Epidemiological Study of Cerebral Palsy in Shiga Prefecture, Japan, during 1977-2000 Part 3: Clinical Features of Cerebral Palsy at Six Years of Age

Abstract

  Clinical features of cerebral palsy (CP), including the types of CP, severity of disability and complications were evaluated at six years of age in 569 children with CP in Shiga Prefecture born in 1977-2000.
  Spastic diplegia and tetraplegia accounted for the vast majority, 43% and 28%, respectively. Hemiplegia was present in 18%, dyskinetic type in 6% and ataxic type in 5% of the subject children respectively. Spastic diplegia increased and dyskinetic type decreased in the latter half of the study period. The prevalence of diplegia and tetraplegia among those born at preterm increased in the latter half of the study period. Forty-four percent of the children could walk alone at six years of age, 5% walked with a crutch, 14% crawled and 37% could not crawl. Non-walkers in preterm children with CP who were born at preterm increased in the latter half of the study period. Thirty-one percent of the children had normal intelligence, 12% were mildly retarded, 25% were moderately and 32% were severely retarded. Children with normal intelligence born at preterm decreased in the latter half of the study period. Forty-two percent of all children developed epilepsy by six years of age. Severe motor disability, severe mental retardation and epilepsy were present more frequently among children born at term than at preterm.
  A break in the increasing CP trend both in the prevalence and degree of disability was not recognized in Shiga Prefecture during the study period, although neonatal care markedly improved.
  Despite the progress and improvement of neonatal care, no decrease in the prevalence or severity of CP was observed in Shiga Prefecture during the study period.