title: Clinical profile, predisposing factors, and associated co-morbidities of children with cerebral palsy in South India.
abstract: BACKGROUND
  Cerebral palsy (CP) is the most common physical disorder of children. Causes like jaundice and birth injury though are decreasing; complications resulting from the survival of low birth weight babies are replacing some of the older etiologies. Hence, this study was planned.
  
  
  OBJECTIVE
  The objective was to study the clinical patterns, predisposing factors, and co-morbidities in children with CP.
  
  
  METHODS
  The present study is a hospital based prospective study conducted from January 2012 to January 2013 in children presenting to neurodevelopmental clinic at a tertiary care teaching hospital in India. Hundred cases with clinical features suggestive of CP were included in the study. Cases were evaluated by history, clinical examination, and necessary investigations.
  
  
  RESULTS
  Results of the study showed 81% of spastic, 12% of hypotonic, 5% of dystonic, and 2% of mixed CP cases. The mean age of presentation was 2 year, 2 month, and male to female ratio of 1:2. Pregnancy-induced hypertension (PIH) was the most common antenatal complication observed in 6%. Four percent had neonatal sepsis and 19% were born premature. Associated co-morbidities were mental retardation (55%), seizure disorder (46%), visual problems (26%), hearing problems (19%), and failure to thrive (47%).
  
  
  CONCLUSIONS
  Sex distribution observed in our study was male to female ratio of 1.2, which was comparable with a multicenter study in Europe. PIH was observed in 6% of cases, which was comparable with prior studies. Birth asphyxia was observed in 43% of cases. Eighty-one percent of the cases constituted a spastic variety of CP which was comparable to other studies.
  
  
  CONCLUSIONS
  Perinatal asphyxia was the important etiological factor. We found preventable intranatal causes (60%) and antenatal causes (20%) forming a significant proportion. Co-morbidities were significantly observed in our study.
authors.affiliation: Department of Pediatrics Neurology, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: Vykuntaraju K
authors.initials: VK
authors.lastname: Gowda
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Shivappa
authors.affiliation: Department of Neurology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India.
authors.forename: Praveen Kumar
authors.initials: PK
authors.lastname: Srikanteswara
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.lastname: Shivananda
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: M S
authors.initials: MS
authors.lastname: Mahadeviah
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: M
authors.initials: M
authors.lastname: Govindraj
authors.affiliation: Department of Pediatrics, Indira Gandhi Institute of Child Health, Bengaluru, Karnataka, India.
authors.forename: Premalatha
authors.initials: P
authors.lastname: Ramaswamy
keywords: Cerebral palsy; South India; clinical profile; co-morbidities; predisposing factors