Skip to main content

Epidemiology of the Cerebral Palsies

  • Chapter
  • First Online:
Cerebral Palsy

Abstract

Epidemiology of CP aims to describe the frequency of the condition in a population and to monitor its changes over time. Also it studies the determinants of this condition which responsible for some changes over time. Classification of CP is an important step toward describing more homogenous subgroups of persons with CP. Several classifications exist based on neurological signs and topography, on motor function loss, on associated impairments, on severity of the clinical pattern and on the neuroimaging findings. Overall prevalence of CP is around 2 per 1000 live births in developed and in developing countries, with a trend toward a decrease during the last decade, at least for the more severe subgroups and the more tiny babies. Caution should be paid when interpreting changes in prevalence rates since factors that may influence these estimates are numerous.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. World Health Organization. International classification of functioning, disabilty and health (ICF). Geneva: World Health Organization; 2001.

    Google Scholar 

  2. Himmelmann K, Hagberg G, Beckung E, et al. The changing panorama of cerebral palsy in Sweden. IX. Prevalence and origin in the birth-year period 1995–1998. Acta Paediatr. 2005;94:287–94.

    Article  CAS  PubMed  Google Scholar 

  3. Himmelmann K, Hagberg G, Uvebrant P. The changing panorama of cerebral palsy in Sweden. X. Prevalence and origin in the birth-year period 1999–2002. Acta Paediatr. 2010;99:1337–147.

    Article  CAS  PubMed  Google Scholar 

  4. Goldsmith S, McIntyre S, Smithers-Sheedy H, et al. On behalf of the Australian Cerebral Palsy Register Group. An international survey of cerebral palsy registers and surveillance systems. Dev Med Child Neurol. 2016;58(Suppl 2):11–7.

    Google Scholar 

  5. Cans C, Surman G, McManus V, et al. Cerebral palsy registries. Semin Pediatr Neurol. 2004;11:18–23.

    Article  PubMed  Google Scholar 

  6. Surveillance of Cerebral Palsy in Europe. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Dev Med Child Neurol. 2000;42:816–24.

    Article  Google Scholar 

  7. ACPR Group. Report of the Australian Cerebral Palsy Register, birth years 1993–2009. 2016. www.cpregister.com

  8. Touyama M, Touyama J, Toyokawa S, Kobayashi Y. Trends in the prevalence of cerebral palsy in children born between 1988 and 2007 in Okinawa, Japan. Brain and Development. 2016;38:792–9.

    Article  PubMed  Google Scholar 

  9. Yeargin-Allsopp M, Van Naarden Braun K, Doernberg NS, et al. Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multi-site collaboration. Pediatrics. 2008;121:547–54.

    Article  PubMed  Google Scholar 

  10. Sellier E, Platt MJ, Andersen GL, et al. Decreasing prevalence in cerebral palsy: a multi-site European population-based study, 1980 to 2003. Dev Med Child Neurol. 2016;58:85–92.

    Article  PubMed  Google Scholar 

  11. Van Naarden Braun K, Doernberg N, Schieve L, et al. Birth prevalence of cerebral palsy: a population-based study. Pediatrics. 2016;137:1–9.

    Article  Google Scholar 

  12. Liu JM, Li S, Lin Q, Li Z. Prevalence of cerebral palsy in China. Int J Epidemiol. 1999;28:949–54.

    Article  CAS  PubMed  Google Scholar 

  13. Yam WK, Chan HS, Tsui KW, et al. Prevalence study of cerebral palsy in Hong Kong children. Hong Kong Med J. 2006;12:180–4.

    CAS  PubMed  Google Scholar 

  14. Smith L, Kelly KD, Prkachin G, Voaklander DC. The prevalence of cerebral palsy in British Columbia, 1991–1995. Can J Neurol Sci. 2008;35:342–7.

