The origins of cerebral palsy.
OBJECTIVE
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.


RESULTS
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.


CONCLUSIONS
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.
Hornsby Ku-Ring Gai Hospital, University of Sydney, Sydney, New South Wales, Australia.
John M
JM
Keogh
Nadia
N
Badawi
D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics / Q000628:therapy; D003952:Diagnostic Imaging / Q000379:methods; D004660:Encephalitis / Q000150:complications; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications; D008297:Male; D010920:Placenta / Q000473:pathology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth; D019851:Thrombophilia / Q000150:complications