Putting prevention into practice for the benefit of children and young people with cerebral palsy

Himmelmann, Kate

doi:10.1136/archdischild-2018-315134

Cited by 8 publications

(9 citation statements)

References 8 publications

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“…The significance of epilepsy in individuals with CP is discussed controversially in the literature. Epilepsy is common in cerebral palsy, present in 30%-40% of cases [4,16], and seizures are reported on 35.5% of CP children in the hemiplegia subgroup [15]. In the 93 children analyzed in the present study, the incidence of epilepsy was calculated to be 49%, on average higher than that reported in the literature [16][17][18].…”

Section: Discussioncontrasting

confidence: 47%

“…It can manifest itself in several ways, mainly as spastic, athetoid, or ataxic palsies; moreover, it is one of the most common causes of motor disability in children and is frequently associated with other problems, such as developmental delays, sensory defects, and epilepsy. The clinical management of children with CP is directed toward maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation, and scoliosis [15]. The significance of epilepsy in individuals with CP is discussed controversially in the literature.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

et al. 2020

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Cerebral palsy (CP) is a frequent cause of childhood disability often associated with a complex group of disorders, including epilepsy, which is reported to impact approximately 40% of affected individuals. This retrospective study involved a group of children affected by CP, some of whom also had comorbid epilepsy. The aim of this study was to report our experience of analyzing, in particular, (a) some of the clinical aspects of the different type of CP, and (b) the relationship between the clinical data of children affected by CP plus epilepsy and each type of CP. Methods: This retrospective single-center study was performed with 93 children admitted to the Pediatric Department of the University of Catania, Italy, affected by CP and distinguished according to the type of motor clinical presentation, with 46 showing epileptic seizures, compared to a control group of 136 children affected by epilepsy without other neurologic disorders. Results: Among the 93 CP children, 25 (27%) had spastic quadriplegia (plus one patient with dystonic quadriplegia), 39 (42%) had spastic hemiplegia, 11 (12%) had spastic diplegia (plus two with ataxia and one with dyskinetic CP), and 14 (15%) did not have a well-defined type of CP. The frequency of epilepsy was higher in affected CP children who showed major motor dysfunction (GMFCS IV–V types). As regards the 46 children with CP plus epilepsy, compared to the group of the control, the age of epilepsy onset was found to be statistically significant: 21 ± 35.1 months vs. 67 ± 39.7. Conclusions: Epilepsy represents one of the most frequent comorbidities of cerebral palsy. In children with CP, particular attention should be paid to the early identification and treatment of comorbid epilepsy.

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Section: Discussioncontrasting

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

et al. 2020

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“…The different levels of EDACS make clinical sense as a way to describe the eating and drinking abilities of children and young people with CP in both clinical and research contexts. It has been highly recommended as a research tool to describe the characteristics of a study population 38,39 . Important clinical information about children's usual eating and drinking performance at mealtimes can be reliably captured and shared with other health professionals in order to improve treatment and management, including the prevention of respiratory harm 12,39 .…”

Section: Discussionmentioning

confidence: 99%

“…It has been highly recommended as a research tool to describe the characteristics of a study population 38,39 . Important clinical information about children's usual eating and drinking performance at mealtimes can be reliably captured and shared with other health professionals in order to improve treatment and management, including the prevention of respiratory harm 12,39 . It can form the basis of conversations with parents about their children's abilities and a context within which to identify risks associated with eating and drinking and options to manage these in different settings.…”

Section: Discussionmentioning

confidence: 99%

The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time

Sellers

Bryant

Hunter

et al. 2019

PRM

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This study evaluated the inter-observer reliability and stability over time of the Eating and Drinking Ability Classification System (EDACS) for children and young people with cerebral palsy (CP). Method: Case-records for 97 children with CP were examined to collect retrospective data about eating and drinking abilities, at four time-points, minimum 2 years between each time-point. Sex, Gross Motor Function Classification System (GMFCS) level, presence of feeding tube and orthopaedic issues were recorded from case-records. One speech and language therapist (SaLT1) classified eating and drinking ability using EDACS for all cases at all time-points; SaLT2 assigned EDACS levels for 50 cases at time-point 1; SaLT3 assigned EDACS levels for 24 cases at all time-points. Inter-observer reliability and stability over time were assessed using Intraclass Correlation Coefficient (ICC). Associations between EDACS levels and functioning recorded with other Functional Classification Systems (FCSs) were calculated using Kendall's tau (τ). Results: Out of 97 children, 48 were male, 48 had feeding tubes, and 83 had orthopaedic issues. ICC for EDACS levels recorded by SaLT1 across all time-points was 0.97 (95%CI 0.96-0.98); changes in EDACS levels occurred infrequently and never by more than one level. ICC between SaLT1 and SaLT2 at time-point 1 was 0.8 (95%CI 0.67-0.89); ICC between SaLT1 and SaLT3 across all time-points was 0.95 (95%CI 0.92-0.98). Association between GMFCS and EDACS was moderate (τ = 0.58).

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“…Reasons for the high rate of respiratory morbidity are complex, multifactorial and several factors, such as seizures, oromotor dysfunction, gastro-esophageal reflux and scoliosis, may coexist within the same individual ( 80 , 81 ). Impaired airway clearance, due to respiratory muscle weakness, impaired coordination and poor positioning, in the context of poorer motor function, may predispose to infection and atelectasis.…”

Section: Respiratory Dysfunctionmentioning

confidence: 99%

Multi-Organ Dysfunction in Cerebral Palsy

et al. 2021

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Cerebral Palsy (CP) describes a heterogenous group of non-progressive disorders of posture or movement, causing activity limitation, due to a lesion in the developing brain. CP is an umbrella term for a heterogenous condition and is, therefore, descriptive rather than a diagnosis. Each case requires detailed consideration of etiology. Our understanding of the underlying cause of CP has developed significantly, with areas such as inflammation, epigenetics and genetic susceptibility to subsequent insults providing new insights. Alongside this, there has been increasing recognition of the multi-organ dysfunction (MOD) associated with CP, in particular in children with higher levels of motor impairment. Therefore, CP should not be seen as an unchanging disorder caused by a solitary insult but rather, as a condition which evolves over time. Assessment of multi-organ function may help to prevent complications in later childhood or adulthood. It may also contribute to an improved understanding of the etiology and thus may have an implication in prevention, interventional methods and therapies. MOD in CP has not yet been quantified and a scoring system may prove useful in allowing advanced clinical planning and follow-up of children with CP. Additionally, several biomarkers hold promise in assisting with long-term monitoring. Clinicians should be aware of the multi-system complications that are associated with CP and which may present significant diagnostic challenges given that many children with CP communicate non-verbally. A step-wise, logical, multi-system approach is required to ensure that the best care is provided to these children. This review summarizes multi-organ dysfunction in children with CP whilst highlighting emerging research and gaps in our knowledge. We identify some potential organ-specific biomarkers which may prove useful in developing guidelines for follow-up and management of these children throughout their lifespan.

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Putting prevention into practice for the benefit of children and young people with cerebral palsy

Cited by 8 publications

References 8 publications

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

The Eating and Drinking Ability Classification System for cerebral palsy: A study of reliability and stability over time

Multi-Organ Dysfunction in Cerebral Palsy

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