[A clinical study of cerebral palsy in Shiga; 1977-1986--I. Etiological analysis of various types of cerebral palsy].

Two hundred and two cases of CP in Shiga Prefecture, born between April 1977 and March 1987, were classified at 6 years of age into 5 groups: 69 with spastic diplegia (34%), 62 with tetraplegia (31%), 33 with hemiplegia (16%), 23 with the dyskinetic type (11%) and 15 with the ataxic type (7%). The rate of preterm birth was 32%, being highest in the spastic diplegia group. The etiological and risk factors were analysed in these cases. In term infants with spastic diplegia, the presumptive causes were unknown in 55%, prenatal in 28%, and perinatal in only 17%. In preterm infants with spastic diplegia, periventricular leukomalacia was the most important. In term infants with tetraplegia, brain anomalies and hypoxic-ischemic encephalopathy were the two main causes. In preterm infants with tetraplegia, the presumptive causes were perinatal in 67%. In most of the patients with hemiplegia, there were unilateral lesions such as middle cerebral artery infarction and cerebral hemiatrophy. Most of the dyskinetic cases had perinatal causes such as bilirubin encephalopathy in 9 patients. In 40% of the ataxic cases, there were brain anomalies.