Suzuki J, Ito M, Tomiwa K, Okuno T
Department of Preschool Education, Shiga Women's Junior College, Otsu.
No To Hattatsu. 1999 Jul;31(4):329-35.
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.
1977年4月至1987年3月间出生于滋贺县的202例脑性瘫痪患儿，在6岁时被分为5组：痉挛性双侧瘫69例（34%），四肢瘫62例（31%），偏瘫33例（16%），运动障碍型23例（11%），共济失调型15例（7%）。早产率为32%，在痉挛性双侧瘫组中最高。对这些病例的病因和危险因素进行了分析。在痉挛性双侧瘫的足月儿中，55%的推测病因不明，28%为产前因素，围产期因素仅占17%。在痉挛性双侧瘫的早产儿中，脑室周围白质软化是最重要的病因。在四肢瘫的足月儿中，脑畸形和缺氧缺血性脑病是两个主要病因。在四肢瘫的早产儿中，67%的推测病因是围产期因素。在大多数偏瘫患者中，存在单侧病变，如大脑中动脉梗死和大脑半球萎缩。大多数运动障碍型病例有围产期病因，如9例患有胆红素脑病。在40%的共济失调型病例中，存在脑畸形。