    Article  PubMed  Google Scholar 

  15. Oskoui M, Coutinho F, Dykeman J, Jette N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol. 2013a;55:509–19.

    Article  PubMed  Google Scholar 

  16. Oskoui M, Joseph L, Dagenais L, Shevell M. Prevalence of cerebral palsy in Quebec: alternative approaches. Neuroepidemiology. 2013b;40:264–8.

    Article  CAS  PubMed  Google Scholar 

  17. Oztürk A, Demirci F, Yavuz T, et al. Antenatal and delivery risk factors and prevalence of cerebral palsy in Duzce (Turkey). Brain and Development. 2007;29:39–42.

    Article  PubMed  Google Scholar 

  18. Banerjee TK, Hazra A, Biswas A, et al. Neurological disorders in children and adolescents. Indian J Pediatr. 2009;76:139–46.

    Article  PubMed  Google Scholar 

  19. Alberman E. Describing the cerebral palsies: methods of classifying and counting. In: Stanley F, Alberman E, editors. The epidemiology of the cerebral palsies, Clinics in developmental medicine, vol. No. 87. London: Spastics International Medical Publications; 1984. p. 27–31.

    Google Scholar 

  20. ACPR Group. Report of the Australian Cerebral Palsy Register, birth years 1993–2003. 2009.

    Google Scholar 

  21. Stanley F, Blair E, Alberman E. Causal pathways to the cerebral palsies: a new aetiological model. Chapter 5. In: Cerebral palsies: epidemiology and causal pathways. London: Mac Keith Press; 2000. p. 40–7.

    Google Scholar 

  22. Colver A. Benefits of a population register of children with cerebral palsy. Indian Pediatr. 2003;40:639–44.

    PubMed  Google Scholar 

  23. Howard J, Soo B, Graham HK, et al. Cerebral palsy in Victoria: motor types, topography and gross motor function. J Paediatr Child Health. 2005;41:479–83.

    Article  PubMed  Google Scholar 

  24. Cans C, Dolk H, Platt MJ, et al. Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy. Dev Med Child Neurol. 2007;109(Suppl):35–8.

    Article  Google Scholar 

  25. Sellier E, Horber V, Krägeloh-Mann I, et al. Interrater reliability study of cerebral palsy diagnosis, neurological subtype, and gross motor function. Dev Med Child Neurol. 2012;54:815–21.

    Article  PubMed  Google Scholar 

  26. Beckung E, Hagberg G, Uldall P, Cans C. Probability of walking in children with cerebral palsy in Europe. Pediatrics. 2008;121:e187–92.

    Article  PubMed  Google Scholar 

  27. Palisano R, Rosenbaum P, Walter S, et al. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39:214–23.

    Article  CAS  PubMed  Google Scholar 

  28. Palisano RJ, Rosenbaum P, Bartlett D, Livingston MH. Content validity of the expanded and revised Gross Motor Function Classification System. Dev Med Child Neurol. 2008;50:744–50.

    Article  PubMed  Google Scholar 

  29. Beckung E, Hagberg G. Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol. 2002;44:309–16.

    Article  PubMed  Google Scholar 

  30. Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Ohrvall AM, Rosenbaum P. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006;48:549–54.

    Article  PubMed  Google Scholar 

  31. Elvrum AK, Andersen GL, Himmelmann K, Beckung E, Öhrvall AM, Lydersen S, Vik T. Bimanual fine motor function (BFMF) classification in children with cerebral palsy: aspects of construct and content validity. Phys Occup Ther Pediatr. 2016;36(1):1–16.

    Article  PubMed  Google Scholar 

  32. Morris C, Kurinczuk JJ, Fitzpatrick R, Rosenbaum PL. Who best to make the assessment? Professionals in cerebral palsy and families’ classifications of gross motor function are highly consistent. Arch Dis Child. 2006;91:675–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Rosenbaum P, Paneth N, Leviton AB, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol. 2007;109(Suppl):8–14.

    Google Scholar 

  34. Barty E, Caynes K, Johnston LM. Development and reliability of the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol. 2016;58(10):1036–41.

