Cerebral palsy causes: Difference between revisions
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==Causes== | ==Causes== | ||
Birth asphyxia is believed to be the principal etiology for cerebral palsy. However, recent studies demonstrated that 70% to 80% of cases of cerebral palsy are due to antenatal factors, while only 10% to 28% of cases are due to birth asphyxia in term and near-term infants. Causes of cerebral palsy are often multifactorial. For example, an intrauterine infection may result in growth restriction, maternal fever, and prematurity, all of which have been associated with cerebral palsy.<ref name="pmid9307261">{{cite journal |vauthors=Thorarensen O, Ryan S, Hunter J, Younkin DP |title=Factor V Leiden mutation: an unrecognized cause of hemiplegic cerebral palsy, neonatal stroke, and placental thrombosis |journal=Ann. Neurol. |volume=42 |issue=3 |pages=372–5 |year=1997 |pmid=9307261 |doi=10.1002/ana.410420316 |url=}}</ref><ref name="pmid15183137">{{cite journal |vauthors=Jacobsson B, Hagberg G |title=Antenatal risk factors for cerebral palsy |journal=Best Pract Res Clin Obstet Gynaecol |volume=18 |issue=3 |pages=425–36 |year=2004 |pmid=15183137 |doi=10.1016/j.bpobgyn.2004.02.011 |url=}}</ref><ref name="pmid8264743">{{cite journal |vauthors=Kuban KC, Leviton A |title=Cerebral palsy |journal=N. Engl. J. Med. |volume=330 |issue=3 |pages=188–95 |year=1994 |pmid=8264743 |doi=10.1056/NEJM199401203300308 |url=}}</ref><ref name="pmid14585946">{{cite journal |vauthors=Nelson KB |title=Can we prevent cerebral palsy? |journal=N. Engl. J. Med. |volume=349 |issue=18 |pages=1765–9 |year=2003 |pmid=14585946 |doi=10.1056/NEJMsb035364 |url=}}</ref><ref name="pmid16467053">{{cite journal |vauthors=Odding E, Roebroeck ME, Stam HJ |title=The epidemiology of cerebral palsy: incidence, impairments and risk factors |journal=Disabil Rehabil |volume=28 |issue=4 |pages=183–91 |year=2006 |pmid=16467053 |doi=10.1080/09638280500158422 |url=}}</ref><ref name="pmid23733804">{{cite journal |vauthors=Ishii N, Kono Y, Yonemoto N, Kusuda S, Fujimura M |title=Outcomes of infants born at 22 and 23 weeks' gestation |journal=Pediatrics |volume=132 |issue=1 |pages=62–71 |year=2013 |pmid=23733804 |doi=10.1542/peds.2012-2857 |url=}}</ref> | [[asphyxia|Birth asphyxia]] is believed to be the principal etiology for cerebral palsy. However, recent studies demonstrated that 70% to 80% of cases of cerebral palsy are due to [[antenatal]] factors, while only 10% to 28% of cases are due to [[asphyxia|birth asphyxia]] in term and near-term infants. Causes of cerebral palsy are often multifactorial. For example, an [[intrauterine infection]] may result in [[IUGR|growth restriction]], [[Fever|maternal fever]], and [[prematurity]], all of which have been associated with cerebral palsy.<ref name="pmid9307261">{{cite journal |vauthors=Thorarensen O, Ryan S, Hunter J, Younkin DP |title=Factor V Leiden mutation: an unrecognized cause of hemiplegic cerebral palsy, neonatal stroke, and placental thrombosis |journal=Ann. Neurol. |volume=42 |issue=3 |pages=372–5 |year=1997 |pmid=9307261 |doi=10.1002/ana.410420316 |url=}}</ref><ref name="pmid15183137">{{cite journal |vauthors=Jacobsson B, Hagberg G |title=Antenatal risk factors for cerebral palsy |journal=Best Pract Res Clin Obstet Gynaecol |volume=18 |issue=3 |pages=425–36 |year=2004 |pmid=15183137 |doi=10.1016/j.bpobgyn.2004.02.011 |url=}}</ref><ref name="pmid8264743">{{cite journal |vauthors=Kuban KC, Leviton A |title=Cerebral palsy |journal=N. Engl. J. Med. |volume=330 |issue=3 |pages=188–95 |year=1994 |pmid=8264743 |doi=10.1056/NEJM199401203300308 |url=}}</ref><ref name="pmid14585946">{{cite journal |vauthors=Nelson KB |title=Can we prevent cerebral palsy? |journal=N. Engl. J. Med. |volume=349 |issue=18 |pages=1765–9 |year=2003 |pmid=14585946 |doi=10.1056/NEJMsb035364 |url=}}</ref><ref name="pmid16467053">{{cite journal |vauthors=Odding E, Roebroeck ME, Stam HJ |title=The epidemiology of cerebral palsy: incidence, impairments and risk factors |journal=Disabil Rehabil |volume=28 |issue=4 |pages=183–91 |year=2006 |pmid=16467053 |doi=10.1080/09638280500158422 |url=}}</ref><ref name="pmid23733804">{{cite journal |vauthors=Ishii N, Kono Y, Yonemoto N, Kusuda S, Fujimura M |title=Outcomes of infants born at 22 and 23 weeks' gestation |journal=Pediatrics |volume=132 |issue=1 |pages=62–71 |year=2013 |pmid=23733804 |doi=10.1542/peds.2012-2857 |url=}}</ref> | ||
