title: Changes in the clinical spectrum of cerebral palsy over two decades in North India--an analysis of 1212 cases.
abstract: BACKGROUND
  Clinical spectrum of cerebral palsy (CP) is different in developing and developed countries. We evaluated the clinical profile, etiological factors and co-morbidities of children with CP in North India, and compared with our previous study.
  
  
  METHODS
  1212 children with CP registered in last 10 years in our rehabilitation center were compared with our previous study of 1000 children from same center.
  
  
  RESULTS
  Spastic quadriplegia is the commonest type of CP (51.5%) although lesser than previous decade (61%). Birth asphyxia remains the main (51.98%) etiological factor as earlier (45.3%). CP due to CNS infections decreased from 63.5% to 57.4%, due to bilirubin-encephalopathy remained same (∼30%). Speech problems (83.7%), microcephaly (64.27%), seizures (44.5%) and intellectual disability (38.61%) are common co-morbidities. Common neuroimaging findings include hypoxic-ischemic changes and periventricular leucomalacia.
  
  
  CONCLUSIONS
  The spectrum of CP is evolving in the developing countries with an increase in diplegic and a decrease in quadriplegic CP.
authors.affiliation: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh-160012, India.
authors.forename: Pratibha
authors.initials: P
authors.lastname: Singhi
authors.forename: Arushi Gahlot
authors.initials: AG
authors.lastname: Saini
mesh_terms: D000293:Adolescent; D001238:Asphyxia Neonatorum / Q000150:complications* / Q000453:epidemiology; D002547:Cerebral Palsy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008607:Intellectual Disability / Q000453:epidemiology / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009128:Muscle Spasticity / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D011247:Pregnancy; D015995:Prevalence; D011782:Quadriplegia / Q000209:etiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: asphyxia; cerebral palsy; intellectual disability; quadriplegia; seizures