    Article  PubMed  Google Scholar 

  35. Remijn L, Speyer R, Groen BE, et al. Validity and reliability of the Mastication Observation and Evaluation (MOE) instrument. Res Dev Disabil. 2014;35(7):1551–61.

    Article  PubMed  Google Scholar 

  36. Virella D, Pennington L, Andersen GL, Andrada Mda G, Greitane A, Himmelmann K, Prasauskiene A, Rackauskaite G, De La Cruz J, Colver A. Surveillance of Cerebral Palsy in Europe Network. Classification systems of communication for use in epidemiological surveillance of children with cerebral palsy. Dev Med Child Neurol. 2016;58:285–91.

    Article  PubMed  Google Scholar 

  37. Pruitt DW, Tsai T. Common medical comorbidities associated with cerebral palsy. Phys Med Rehabil Clin N Am. 2009;20:453–67.

    Article  PubMed  Google Scholar 

  38. Surveillance of cerebral palsy in Europe. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol. 2002;44:633–40.

    Google Scholar 

  39. Sigurdardottir S, Eiriksdottir A, Gunnarsdottir E, et al. Cognitive profile in young Icelandic children with cerebral palsy. Dev Med Child Neurol. 2008;50:357–62.

    Article  PubMed  Google Scholar 

  40. Carlsson M, Hagberg G, Olsson I. Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Dev Med Child Neurol. 2003;45:371–6.

    Article  PubMed  Google Scholar 

  41. Venkateswaran S, Shevell MI. Comorbidities and clinical determinants of outcome in children with spastic quadriplegic cerebral palsy. Dev Med Child Neurol. 2008;50:216–22.

    Article  PubMed  Google Scholar 

  42. Kilincaslan A, Mukaddes NM. Pervasive developmental disorders in individuals with cerebral palsy. Dev Med Child Neurol. 2009;51:289–94.

    Article  PubMed  Google Scholar 

  43. Shevell MI, Dagenais L, Hall N. The relationship of cerebral palsy subtype and functional motor impairment: a population-based study. Dev Med Child Neurol. 2009;51:872–7.

    Article  PubMed  Google Scholar 

  44. Surman G, Hemming K, Platt MJ, et al. Children with cerebral palsy: severity and trends over time. Paediatr Perinat Epidemiol. 2009;23:513–21.

    Article  PubMed  Google Scholar 

  45. Love S, Gibson N, Smith N, et al. Interobserver reliability of the Australian Spasticity Assessment Scale (ASAS). Dev Med Child Neurol. 2016;58(Suppl 2):18–24.

    Article  PubMed  Google Scholar 

  46. Barry MJ, VanSwearingen JM, Albright AL. Reliability and responsiveness of the Barry-Albright Dystonia Scale. Dev Med Child Neurol. 1999;41(6):404–11.

    Article  CAS  PubMed  Google Scholar 

  47. Monbaliu E, Ortibus E, De Cat J, et al. The Dyskinesia Impairment Scale: a new instrument to measure dystonia and choreoathetosis in dyskinetic cerebral palsy. Dev Med Child Neurol. 2012;54(3):278–83.

    Article  PubMed  Google Scholar 

  48. Himmelmann K, McManus V, Hagberg G, et al. Dyskinetic cerebral palsy in Europe: trends in prevalence and severity. Arch Dis Child. 2009;94:921–6.

    Article  CAS  PubMed  Google Scholar 

  49. Platt MJ, Cans C, Johnson A, et al. Trends in cerebral palsy among infants of very low birthweight (<1500 g) or born prematurely (<32 weeks) in 16 European centres: a database study. Lancet. 2007;369:43–50.

    Article  PubMed  Google Scholar 

  50. Sellier E, Surman G, Himmelmann K, et al. Trends in prevalence of cerebral palsy in children born ≥2500 g in Europe from 1980 to 1998. Eur J Epidemiol. 2010;25:635–42.

    Article  PubMed  Google Scholar 

  51. Blair E, Watson L, Badawi N, Stanley F. Life expectancy among people with cerebral palsy in Western Australia. Dev Med Child Neurol. 2001;43:508–15.

