of educational inclusion,  lack of adequate and continuous multidisciplinary community support for all education levels for children and adolescents with intellectual disabilities,  lack of adequate programs for profession selection and employment, as well as accompanying legislation, and,  high cost of habilitation-education programs for children and adolescents with intellectual disabilities and their insufficient financing.The aims of the study "The influence of prenatal etiological factors on learning disabilities of children and adolescents with cerebral palsy" were: to identify the prenatal etiological factors of cerebral palsy in children and adolescents aged from 6 to 20 years in the Canton of Sarajevo, Bosnia and Herzegovina;  to determine the learning disabilities among children with the cerebral palsy, and  to determine relationship between prenatal etiological factors of cerebral palsy and learning disabilities of children and adolescents with cerebral palsy.Importance of this study is reflected in the fact that this is the first time in Bosnia and Herzegovina that the influence of the prenatal etiological factors on learning difficulties of the children and adolescents with the cerebral palsy has been determined with use of a scientific method.Knowing the cause of the condition is fundamental to understanding its prevention, its potential complications, and prospective treatment strategies. Thus, there is a great need for better communication and cooperation between all professional dedicated to the care of individuals with intellectual and developmental disabilities (Percy, 2007). The influence of prenatal etiological factors on learning disabilities of children and adolescents with cerebral palsyThe study of the influence of prenatal etiological factors on learning disabilities of children and adolescents with cerebral palsy in the Canton of Sarajevo was conducted as a cohort, retrospective study. The research was conducted in homes of 67 (83,75%) participants, ...

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Cerebral palsy in southern Sweden I. Prevalence and clinical features

Cited by 73 publications

References 24 publications

Unilateral varus osteotomy of the proximal femur in children with cerebral palsy: A five-year follow-up of the development of both hips

Unilateral varus osteotomy of the proximal femur in children with cerebral palsy: A five-year follow-up of the development of both hips

Radiographic threshold values for hip screening in cerebral palsy

Children with Cerebral Palsy and Epilepsy

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