Abstract

Objective: To determine the frequency of predisposing factors of cerebral palsy (CP) in children presenting to a tertiary care hospital.
Methodology: This cross-sectional study was conducted at the department of Pediatrics, Qazi Hussain Ahmad Medical Complex, Nowshera, Pakistan from August 2023 to January 2024. Children of both genders aged 6 months to 14 years, having CP with motor weakness and onset of signs before the age of 12 months were included. Demographic information, and Gross Motor Function Classification System (GMFCS) evaluation were noted. Types and possible factors leading to CP were noted through analyzing medical history and relevant laboratory and imaging studies.
Result: Out of 139 children, 70 (50.4%) were aged 1-10 years, and 69 (49.6%) between 11-14 years. Male patients were 90 (64.7%). Most children (85; 61.2%) had spastic CP, followed by atonic CP in 31 (22.3%), mixed in 20 (14.4%), and extrapyramidal in 3 (2.2%). Family history of CP was noted in 19 (13.7%) children. Key etiological factors identified included intrapartum hypoxic events in 66 (47.5%) cases, perinatal infections in 26 (18.7%), kernicterus in 9 (6.5%), prematurity in 8 (5.8%), congenital anomalies in 4 (2.9%), and unknown causes in 26 (18.7%). Spastic CP was most frequent across all etiologies, particularly in intrapartum hypoxic events 43 (65.2%) and kernicterus 6 (66.7%), showing a significant association (p=0.004).
Conclusion: Our study highlights the prevalence of preventable causes like intrapartum hypoxia and kernicterus in the development of CP. Spastic CP remains the most common subtype, consistent with global trends, but the high rate of birth-related complications emphasizes the need for improved perinatal care.

Key words: Atonic, cerebral palsy, hypoxia, kernicterus, prematurity, spastic.