Is cerebral palsy preventable?
OBJECTIVE
To use evidence of good medical quality to update information on strategies for prevention of cerebral palsy, and on the success of these preventive efforts to date.


RESULTS
Causes of cerebral palsy, and therefore promising approaches to prevention, differ by gestational age group and by clinical subtype. Neuroimaging and neuropathology indicate the importance of white matter disorders and of ischemic stroke in cerebral palsy; birth asphyxia, congenital malformations, placental pathology, and genetic variants also contribute to cerebral palsy risk. Multiplicity of risk factors markedly increases risk. Recent studies indicate that mild hypothermia lessens cerebral palsy risk in term infants with moderate neonatal encephalopathy, and the possibility that administration of magnesium sulphate to women in preterm labor may aid in primary prevention of cerebral palsy in very preterm infants.


CONCLUSIONS
Past efforts to prevent cerebral palsy have not had the benefits sought, but recent results provide new hope and new challenges.
Nelson
Karin B
KB
National Institute of Neurological Disorders and Stroke, Bethesda, Maryland 20892-2540, USA. knelson@helix.nih.gov
Chang
Taeun
T
D001238:Asphyxia Neonatorum / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D001921:Brain / Q000002:abnormalities* / Q000254:growth & development / Q000503:physiopathology; D002547:Cerebral Palsy / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D004660:Encephalitis / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control; D007231:Infant, Newborn; D009421:Nervous System Malformations / Q000473:pathology / Q000503:physiopathology; D047928:Premature Birth / Q000503:physiopathology; D020521:Stroke / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control