Neuropediatrics 2006; 37 - PS2_2_4
DOI: 10.1055/s-2006-945568

COMORBIDITIES IN CHILDREN WITH SPASTIC QUADRIPLEGIA

S Venkateswaran 1, M Shevell 1
  • 1McGill University, Montreal, QC, Canada

Objectives: The objective of this study was to determine the the major comorbidites in patients with spastic quadriplegia.

Methods: Medical records of patients with spastic quadriplegia from a single pediatric neurology practice over a 14 year period, were retrospectively and systematically reviewed. Variables examined included demographics, prenatal, perinatal, and postnatal risk factors, and investigations. Comorbidity analysis included hearing, vision, feeding, orthopedic abnormalities, learning disabilities, and epilepsy. Binomial logistic regression analyses will be applied to identify predictors of the comorbidities.

Results: 100 patients with spastic quadriplegia were included in this study. 39% of patients were premature, 60% were term and 1 was unknown. 62.5% of patient were wheelchair dependent and had a groß motor function classification (GMFCS) of IV or V. 33% of patients were fed by nasogastric or gastric tube. Hearing loss occurred in 39% with 5% of patients requiring hearing aids or being completely deaf. Vision was abnormal in 71% with 18% having cortical blindness or optic atrophy. 44% of patients had epilepsy with 20% acquired, and 34% beginning in the neonatal period. 54.4% needed special education while only 12.2% of children went to a regular school with no extra help. At least 50% of patients needed orthopedic intervention. 31% had baclofen or botox treatments, and 6% had selective dorsal rhizotomies.

Conclusion: The majority of patients with spastic quadriplegia are classified in GMFCS levels IV and V. The associated comorbidities of hearing loss, epilepsy, and the need for assisted feeding occur in almost half the patients. Abnormal vision, orthopedic abnormalities, and the need for special education is present in the majority of patients. Pending subgroup analyses include clinical factors predicting these comorbidities. Consultation and intervention by appropriate subspecialists should help optimize function and integration of these children into our society.