P 468. Clinical Phenotype of Cerebral Palsy Depending on the Cause

Background: Cerebral palsy (CP) is the most common motor disability in childhood, with a prevalence of 2 to 3 per 1,000 live births (premature birth: 40–100 per 1,000 live births). Cerebral hemorrhage, asphyxia, intrauterine infections, and cerebral infections are typically among the possible causes. Still, the precise definition in terms of causes and timing of the brain damage remains controversial. There are several studies which examine the clinical phenotype of certain CP types, some of which consider individual causes.

Objective: The aim of our study was to identify all known causes and to correlate them with possible influencing factors and the clinical phenotype of the patients. The question occurs to what extent the clinical phenotype of CP patients depends on the CP cause.

Methods: We were able to evaluate retrospectively the clinical neurological phenotype, abnormalities during pregnancy, as well as data on cognitive performance of 384 patients using a standardized questionnaire and to relate the findings to the CP cause. All patients were treated at the Center for Chronically Sick Children at the Charité – Universitätsmedizin Berlin, Germany between June 2015 and June 2017. Patients with postnatal brain damage occurring after 28 days or more were excluded from this study.

Results: In 306 cases (79.9%), we could find a CP cause, and in 78 cases (20.3%), we could not. However, 44 of these 78 patients showed abnormalities during pregnancy or perinatal period (e.g., premature birth, part of multiple birth, pathological CTG during delivery, etc.). Regarding the clinical phenotype, there were several aspects that differed significantly depending on the CP cause. For example, in the group with brain damage before the perinatal period (chromosomal aberration and/or brain malformations), we found significantly more frequent comorbidities such as vision, swallowing, and hearing disorders, as well as epilepsy, hip dislocation, scoliosis, osteoporosis, and pathological fractures, compared with the group with perinatal brain damage (e.g., hypoxic-ischemic encephalopathy, cerebral hemorrhage, neonatal stroke, chorioamnionitis, etc.).

Conclusion: The term CP does not describe a single disease but is rather a generic term that covers many different diseases with a similar clinical phenotype. The awareness of this fact should be strengthened as, depending on the cause, a deviant clinical phenotype can be found. This offers great potential in terms of individual treatment and prevention of comorbidities.

No conflict of interest has been declared by the author(s).