Keogh John M, Badawi Nadia
Hornsby Ku-Ring Gai Hospital, University of Sydney, Sydney, New South Wales, Australia.
Curr Opin Neurol. 2006 Apr;19(2):129-34. doi: 10.1097/01.wco.0000218227.35560.0d.
Cerebral palsy is the most common and visible motor disability of childhood. Its aetiology remains a topic of hot debate between those who see it as a reflection of medical mismanagement of an avoidable complication and those who see its origins in the development of the fetal brain affected at many points along a causal pathway to damage. This review outlines the themes of research publications over the year 2004/2005.
The review looks at recent findings relating to epidemiology, infection and inflammation, prematurity, multiple pregnancy, thrombophilias, genetics, placenta, neuroimaging and rescue therapies in cerebral palsy.
Papers this year have helped clarify risk groups and identify some areas (e.g. the management of thrombophilias and the potential of induced hypothermia) with the potential to be rapidly introduced into clinical practice. In this enigmatic and multifactorial condition, however, progress remains slow. New tools such as magnetic resonance imaging are providing valuable insights into the lesions that result in cerebral palsy but the pathways to injury remain unclear. The future of cerebral palsy research lies in understanding the complex interactions of multiple factors on the road to cerebral palsy or in looking for final common pathways such as inflammation which may be amenable to manipulation.
脑瘫是儿童期最常见且明显的运动障碍。其病因仍是一个热门争议话题，一方认为它是可避免并发症医疗管理不当的反映，另一方则认为其起源于胎儿大脑在导致损伤的因果路径上多个点受到影响的发育过程。本综述概述了2004/2005年研究出版物的主题。
该综述探讨了与脑瘫的流行病学、感染与炎症、早产、多胎妊娠、血栓形成倾向、遗传学、胎盘、神经影像学及挽救治疗相关的近期发现。
今年的论文有助于明确风险群体，并确定了一些有可能迅速应用于临床实践的领域（如血栓形成倾向的管理及亚低温治疗的潜力）。然而，在这种病因不明且多因素的疾病中，进展依然缓慢。诸如磁共振成像等新工具为导致脑瘫的病变提供了有价值的见解，但损伤途径仍不明确。脑瘫研究的未来在于了解导致脑瘫过程中多种因素的复杂相互作用，或者寻找诸如炎症等可能易于调控的最终共同途径。
