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Category: Volume 09 Issue 07 July 2021
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Title: Clinical patterns of Cerebral palsy in children who underwent serial casting for improvement in mobility at a tertiary care centre

Authors: Sudhir Ravindran, George Zachariah, Padmakumar G, Jijo Varghese

 DOI: https://dx.doi.org/10.18535/jmscr/v9i7.19

Abstract

Introduction and Rationale: Tone and movement abnormalities are the major impairments in Children with Cerebral palsy. The various clinical patterns of tone and movement abnormalities in children with Cerebral palsy include Spasticity, Dyskinesia, Hypotonia, Ataxia, and Dystonia. These clinical patterns also affect the limbs and trunk in different proportions. Serial Casting with plaster of Paris is one of the few interventions used for improving movement dysfunction and tone in children with cerebral palsy. Very little data is available describing the various patterns and its topographical involvement in such children who undergo serial casting for improvement in movement dysfunction and tone abnormality. The aim of this study is to describe the proportion of various clinical patterns of cerebral palsy in children who underwent serial casting for improvement in mobility.

Methodology: Retrospective data of clinical patterns of Cerebral palsy and its topographic distribution in 145 children who underwent serial casting at a tertiary care centre in India from 2016 to 2019 were compiled. This data was entered into a proforma after maintaining confidentiality of the patient and after Institutional Ethical committee clearance. This data was analysed for demographic data, proportions of clinical patterns of cerebral palsy and the topographic distribution of the impairments. This is a retrospective, descriptive, record based census type study.

Results & Discussion: Data of 145 children with cerebral palsy were studied. The mean age was 5.8 yrs. Majority of them belonged to the 2 to 6 age group (66.9%). About 58.6 % of the study subjects were males and 41.4 % were females. Similar to other studies, majority (93.8%) of the children with CP had hypertonia and the rest had hypotonia. The prevalence of various types of tone and movement abnormalities were as follows. Most of the children had spasticity (93.1%), 6.2% had dyskinesia, 3.4% had hypotonia, 2.8% had ataxia and 1.4% had dystonia. Diplegia accounted for 57.9% of the children and 15.2% had tetraplegia/quadriplegia. 11% had total body involvement. Most of the children with hemiplegia had involvement of the right side (73.3%) and 26.7% had left side involvement.

Conclusion: Majority of the children with cerebral palsy who underwent serial casting had hypertonia. 93.1% of the children had spasticity, 6.2% had dyskinesia, 3.4% had hypotonia, 2.8% had ataxia and only 1.4% had dystonia. 11.7% of the children had a mixed pattern of movement dysfunction. 57.9 % of the children had diplegia, and 15.2 % had tetraplegia and 11% had total body involvement. All of the children who had hemiplegia had spasticity only. Majority of the children with mixed pattern of CP had either tetraplegia or total body involvement.

Keywords: Cerebral palsy, prevalence, proportion, type of CP, spasticity, ataxia ,dyskinesia, hypotonia, dystonia, hemiplegia, diplegia, quadriplegia, total body involvement.

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Corresponding Author

Sudhir Ravindran

Associate Professor, Department of Orthopaedics, Government Medical College, Thiruvananthapuram, Kerala, India