Anesthetic Considerations in Patients With Cerebral Palsy

Cerebral palsy is a group of permanent neurodevelopmental disorders that affects an individual’s muscle tone, motor functions, movement, and posture. It encompasses a broad spectrum of clinical symptoms affecting multiple organ systems, with clinical presentation varying widely between individuals. It occurs in approximately 2 per 1,000 live births, and incidence has remained stable, or slightly increased, over the last 50 years.  Patients with cerebral palsy are often encountered in the perioperative setting for a variety of indications, including orthopedic or neurosurgical procedures, gastrostomy tubes or tracheostomy, dental extractions, and imaging, to name a few. Cerebral palsy poses a particular challenge to the anesthesiologist. Appropriate perioperative management requires a meticulous understanding of the etiology, pathophysiology, and clinical implications of this group of disorders.