In our research, female majority over males was perceived as 51.7% patients fit in to female sex contradiction of 48.3% males. Yamada et al whose study had 60.25% of 38 cases of CP have also reported female preponderance.15 However, Kulak et al obtained male majority of the CP study.16
The most mutual type of CP in our research was spastic quadriplegia, followed by spastic diplegia. Research of Robinson et al is in assenting with our research, which also had spastic quadriplegia (37.5%) as mutual type of CP.17 The less mutual types in our research was athetoid( 7.01%) type, alike to remark of Bax et al who had ataxic type in 3.9% CP patients.Number of limbs affected in CP hadsignificant correlation to disease severity in this study. Mean GMFCS scores of quadriplegic CP subjects were considered to be lower compared to other groups.18 Chen et al found that children with spastic quadriplegia had lower developmental functions compared to spastic diplegia children.19
The recent investigation showed that severe CP group had higher prevalence of suffering from epilepsy. However, this resultwas not statistically significant. The possibility to become epilepsy could be determined by the etiology of recurrent seizure. Epilepsy found in 50-94% patients regardless of secondary CPdue to global cortical malformationas well as 50% in stroke children due to perinatal asphyxia.
Magnetic Resonance Imaging was within normal findings in 14.03% of our investigated CP patientsinspection. Approximately, 85.90% CP subjects demonstrated abnormal MRI, this is in agreement with Bax et alresult that showed normal brain MRI in 11.76% CP subjects as well as abnormal brain MRI in 88.24% cases.1 A matching observationwas constructed by Kulak et alwhich displayed 4.7% normal brain MRI.16 Two studies exhibited normal brain imaging of CP subjects in higher percentages 14-16%.17,20
Both white matter as well as grey matter lesion were the commonest MRI abnormality discovered in CP. However, only grey matter injury had significant correlation to CP severity. Profound grey matter lesion shows wide range of patterns on brain MRI findings, hence grading techniques vary greatly in some research.20-22Profound grey matter caused by abrupt prenatal hypoxic ischemic encephalopathy has been identified as a leading cause of death and CP.21 Because the basal ganglia and thalamus play such an important role in motor, postural regulator, and movement, the general outcomes of HIE children are poor.20,23,24 Furthermore, there was a clear link between the severity of profound grey matter injury and cognitive results. A higher likelihood of severe cognitive impairment was linked to more extensive profound grey matter injury affecting additional central sulci or the hippocampus.13,21,25 The main noteworthy clinical result is that combined involvement of cortical – subcortical and pallidum is related with an extreme gross motor outcome (89 % and 100% respectively), e.g. GMFCS level IV and V.26
Cerebral white matter lesion is such as mainpattern of brain injury in premature birth survivors, with thepeak rate is baby in 23–32-week post-conceptional age, during the early several months of a child's existence.27White matter damage is demonstrated in about 50% of all CP patients. In preterm survivors, MRI-defined white matter injury (WMI) appears as aberrant movements that are indicative of CP.28 Furthermore, premature delivery is linked to a higher risk of reduced cerebral grey and white matter volumes, both of which are linked to cognitive development impairment.29,30 In some populations of full-term newborn, WMI may be more common because in utero insults appear to correlate with a vulnerable time in white matter development prior to the commencement of myelination process.21,31Patients with abnormal MRIs were found to have congenital abnormalities in 28.33% of cases. According to Robinson and Kulak, brain MRI revealed a higher number of congenital abnormality cases of 12 percent and 10%, independently.16,17
There was no risk factor identified in 36.7% patients of severe CP and 40% in mild moderate. In this study, risk factor had no significant correlation to disease severity.Garfinkle et al reported when compared to children without birth asphyxia, children with CP after neonatal encephalopathy and severe birth asphyxia were experiencing high possibility to have a later more severe neurological subtype (spasticity/paralysis), severe level of GMFCS and nonverbal communication skills impairment, as well as a higher comorbidities consequences.32Previous CP registries also showed that overall burden children who got CP as a result of neonatal encephalopathy had a higher-level disability.32,33 This discrepancy might be caused by giving birth outside the hospital, so the APGAR score was ignored.