Dyskinetic cerebral palsy in Europe: trends in prevalence and severity.
OBJECTIVE
To describe the trends for and severity of dyskinetic cerebral palsy in a European collaborative study between cerebral palsy registers, the Surveillance of Cerebral Palsy in Europe (SCPE).


METHODS
The prevalence of dyskinetic cerebral palsy was calculated in children born in 1976-1996. Walking ability, accompanying impairments and perinatal adverse events were analysed.


RESULTS
578 children had dyskinetic cerebral palsy, of whom 70% were born at term. The prevalence per 1000 live births increased from 0.08 in the 1970s to 0.14 in the 1990s. For the 386 children (70%) with a birth weight of > or =2500 g, the increase was significant (0.05 to 0.12). There was a concurrent decrease in neonatal mortality among children with a birth weight of > or =2500 g. Overall, 16% of the children walked without aids, 24% with aids and 59% needed a wheelchair. Severe learning disability was present in 52%, epilepsy in 51% and severe visual and hearing impairment in 19% and 6%, respectively. Accompanying impairments increased with motor severity. In children born in 1991-1996, perinatal adverse events, that is an Apgar score of <5 at 5 min and convulsions before 72 h, had occurred more frequently compared with children with bilateral spastic cerebral palsy (BSCP, n = 4746). Children with dyskinetic cerebral palsy had more severe cognitive and motor impairments than children with BSCP.


CONCLUSIONS
The prevalence of dyskinetic cerebral palsy appears to have increased in children with a normal birth weight. They have frequently experienced perinatal adverse events. Most children have a severe motor impairment and several accompanying impairments.
Himmelmann
K
K
Queen Silvia Children's Hospital/Sahlgrenska University Hospital, SE-416 85 Göteborg, Sweden. kate.himmelmann@vgregion.se
McManus
V
V
Hagberg
G
G
Uvebrant
P
P
Krägeloh-Mann
I
I
Cans
C
C
D001034:Apgar Score; D001724:Birth Weight; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D007391:International Cooperation; D007859:Learning Disabilities / Q000453:epidemiology / Q000209:etiology; D008297:Male; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D016138:Walking