Contents

#### **Preface XI**


Moneer K. Faraj

Chapter 8 **Plasma Growth Factors in Cerebral Palsy 123** Jesús Alcaraz Rubio and Juana María Sánchez López

Preface

cover various fields in CP.

Cerebral palsy (CP) is a common pediatric problem and is the leading cause of childhood disability. It occurs at a rate of 3.6 cases per 1000 children. Spastic CP is the most common form accounting for about 77%. It represents a major social and psychological impact on both family and society, and is a group of disorders with movement difficulties being com‐ mon for all affected patients. Its severity and extent are variable from one patient to another. Additionally, the impacts of CP on daily activities, communications, and requirements are also variable. So, probably each patient is unique in his or her presentation and require‐ ments. Wide-spectrum problems in CP are furthermore compromised by many associated medical problems, including epilepsy (40%), visual impairment (15%), hearing impairment (7%), and communication difficulties (25%). Recent advances in clinical research increase our knowledge and understanding of causal pathways, possible preventive measures, spe‐ cific intervention strategies, and the value of new treatment modalities such as botulinum toxin and intrathecal baclofen in the management of cerebral palsy. Therefore, I am extreme‐ ly honored to present this book with its four sections and 10 very interesting chapters, which

The first chapter by assistant professor Ali A. AL-Mayahi discusses the early markers for anticipating CP. Since cerebral palsy is a permanent disorder in the development of move‐ ment and posture in the developing fetal or infant brain, which usually manifest before 18 months of age, the most challenging tasks for medical practitioners is to identify specific risk factors in early infancy and predict severe impairment that manifests later in development. So, early detection of signs of motor impairment is crucial to assist physicians to give close follow-up of those infants and to reassure parents whose children are normal. It has been shown that intervention may be most efficient when the plasticity of the brain is high, and an early detection of brain impairment is therefore crucial. An earlier follow-up and training program can have a positive effect on the motor development of a child with CP, in particu‐ lar through prevention of limb contractions, and might make a difference in the child's abili‐ ty to handle everyday challenges. In addition, an early detection of CP gives the parents more time for adjustment and preparation. Since clinical manifestations of CP do not emerge before a child is at least six months, the general movement is considered the most reliable early marker for monitoring fetal and infant movement. Abnormal general move‐ ment carries a high risk of developing CP. In addition, the absence of so-called fidgety movements at 3–5 months post-term age. Besides high sensitivity (>91%) and specificity (>81%), the assessment of general movement is quick, non-intrusive, and easy to acquire. In the second chapter, Dr. Ogoke Christian gives a review of the clinical classification of CP. Classification of CP remains a debatable issue. In this chapter, the author discusses the vari‐ ous classifications of CP, highlights the clinical features used in the various classifications,

Chapter 9 **Hip Surgery in Cerebral Palsy 131** João Lameiras-Campagnolo
