Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

parálisis cerebral

 

Relación entre factores de riesgo y la distribución topográfica en niños con parálisis cerebral. Relationship between etiological factors and topographic distribution in children with cerebral palsy

 Introduction: Cerebral palsy is a health condition that seriously impacts the life condition of children and their family. Different risk factors are becoming increasingly important in its etiology.

Objective: The aim of this study was to analyze the most frequent risk factors for cerebral palsy and their association with topographic distribution in children aged 0 to 15 years in the city of Barranquilla.

Methods: An analytical observational cross-sectional survey type study was conducted with a sample of 78 children diagnosed with cerebral palsy in the city of Barranquilla, where the association of the most frequent risk factors of this condition with the topographic distribution was analyzed.

Results: The risk factors associated with cerebral palsy in order of importance were: perinatal hypoxia, gestational history of maternal infections, maternal trauma and congenital malformations. There was statistically significant association between gestational weeks at birth and GMFCS level (p<0.05) and between gestational weeks and topographic distribution.

Conclusions: Subjects with higher gestational age presented greater involvement at the level of motor function and a more extensive topographic distribution.

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Palabras clave: adolescentes, Etiología, Infantes, parálisis cerebral,

Keywords: adolescents, cerebral palsy, Etiology, Infants,

Parálisis Cerebral en Pediatría: Problemas Asociados. Cerebral Palsy In Pediatrics: Associated Problems

Introduction: Cerebral palsy is the most frequent cause of childhood disability. Children with CP will associate, in addition to neurological problems, other non-neurological disorders that will be more frequent with a greater degree of CP involvement.

Objective: To address the clinical manifestations of children with cerebral palsy and their diagnostic and therapeutic management in order to provide a comprehensive approach to these patients in a single document.

Development: A review is made of the clinical manifestations of the child with cerebral palsy including neurological disorders, orthopedic problems, digestive disorders, respiratory problems, bone health, visual and hearing problems, urological and sexual disorders, oral health, hypersalivation, sleep disorder and pain.

Conclusions: The approach to the patient with CP has changed in recent years. Care provided by an specialized multidisciplinary team is essential. However, from our experience, the role of a pediatrician who knows all the associated problems seems essential to coordinate all the follow-up.

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Palabras clave: diagnóstico, Discapacidad, parálisis cerebral, trastornos neurológicos, Tratamiento,

Keywords: cerebral palsy, diagnosis, Disability, neurological disorders, Treatment,

Ictus no comunicable en un adulto joven con parálisis cerebral portador del genotipo MTHFR variante C677T homocigótica. Noncommunicable stroke in a young adult with cerebral palsy carrying the homozygous variant MTHFR C677T genotype.

Cerebral palsy (CP) is a group of disorders that affect movement and muscle tone or posture. It is caused by damage that occurs in the immature brain as it develops, most often before birth.

Although there are few studies in the literature, it has been seen that the risk of stroke is increased in this type of patients. We present the case of a young adult with a recent stroke and CP carrying. The homozygous variant MTHFR C677T genotype, decreased folic acid and vitamin D were found. Stroke in CP context is a challenge for the clinician. Therefore, we think that the possibility of stroke should be considered in every patient with CP, suggesting primary prevention measures in every patient with CP.

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Palabras clave: Genotipo MTHFR variante C677T homocigótica, Ictus no comunicable, Índice de masa corporal, parálisis cerebral,

Keywords: Body mass index, cerebral palsy, Homozygous variant MTHFR C677T genotype, Noncommunicable stroke,

Estimulación Eléctrica en Niños y Adolescentes Con Parálisis Cerebral: Una Revisión Sistemática. Electrical Stimulation In Children And Adolescents With Cerebral Palsy: A Systematic Review

Objectives: To analyze the most investigated age ranges in children with cerebral palsy. To identify the anatomical regions treated by electro stimulation. To determine the frequency and duration of the protocols used in the studies carried out between 2009 to 2019.

Methodology: A systematic review of the literature on the utilization of electro stimulation in children with cerebral palsy in the last 10 years was carried out. The search was considered in the Pub Med database. The observation technique was used to extract the information and the indicators were recorded in an evaluation form (type of study, sample, anatomical region treated, subjects investigated, frequency and duration of therapies).

Results: Most of the studies have developed the treatments with electro stimulation in the legs and extensors of the elbow and the wrist and one study -at the same time- in the face and legs. The ages investigated ranged between 1 and 16 years. The protocols have been used from 3 to 5 times per week and in a range of 2 to 12 weeks. The time of administration of the electro stimulation ranged between 20 to 60 minutes.

Conclusion: To obtain positive benefits it is necessary to develop programs from 3-5 times per week and each session in periods of 20 to 60 minutes. This systematization could contribute to an efficient organization in future intervention programs and in the stimulation of other anatomical regions less explored.

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Palabras clave: Estimulación eléctrica, intervenciones, niños y adolescentes, parálisis cerebral,

Keywords: cerebral palsy, children and adolescents, Electrical stimulation, interventions,

Factores de Riesgo Asociados a Parálisis Cerebral en una Poblacion de Niños y Jóvenes Mexicanos. Risk Factors Associated With Cerebral Palsy In A Population Of Mexican Children.

Objectives: To establish the risk factors associated with Cerebral Palsy in a population of Mexican children and compare the results with studies from other countries.Methods: Analytical, retrospective, randomized, observational study, through review of the file and a survey, comparison of proportions. Participants: 230 patients with Cerebral Palsy between 0 and 29 years of age and their biological mothers from a specialized institution in Mexico. Results: We studied 29 risk factors , range 0 to 9 in each patient. Prenatal 244 factors; Perinatal 378, Postnatal 319. Most frequent prenatal risk factors: urinary infection, 99 (43%), and transvaginal bleeding, 61 (27%). Perinatal: perinatal hypoxia, 131 (57%); and prematurity, 116, (50%). Postnatal: convulsive syndrome <2 Years old, 92 (42%); and jaundice, 84 (37%). Conclusions: The most common cerebral palsy associated risk factors were perinatal, which differs from that reported in countries such as Spain, USA and England, where the prenatal ones are. Sweden results are similar to Mexico. It is suggested to carry out prospective studies in this field.

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Palabras clave: Atención Primaria, Espasticidad Muscular, Factores de riesgo, parálisis cerebral, Prematuro,

Keywords: cerebral palsy, Muscle Spasticity, Premature, Primary Care, Risk factors,

Combinación de un Programa de Rehabilitación y Estímulo Eléctrico en Pie Equino para las Alteraciones de la Marcha en Niños con Parálisis Cerebral.

There are many factors that cause gait disorders as is the case of patients suffering encephalic lesions that cause brain palsy with hemiplegia as sequelae. One of the most important and interesting features of rehabilitation of the patient with hemiplegia is gait reeducation. Because of that, a therapeutic strategy was created with the application of electric stimulus and a program of exercises in order to preserve the maximum of functional capabilities. For this reason, a retrospective study was performed including a sample of 10 patients with cerebral spastic palsy hospitalized at CIREN’s Clinic of Child Neurology with clubfoot and gait disorder. Every child was submitted to a rehabilitation treatment for four to eight weeks -six times per week- assessing the effectiveness of the neuromuscular stimulation over gross motor function and gait, including frequency of steps in 10 meters and its amplitude. At the end of the treatment, improvement was observed in the treated cases.

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Palabras clave: Marcha funcional, parálisis cerebral, Tratamiento rehabilitador,

Keywords: cerebral palsy, Functional gait, Rehabilitation treatment,
 
 
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