Affiliations: Department of Pediatric Neurology, College of
Medicine, University of Ibadan, University College Hospital, Ibadan,
Nigeria | Department of Epidemiology and Medical Statistics,
College of Medicine, University of Ibadan, University College Hospital, Ibadan,
Nigeria
Note: [] Correspondence: Dr. Ike A. Lagunju, Department of Pediatrics,
University College Hospital, Ibadan, Nigeria. Tel.: +234 803 585 7326; E-mail:
ilagunju@yahoo.co.uk
Abstract: Cerebral palsy (CP) is one of the leading causes of childhood
disability worldwide. Children in the developing world are disproportionately
affected with majority of the cases resulting from preventable causes. Various
topographic classes of CP have been described in literature, with varying
degrees of functional impairments and neuro-cognitive dysfunction. We aimed to
compare the characteristics of children with quadriplegic and hemiplegic CP.
Two hundred and thirty six consecutive cases of CP, 186 with spastic
quadriplegia and 50 with spastic hemiplegia seen over a period of 30 months
were studied. Their demographic characteristics, functional and associated
neuro-cognitive impairments were compared using the SPSS for windows software.
The study showed relatively high proportions (20.3%) of post-neonatally
acquired CP. Children with spastic quadriplegia were found to present at a
relatively younger age than those with hemiplegia. Spastic hemiplegia was found
to be associated with mild to moderate degrees of functional impairment
(P < 0.001), and a significantly lower prevalence of hearing
impairment (P < 0.001), speech defects (95% CI OR =1.50–7.19), mental retardation (0.026) and growth impairment
(P< 0.001). Although epilepsy was a common associated deficit in
quadriplegic CP, a higher prevalence was found in the hemiplegic group. We can
conclude that hemiplegic CP is a less severe disease compared with quadriplegic
CP. Post-neonatally acquired CP accounts for a significant proportion of CP in
Nigeria, and majority are due to intracranial infections. Although, CP cannot
be cured, prompt diagnosis of this condition and early identification of the
associated deficits and institution of the necessary management will often
improve the child's capabilities.
