Comparative Aetiological Studies of Congenital Diplegia in Scotland

The Neurology of Cerebral Palsy

“…Mothers of children who suffer from diplegia tend to be less fertile than other women in the community, and there is a high reproductive casualty rate amongst other conceptions through abortion, stillbirth, neonatal death, and postnatal death. In addition, a higher proportion than expected of surviving children are mentally retarded, and have epileptic seizures, or other diseases of the central nervous system (Drillien et al, 1962(Drillien et al, , 1964. These studies suggest that Freud's (1897) speculations about there being predisposition to suffer from diplegia and other abnormalities of the nervous system in the offspring of some mothers may have been well founded.…”

“…3), allows a diagnosis to be made of dyskinetic cerebral palsy attributable to rhesus incompatibility (Crothers, 1921;Byers, 1942;Evans and Polani, 1950;Forrester and Miller, 1955;Plum, 1965). The clinical picture of more or less symmetrical paresis of the limbs, more marked in the lower limbs than in the upper, and usually associated with rigidity or spasticity, which is found in a high proportion of babies of small birth weight, is also characteristic, though it is much more difficult to identify the 'cause' in this example (Drillien, 1964;Russell, 1960a).…”

“…More recent work has supported Freud's conclusions, for it is shown how difficult it may be to distinguish on clinical grounds (and even after radiological and other investigations) when cerebral palsy has been the result of developmental malformations of the brain and when it has been caused by perinatal injury (Minkowski, 1955;Courville, 1953Courville, , 1954Norman, 1963). The need for caution in attributing 'a cause' to the brain damage in these patients has been further emphasized by the demonstration that there appear to be predisposing factors, probably genetically determined, which make some individuals susceptible to cerebral palsy as a result of perinatal injury to the brain (Drillien, Ingram, and Russell, 1962).…”

“…Attention is no longer practically confined to what happened in the perinatal period; a more detailed family history is taken as to the reproductive history of the mother, and ofher sisters, mother, and aunts (Ingram and Russell, 1961;Ingram, 1964b;Drillien, Ingram, and Russell, 1964).…”

Aetiological Aspects of Febrile Convulsions: Pregnancy and Perinatal Factors

“…When compared with matched controls, mature diplegic infants are found to have a statistically significant excess of problems during labour and delivery, and in the neonatal period (Drillien, Ingram, and Russell, 1962). The present finding that fetal distress is significantly commoner only in males probably reflects the increased vulnerability of this sex to the birth process.…”