Cerebral palsy: A regional study

This study shows an increase in cerebral palsy over a 10-yr period. This must be seen in the light of a falling perinatal mortality rate over the same period. The most probable explanations for the increase in incidence are (1) inadequacy of special accommodation for severely handicapped children especially in 1966-1970, (2) children with severe cerebral palsy who died, classified as mentally handicapped only, (3) survival of more severely brain-damaged children in the 1971-1975 group due to 'better' neonatal care. If the latter be correct, our efforts to prevent death by asphyxia are giving rise to a large number of surviving but brain-damaged infants. Whatever way we look at it, the data in this study must give rise to serious concern. Translated to the country at large, it would suggest about 170 cases of cerebral palsy every year, of which approximately 40 involve serious handicap. Each severely handicapped infant is a potential economic liability to the extent of £300,000 over a period of 50 years (Cussen, 1978). We do not dare mention the suffering of the children, or the great parental anguish with each child. These figures could be reduced immediately by 40% to 50% by the introduction of known methods of care and treatment to our obstetric and neonatal services (U.S. Presidential Committee, 1969; Report of Quebec Perinatal Committee, 1973; Wynn and Wynn, 1976). The Swedish figures show what can be done. The French appear to be on the way to achieving the great reductions in mortality and morbidity outlined in the now famous Sixth Plan. There cannot be any further justification for our procrastination.