===Prenatal causes=== | ===Prenatal causes=== | ||
*Placental insufficiency | *[[Placental insufficiency]] | ||
*Intrauterine infection | *[[Intrauterine infection]] | ||
*Chromosomal abnormalities | *Chromosomal abnormalities | ||
*Maternal illness | *Maternal illness | ||
**Chorioamnionitis | **[[Chorioamnionitis]] | ||
**Thyroid disease | **[[Thyroid disease]] | ||
**Thrombotic disorders including factor V Leiden mutations | **Thrombotic disorders including [[factor V Leiden mutations]] | ||
**TORCH infections (toxoplasmosis, syphilis, | **[[TORCH infections]] ([[toxoplasmosis]], [[syphilis]], [[rublla]], [[cytomegalovirus]], [[varicella zoster]], [[HIV]], [[herpes viruses]]) | ||
*Multiple births | *[[Multile gestation|Multiple births]] | ||
*Teratogen exposure | *[[Teratogen|Teratogen exposure]] | ||
*Metabolic disorders | *[[Metabolic disorders]] | ||
*Fetal brain malformation | *[[malformation|Fetal brain malformation]] | ||
===Placental pathology=== | ===Placental pathology=== | ||
*Thrombotic lesions | *[[Thrombotic lesions]] | ||
*Placental ischemia has been associated with spastic diplegia | *Placental ischemia has been associated with spastic diplegia | ||
*Chronic villitis | *[[Chronic villitis]] | ||
* | *[[Preeclampsia]] | ||
===Perinatal causes=== | ===Perinatal causes=== | ||
*Hypoxia-ischemia | *[[Hypoxia]]-[[ischemia]] | ||
*Neonatal encephalopathy | *[[Neonatal encephalopathy]] | ||
*Periventricular leukomalacia | *[[Periventricular leukomalacia]] | ||
** | **[[Periventricular leukomalacia]] increases the risk of cerebral palsy, independent of [[gestational age]]. | ||
**Approximately 75% of infants with cystic | **Approximately 75% of infants with cystic [[periventricular leukomalacia]] develop cerebral palsy. | ||
*Fetal/neonatal stroke | *[[stroke|Fetal/neonatal stroke]] | ||
*Hyperbilirubinemia | *[[Hyperbilirubinemia]] | ||
*Hemolytic disease | *Hemolytic disease | ||
*Kernicterus | *[[Kernicterus]] | ||
===Postnatal causes=== | ===Postnatal causes=== | ||
*Stroke | *[[Stroke]] | ||
*Trauma | *[[Trauma]] | ||
*Infection | *[[Infection]] | ||
{{familytree/start}} | {{familytree/start}} | ||
| Line 46: | Line 46: | ||
{{familytree | | C01 | | | | | C02 | | | | | C03 |C01=Antenatal|C02=Perinatal|C03=Postnatal}} | {{familytree | | C01 | | | | | C02 | | | | | C03 |C01=Antenatal|C02=Perinatal|C03=Postnatal}} | ||
{{familytree | | |!| | | | | | |!| | | | | | |!| }} | {{familytree | | |!| | | | | | |!| | | | | | |!| }} | ||
{{familytree | | D01 | | | | | D02 | | | | | D03 |D01=Prematurity and low birth weight <br> Intrauterine infections<br>Multiple gestations<br> Pregnancy complications|D02=Birth | {{familytree | | D01 | | | | | D02 | | | | | D03 |D01=[[Prematurity]] and [[low birth weight]] <br> Intrauterine infections<br>Multiple gestations<br> Pregnancy complications|D02=Birth [[asphyxia]]<br> complicated labour and delivery |D03=[[Head trauma]]<br>[[Meningitis]]<br>Cardio-pulmonary arrest}} | ||
{{familytree/end}} | {{familytree/end}} | ||
Latest revision as of 16:43, 6 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
Birth asphyxia is believed to be the principal etiology for cerebral palsy. However, recent studies demonstrated that 70% to 80% of cases of cerebral palsy are due to antenatal factors, while only 10% to 28% of cases are due to birth asphyxia in term and near-term infants. Causes of cerebral palsy are often multifactorial.
