Management of Growth Retardation with a View to Preventing Neuromotor Dysfunction and Mental Handicaps

Abstract

My remarks will be based on several uncertain assumptions and these need to be briefly discussed before proceeding to my topic. The first assumption is that we usually know what causes cerebral palsy in an individual case. Clearly this is not so. We can make certain generalizations about the etiology if we analyze groups of cases rather than try to arrive at a cause in an individual patient. Hagberg and Hagberg (1984), for example, did not try to find a single cause for each case of cerebral palsy. Rather, they listed all of the prenatal, perinatal (intrapartum plus neonatal), and postnatal “factors” that they felt might have contributed to the cause. With this exercise, they were able to suggest that certain types of cerebral palsy (e.g., dyskinesia) are more likely than not to be related to perinatal events, while other types (e.g., spastic/ataxic diplegia in term children) are more than likely to be due to prenatal events. They emphasized, however, the likelihood of multiple causes in an individual patient, e.g., a prenatal disposition to the ill effects of a perinatal event.