Last modified: 2018-09-09
Abstract
Background: Much work exists on comorbidities in cerebral palsy (CP), but only a few studies have explored their correlation with GMFCS, CP type and quality of life (QoL).
Objective: Clinical correlation between comorbidities and GMFCS levels, CP type and QoL.
Methods : Prospective observational study at Pediatric Neurology Clinic at tertiary care public hospital in northern India. The first 3 new cases of CP diagnosed by pediatric neurologists were enrolled and mothers administered the Caregiver’s Quality of Life questionnaire. Functional mobility was classified (GMFCS ). Comorbidities were pre-defined.
Results: 138 cases of CP [mean age 2.71 (SD=1.91) years; range 2 months to 15 years], with spastic diplegia (39, 28.5%), spastic quadriplegia (66, 47.8%), spastic hemiplegia (16, 11.6%), extrapyramidal (9, 6.5%) and ataxic/hypotonic (8, 5.8%). Co- morbidities like feeding difficulty (p=0.005), drooling(p=0.005), hearing impairment (p=0.032), sleep problems (0.004), squint (0.014), malnutrition (0.005) were significantly correlated to GMFCS 5. There was significant association between seizures (p=0.027), feeding difficulty (p=0.001), sleep problems (0.004) contractures, drooling, constipation, vision and hearing impairments, squint and malnutrition with spastic quadriplegia. Comorbidities [seizures (p=0.004), feeding difficulty (0.002), drooling (0.002), constipation (p=0.01), vision impairment (p=0.001), Autism (0.001) , ADHD (0.005), moderate malnutrition(p=0.01 )] were also significantly related to QoL.
Conclusion: Comorbidities were significantly related to CP type , GMFCS and QoL. This information is useful in prognostication.