Causes
Birth asphyxia is believed to be the principal etiology for cerebral palsy. However, recent studies demonstrated that 70% to 80% of cases of cerebral palsy are due to antenatal factors, while only 10% to 28% of cases are due to birth asphyxia in term and near-term infants. Causes of cerebral palsy are often multifactorial. For example, an intrauterine infection may result in growth restriction, maternal fever, and prematurity, all of which have been associated with cerebral palsy.[1][2][3][4][5][6]
Prenatal causes
- Placental insufficiency
- Intrauterine infection
- Chromosomal abnormalities
- Maternal illness
- Chorioamnionitis
- Thyroid disease
- Thrombotic disorders including factor V Leiden mutations
- TORCH infections (toxoplasmosis, syphilis, rublla, cytomegalovirus, varicella zoster, HIV, herpes viruses)
- Multiple births
- Teratogen exposure
- Metabolic disorders
- Fetal brain malformation
Placental pathology
- Thrombotic lesions
- Placental ischemia has been associated with spastic diplegia
- Chronic villitis
- Preeclampsia
Perinatal causes
- Hypoxia-ischemia
- Neonatal encephalopathy
- Periventricular leukomalacia
- Periventricular leukomalacia increases the risk of cerebral palsy, independent of gestational age.
- Approximately 75% of infants with cystic periventricular leukomalacia develop cerebral palsy.
- Fetal/neonatal stroke
- Hyperbilirubinemia
- Hemolytic disease
- Kernicterus
Postnatal causes
| Cerebral palsy | |||||||||||||||||||||||||||||||||||
| Antenatal | Perinatal | Postnatal | |||||||||||||||||||||||||||||||||
| Prematurity and low birth weight Intrauterine infections Multiple gestations Pregnancy complications | Birth asphyxia complicated labour and delivery | Head trauma Meningitis Cardio-pulmonary arrest | |||||||||||||||||||||||||||||||||
References
- ↑ Thorarensen O, Ryan S, Hunter J, Younkin DP (1997). "Factor V Leiden mutation: an unrecognized cause of hemiplegic cerebral palsy, neonatal stroke, and placental thrombosis". Ann. Neurol. 42 (3): 372–5. doi:10.1002/ana.410420316. PMID 9307261.
- ↑ Jacobsson B, Hagberg G (2004). "Antenatal risk factors for cerebral palsy". Best Pract Res Clin Obstet Gynaecol. 18 (3): 425–36. doi:10.1016/j.bpobgyn.2004.02.011. PMID 15183137.
- ↑ Kuban KC, Leviton A (1994). "Cerebral palsy". N. Engl. J. Med. 330 (3): 188–95. doi:10.1056/NEJM199401203300308. PMID 8264743.
- ↑ Nelson KB (2003). "Can we prevent cerebral palsy?". N. Engl. J. Med. 349 (18): 1765–9. doi:10.1056/NEJMsb035364. PMID 14585946.
- ↑ Odding E, Roebroeck ME, Stam HJ (2006). "The epidemiology of cerebral palsy: incidence, impairments and risk factors". Disabil Rehabil. 28 (4): 183–91. doi:10.1080/09638280500158422. PMID 16467053.
- ↑ Ishii N, Kono Y, Yonemoto N, Kusuda S, Fujimura M (2013). "Outcomes of infants born at 22 and 23 weeks' gestation". Pediatrics. 132 (1): 62–71. doi:10.1542/peds.2012-2857. PMID 23733804.