Children with cerebral Palsy constitute the largest group of pediatric patients with neuromuscular disorder in Pakistan as in any other country of the world like, USA.
The prevalence of cerebral palsy varies around the world according to the amount and quality of prenatal care, the socioeconomic condition of the parents, the environment, and the type of obstetrical and pediatric care the mother and child receive. The number of CP Children must be very high due to the fact that Pakistan is amongst the countries is where the Infant Mortality rate is highest in the world.
In the USA the occurrence is approximately two per 1000 live births; there are approximately 25,000 new patients with cerebral palsy each years and approximately 400,000 children with cerebral palsy at any given time. Worldwide, the prevalence ranges from 0.6 to seven cases per 1000 live birth.
Cerebral Palsy is a disorder in which child is physically handicaped (Disable) and this is a disorder of movement and posture that has a wide variety of presentations, ranging from mildly affected individuals who present with some degree of controlled movements of upper and lower limbs to severely affected patients who have total body involvement i.e. totally disabled even unable to sit and control the neck movement.
This all happens due to some insult/injury to the developing brain between the time of conception and age 2 years. Injury to the developing brain can occur anytime from gestation to early childhood and typically is categorized as perinatal, Prenatal or postnatal. Cerebral palsy in the perinatal period (when the child is being born) from birth until a few days after birth. Typically is associated with asphyxia or trauma that occurs during labor. Oxtocin augmentation, umbilical cord prolapse. Delay labor, meconium inhalation, and breech presentation all have been associated with as increased occurrence of cerebral palsy. Low birth weight infants (<1500 g) are at dramatically increased risk of Cerebral Palsy, with as increase of 60 per 1000 births compared with two per 1000 births in normal weight infants.
Normal Motor Development Milestone are delayed and primitive reflexes that mean that child neck control, sitting & crawling and standing is delayed than normal time period. Good prognostic sign is if child starts sitting by the age of 2 -- 3 years. Associated problem are motor impairment learning disability, seizures, complex movement disorder, visual disturbance.
Individualize approach to each patient is required and multidisciplinary team approach including physical occupational, speach therapy, Orthotics, nutrition , social work, Orthopaedic and General paediatric surgery.
Operative Treatment can be divided into several groups, including procedure to,