Serebral palsi’li hastalarda demografik ve klinik özellikler: Retrospektif tek merkezli gözlemsel çalışma

Öz

Amaç: Serebral palsi (CP) genellikle doğumdan önce, olgunlaşmamış, gelişmekte olan beyinde meydana gelen hasarın neden olduğu bir hareket, kas tonusu veya postür bozukluğudur. Hastalığın iyi bir tanımlanması erken teşhis ve tedavi için yardımcı olacaktır. Burada CP tanısı ile takipli hastaların sosyodemografik, klinik ve radyolojik özelliklerinin değerlendirilmesini amaçladık.

Yöntemler: Çalışmamız retrospektif, kesitsel, tanımlayıcı olarak dizayn edildi. CP tanılı 46 hasta çalışmaya dahil edildi. Hasta dosyalarındaki yaş, cinsiyet, CP türü, eşlik eden klinik bulgular, mental retardasyon varlığı ve kraniyal magnetik rezonans görüntüleme (MRI) bulguları kayıt edildi. 

Bulgular: CP tiplerinden 12 hasta (%26.1) spastik hemiparezik, 9 hasta (%19,6) spastik paraparezik, 17 hasta (%37.0, en sık) spastik tetraparezik, 3 hasta (%6,5) ataksik, 1 hasta (%2,2) hipotonik, 2 hasta (%4,4) ekstrapiramidal, 2 hasta (%4,4) mikst tipte idi. MRI bulgularından araknoid kist 4 hastada (%11.4), bazal ganglion intensitesi 8 hastada (%20,2), ensefalomalazik alan 8 hastada (%20,2), frontogliotik alan 30 hastada (%80,7, en sık), kortikal atrofi 6 hastada (%17,1), megasisterna 5 hastada (%14.3), sentrum semiovale hiperintensitesi 8 hastada (%20,2), ensefalomalazi 8 hastada (%20,2) gözlendi. Hipoksik iskemik beyin hasarı bulguları hastaların 32 (%91.4)’ünde saptandı.

Sonuç: CP tanısı güç koyulabilen fakat erken tanı konulması durumunda daha faydalı olunabilen bir grup hastalık olduğundan özellikle riskli doğan çocuklar yakın takip edilmeli, aileleri uyarılmalı, gerekli görülürse erken dönemde nörogörüntüleme tetkikleri istenmelidir. İleri dönem takip sürecinde hem epilepsi gibi eşlik eden durumların takibi hem de rehabilitasyon açısından hastanın maksimum fiziksel kapasitesine ulaşması için multidisipliner bir ekip tarafından tedavi ve takibinin yapılması gerekmektedir.

Anahtar Kelimeler

• Serebral palsi,Klinik karakteristikler,Manyetik rezonans görüntüleme

The demographic and clinical characteristics of patients with cerebral palsy: A retrospective, single center, observational study

Abstract

Aim: Cerebral palsy (CP) is a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth. 

A good definition of the disease will help for early diagnosis and treatment. The aim of this study was to evaluate the sociodemographic, clinical and radiologic characteristics of patients who were followed up as CP diagnosis.

Methods: Our study was designed as a retrospective, cross-sectional and descriptive. Forty-six patients with CP were included in the study. The age, sex, type of CP, accompanying clinical findings, presence of mental retardation, and cranial magnetic resonance imaging (MRI) data were recorded in the patient files.

Results: The types of CP were determined as spastic hemiparesis in 12 (26.1%) patients, spastic paraparesis in 9 (19.6%), spastic tetraparesis in 17 (37.0%, most frequently)), ataxic in 3 (6.5%), hypotonic in 1 (2.2%), extrapyramidal in 2 (4.4%) and mixed type in 2 (4.4%). In the MRI findings, arachnoid cyst was observed in 4 (11.4%) patients, basal ganglion intensity in 8 (20.2%), encephalomalacia in 8 (20.2%), frontogliotic area in 30 (80.7%, mostly frequently), cortical atrophy in 6 (17.1%), megacisterna in 5 (14.3%), and centrum semiovale hyperintensity in 8 (20.2%). Findings of hypoxic ischaemic brain injury were determined in 32 (91.4%) patients.

Conclusion: As CP is a group of diseases for which diagnosis may be difficult but early diagnosis can be beneficial, children at high-risk from birth must be closely monitored, the families must be warned, and if necessary early neuro-imaging tests should be requested. In the long-term follow-up process, in respect of both rehabilitation and the follow-up of comorbidities such as epilepsy, the treatment and follow-up of patients must be applied by a multidisciplinary team to be able to reach maximum physical capacity.

Keywords

• Cerebral palsy
• Clinical characteristics
• Magnetic resonance imaging

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