Professor of Pediatric Neurology and In-Charge of Child Development Clinic, KAHER's J N Medical College, Belgaum, Karnataka, India.
Fellow in Pediatric Neurology, Senior Resident, Child Development Center, KLE Prabhakar Kore Hospital, Belgaum, Karnataka, India.
Neurol India. 2022 May-Jun;70(3):1048-1051. doi: 10.4103/0028-3886.349640.
Spastic cerebral palsy (CP) is the commonest physiological type according to literature which comes mainly from the developed countries where prematurity is a common cause for cerebral palsy. In developing countries like India, the leading causes of cerebral palsy are birth asphyxia, infections, and hyperbilirubinemia and, hence, the physiological type of CP is likely to be different. However, the data from our country is scant.
103 consecutive treatment-naive CP patients attending pediatric neurology clinic were evaluated in detail using an objective tool, hypertonia assessment tool (HAT) over a period of 6months. Based on the predominant tone, the cases were classified as spastic, dyskinetic, ataxic/hypotonic, and mixed. The type of cerebral palsy was correlated with perinatal details and neuroimaging findings.
Out of 103 children, the most common physiological type of CP seen was of dyskinetic type [54 (52.4%)], followed by spastic CP in 30 (29.1%) and mixed (dyskinetic+spastic) CP in 19 (18.4%) children. The most common cause for dyskinetic CP was perinatal asphyxia 33 (61%); for spastic CP was prematurity 17 (56.7%) and; for mixed CP, the main cause was perinatal asphyxia 12 (63.2%). The main neuroimaging finding in predominant dyskinetic CP was basal ganglia/thalamus involvement followed by pericentral and perirolandic gliosis, whereas in spastic CP, it was periventricular leucomalacia. In mixed CP, there was multicystic encephalomalacia.
Dyskinetic CP either as predominant type or along with spasticity is the most common physiological type of CP in India and is due to birth-asphyxia, hyperbilirubinemia, hypoglycemia, and infections.
痉挛性脑瘫（CP）是文献中最常见的生理类型，主要来自发达国家，那里早产是脑瘫的常见原因。在印度等发展中国家，脑瘫的主要原因是出生窒息、感染和高胆红素血症，因此 CP 的生理类型可能有所不同。然而，我们国家的数据很少。
在 6 个月的时间里，使用客观工具——张力评估工具（HAT）对 103 名连续未经治疗的 CP 患者进行详细评估。根据主要张力类型，病例被分为痉挛型、运动障碍型、共济失调/张力减退型和混合型。脑瘫类型与围产期细节和神经影像学发现相关。
在 103 名儿童中，最常见的 CP 生理类型是运动障碍型[54 例（52.4%）]，其次是痉挛型 CP 30 例（29.1%）和混合型（运动障碍+痉挛）CP 19 例（18.4%）。运动障碍型 CP 最常见的病因是围产期窒息 33 例（61%）；痉挛型 CP 是早产 17 例（56.7%）；混合 CP 的主要病因是围产期窒息 12 例（63.2%）。主要运动障碍型 CP 的主要神经影像学发现是基底节/丘脑受累，其次是中央区和额顶叶胶质增生，而痉挛型 CP 则是脑室周围白质软化。在混合型 CP 中，有多囊性脑软化。
在印度，以运动障碍为主或伴有痉挛的运动障碍型 CP 是最常见的 CP 生理类型，其病因是出生窒息、高胆红素血症、低血糖和感染。
