Changes in the Clinical Spectrum of Cerebral Palsy over Two Decades in North India--An Analysis of 1212 Cases

BACKGROUND: Clinical spectrum of cerebral palsy (CP) is different in developing and developed countries. We evaluated the clinical profile, etiological factors and co-morbidities of children with CP in North India, and compared with our previous study. METHODS: 1212 children with CP registered in last 10 years in our rehabilitation center were compared with our previous study of 1000 children from same center. RESULTS: Spastic quadriplegia is the commonest type of CP (51.5%) although lesser than previous decade (61%). Birth asphyxia remains the main (51.98%) etiological factor as earlier (45.3%). CP due to CNS infections decreased from 63.5% to 57.4%, due to bilirubin-encephalopathy remained same (∼30%). Speech problems (83.7%), microcephaly (64.27%), seizures (44.5%) and intellectual disability (38.61%) are common co-morbidities. Common neuroimaging findings include hypoxic-ischemic changes and periventricular leucomalacia. CONCLUSION: The spectrum of CP is evolving in the developing countries with an increase in diplegic and a decrease in quadriplegic CP.