Multiple nutritional deficiencies in cerebral palsy compounding physical and functional impairments

Abstract

Introduction:Cerebral palsy (CP) refers to a spectrum of disorders causing physical and intellectual morbidity. Macro and micro nutrient deficiencies often contribute to the subnormal physical and mental capabilities of them.Objectives:To assess the growth, nutritional status, physical and functional ability and quality of life in cerebral palsy children and to determine any relation with their gross motor and functional capabilities.Method:The study was conducted at a Tertiary Care Centre, with the participants in the age group 1-16 years. A pretested evaluation tool was prepared which included Anthropometric measurements, tests for hemoglobin and Vitamin D estimation, evidence of micronutrient deficiencies, Dietary patterns, Epidemiological factors, Functional assessment using GMFM (Gross Motor Function Measure ) and FIM (Functional Independent Measurement) scales and Quality of life (QOL) assessment. The data was statistically analyzed.Results:Out of the 41 children, 30 had quadriplegia, 3 had hemiplegia and 8 had spastic diplegia. 34 (82.9%) were severely underweight, 35 (85.4%) had severe stunting and 38 (92.7%) had severe wasting. Micronutrient deficiencies were noted like vitamin B complex deficiency in 37 (90.2%), vitamin A deficiency in 31 (75.6%), low vitamin D levels in 27 (65.9%) and insufficient levels in 9 (22%), severe anemia in 5 (12.2%) and moderate anemia in 26 (63.4%). The gross motor and functional scores were suboptimum in the majority of patients and the care givers had significant impairment in the quality of life.Conclusion:Majority of children with cerebral palsy had multiple nutritional deficiencies, gross motor and functional disabilities. QOL of the children and their care givers were suboptimum. A comprehensive package that address dietary intake, correction of micronutrient deficiencies especially anemia and vitamin D deficiency, physical and emotional support is recommended for the wellbeing of the affected children.

Determinants of Time to Care for Children and Adolescents With Disabilities

“…This finding contradicts one of our hypothesis, which proposed that children who used more adaptations would be more functional. However, it is consistent with the findings from other studies that reported an association between lower gross motor function, use of more adaptations, and more assistance provided by the caregiver in self-care and mobility activities (Alghamdi et al, 2019; Hariprasad et al, 2017; Østensjø et al, 2005; Sawyer et al, 2011).…”

Profile of Cerebral Palsy Patients in Dr. Soetomo General Hospital Surabaya, Indonesia

“…20 Another study explained this situation as a disturbance in growth hormone (GH) release. 21 A severe brain damage in CP patient may cause this disruption in normal GH secretion 22 and may affects growth and development of CP patient in various way.…”

Vitamin B1 and B12 mitigates neuron apoptosis in cerebral palsy by augmenting BDNF expression through MALAT1/miR-1 axis

“…It is well known that vitamin B is a class of significant nutrient that highly benefit neurological system, and vitamin B complex in low-doses promote the development, maturation, and enlargement of human embryonic brain cells [26]. Actually, vitamin B complex deficiency has been noted in children with cerebral palsy [27], and the effects of vitamin B1 and B12 on facilitating the regeneration of the peripheral have been previously confirmed [28]. Regretfully, seldom progress has been made in cerebral palsy treatment with vitamin B.…”