This chapter will address the variations in pubertal development and its altered regulation in the child with cerebral palsy.
After an overview of the (1) hypothalamic-pituitary-gonadal (HPG) axis in the fetus, infant, child, and adolescent and (2) the hypothalamic-pituitary-adrenal (HPA) axis as it relates to the sex steroid’s role in puberty, abnormalities in pubertal development will be discussed. The role of these processes in children with cerebral palsy will also be addressed.
The Tanner pubertal staging system addresses the physical manifestations of puberty. It helps to define an expected age of onset of these signs in boys and girls. Defining these ages is difficult in typically developing children, becoming even more problematic in children with cerebral palsy.
The accepted approaches to the diagnosis and treatment of precocious and delayed puberty will be presented as well as controversies in treatment recommendations in children with or without cerebral palsy.
Studies over the last 40 years concerning the timing and comorbidities in children with cerebral palsy will be reviewed.
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