Pattern of cerebral palsy seen in children attending the outpatient paediatric physiotherapy clinics in Osun State tertiary hospitals in Nigeria

Abstract

Background. Cerebral palsy (CP) is a major cause of disability in children and the most commonly encountered neurologic condition by paediatric physiotherapists in Nigeria. Local data on the pattern of presentation of CP and standardised management protocols are lacking.
Objectives. To assess the pattern of CP seen in children attending paediatric physiotherapy clinics in Osun State tertiary hospitals.
Methods. A hospital-based cross-sectional study was conducted in three tertiary hospitals within Osun State, Nigeria. Data were collected using caregiver questionnaires, medical records and physical assessment (Gross Motor Function Measure-88) and were recorded on a standardised case record form. Data were analysed using appropriate statistical tests with alpha set at p<0.05.
Results. A total of 187 children with CP were seen during the six-month period. The male to female ratio was 1.2:1 and the children were aged 12 months to 12 years. The majority of the mothers (63.6%) were primiparous and, at the time of delivery, most mothers were aged between 28 and 33 years. Spastic (72.7%) and quadriplegic (69.5%) presentations were the leading sub-types of CP, with 76.5% of children having one or more associated problems. Birth asphyxia (57.2%) was the leading aetiology of CP while speech impairment was common in 63.6% of cases. One hundred and fourteen (61%) children were classified as being severely disabled and 53.5% had a gross motor function measure score of less than 40.9%.
Conclusion. Severe CP is commonly encountered in the region, with children most frequently presenting with spastic quadriplegia and speech impairment. A good knowledge of the pattern of CP seen in south-western Nigeria is one of the first steps in developing a standardised protocol.