Atif Ahmed KHAN, Khalil AHMAD, Saeed Bin AYAZ, Aisha AYYUB, Uzma AKHLAQ

Pakistanlı Çocuklarda Serebral Palsi: Hastane Tabanlı İnceleme

Amaç: Pakistan"da serebralpalsi frekansı yüksektir ancak bu durumun daha fazla araştırılması gerekmektedir. Bu çalışmanın amacı Pakistan"da hastanede serebralpalsili çocuklar arasında klinik sunumların ve etyolojik faktörlerin değerlendirilmesidir. Materyal ve Metod: Bu çalışmaya dahil edilen 102 çocuk, Avrupa"daki Surveillance of CerebralPalsyde gözetim altında bulunan çocuklarla aynı kriterlere sahiptir ve Rawalpindi"de Silahlı kuvvetler rehabilitasyon merkezi enstitüsünde bulunmaktadır. Bulgular: 102 çocuktan 46"sı (%45.1) erkek, 56"sı (%54.9) kızdır, çocukların ortalama yaşları 5.6 ± 2.25" tir. En sık spastik serebralpalsi (%90.2) görülmektedir, bu da dipleji (%33.3), kuadriplejiyi (%32.4) takip eden 3.9% atonik, % 3.9 ataksik/karışık ve %2 atedoit CP olarak görülmektedir. Doğum asfiksisi en sık karşılaşılan etyolojik faktördür (%32.4) bunu prematürite (%26.5), kernikterus (%12.7) ve meningoensefalit (%10.8) takip etmektedir. Spastik kuadriplejik ve diplejik CP, ana olarak doğum asfiksisi, hemiplejik, ataksik ve karışık CP prematurite, atonik ve atedoit CP ise kernikterus ile ilişkilidir. Sonuç: Spastik kuadripleji veya spastik dipleji ,CP teşhisi konulan Pakistanlı çocuklarda en sık karşılaşılan durumlardır. CP gelişiminde en sık karşılaşılan etyolojik faktörler doğum asfeksisi, prematürite, meningoensefalit ve kernikterustur.

Anahtar Kelimeler:

Serebral Palsi, Klinik sunum, etyoloji, doğum asfiksisi, prematurite, düşük doğum ağırlığı, kernikterus, Pakistan

Cerebral Palsy in Pakistani Children: A Hospital Based Survey

Purpose: The prevalence of cerebral palsy is high in Pakistan, however, it needs to be further explored. This study aimed at assessing clinical presentations and etiological factors among children with cerebral palsy in a Pakistani hospital. Materials and Methods:It was a descriptive case series recruiting 102 children who presented to cerebral palsy rehabilitation clinic of Armed Forces Institute of Rehabilitation Medicine, Rawalpindi fulfilling the criteria adopted by Surveillance of Cerebral Palsy in Europe. Results:Of 102 children, 46 (45.1%) were male and 56 (54.9%) were female with a mean age of 5.6 ± 2.25 years. Spastic cerebral palsy was the commonest presentation (90.2%) mainly presenting as diplegia (33.3%) and quadriplegia (32.4%) followed by atonic, ataxic/mixed and athetoid CP accounting for 3.9%, 3.9%, and 2.0% respectively. Birth asphyxia was the most encountered etiologic factor (32.4%) followed by prematurity (26.5%), kernicterus (12.7%) and meningoencephalitis (10.8%). Spastic quadriplegic and diplegic CP were primarily related to birth asphyxia, hemiplegic, ataxic and mixed CP to prematurity and atonic and athetoid CP to kernicterus. Conclusion:Spastic quadriplegia or spastic diplegia are the commonest presentations in Pakistani children diagnosed with CP. The frequent etiological factors in CP development are birth asphyxia, prematurity, meningoencephalitis and kernicterus.

Keywords:

Cerebral Palsy, Clinical presentation, Etiology, Birth asphyxia, Prematurity, Low birth weight, Kernicterus, Pakistan,

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