    Article  CAS  PubMed  Google Scholar 

  52. Ashwal S, Russman BS, Blasco PA, et al. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2004;62(6):851–63.

    Article  CAS  PubMed  Google Scholar 

  53. Krägeloh-Mann I, Horber V. The role of magnetic resonance imaging in furthering understanding of the pathogenesis of cerebral palsy. Dev Med Child Neurol. 2007;49(12):948.

    Article  PubMed  Google Scholar 

  54. Reid SM, Dagia CD, Ditchfield MR, et al. Population-based studies of brain imaging patterns in cerebral palsy. Dev Med Child Neurol. 2014;56(3):222–32.

    Article  PubMed  Google Scholar 

  55. Platt MJ, Krageloh-Mann I, Cans C. Surveillance of cerebral palsy in Europe: reference and training manual. Med Educ. 2009;43(5):495–6.

    Article  PubMed  Google Scholar 

  56. Shiran S, Weinstein M, Sirota-Cohen C, Myers V, Ben Bashat D, Fattal-Valevski A, Green D, Schertz M. MRI-based radiologic scoring system for extent of brain injury in children with hemiplegia. Am J Neuroradiol. 2014;35:2388–96.

    Article  CAS  PubMed  Google Scholar 

  57. Fiori S, Cioni G, Klingels K, Ortibus E, Van Gestel L, Rose S, Boyd R, Feys H, Guzetta A. Reliability of a novel, semi-quantitative scale for classification of structural brain magnetic resonance imaging in children with cerebral palsy. Dev Med Child Neurol. 2014;56:839–45.

    Article  PubMed  Google Scholar 

  58. Cans C, de la Cruz J, Mermet MA. The epidemiology of cerebral palsy. Paediatr Child Health. 2008;18:393–8.

    Article  Google Scholar 

  59. Reid SM, Meehan E, Gibson C, Scott H, Delacy M, On behalf of the Australian Cerebral Palsy Register Group. Biological sex and the risk of cerebral palsy in Victoria, Australia. Dev Med Child Neurol. 2016;58:43–9.

    Article  PubMed  Google Scholar 

  60. Topp M, Huusom LD, Langhoff-Roos J, Delhumeau C, Hutton JL, Dolk H, SCPE Collaborative Group. Multiple birth and cerebral palsy in Europe: a multicenter study. Acta Obstet Gynecol Scand. 2004;83:548–53.

    Article  PubMed  Google Scholar 

  61. Blair E, Watson L, O’Kearney E. Comparing risks of cerebral palsy in births between Australian Indigenous and non-Indigenous mothers. Dev Med Child Neurol. 2016;58(Suppl 2):36–42.

    Article  PubMed  Google Scholar 

  62. Gladstone M. A review of the incidence and prevalence, types and aetiology of childhood cerebral palsy in resource-poor settings. Ann Trop Paediatr. 2010;30:181–96.

    Article  CAS  PubMed  Google Scholar 

  63. Germany L, Ehlinger V, Klapouszczak D, et al. Trends in prevalence and characteristics of post-natal cerebral palsy cases: a European registry-based study. Res Dev Disabil. 2013;34:1669–77.

    Article  PubMed  Google Scholar 

  64. Paneth N, Hong T, Korzeniewski S. The descriptive epidemiology of cerebral palsy. Clin Perinatol. 2006;33:251–67.

    Article  PubMed  Google Scholar 

  65. Himmelmann K, Beckung E, Hagberg G, Uvebrant P. Bilateral spastic cerebral palsy - prevalence through four decades, motor function and growth. Eur J Paediatr Neurol. 2007;11:215–22.

    Article  PubMed  Google Scholar 

  66. Ravn SH, Flachs EM, Uldall P. Cerebral palsy in eastern Denmark: declining birth prevalence but increasing numbers of unilateral cerebral palsy in birth year period 1986–1998. Eur J Paediatr Neurol. 2009;14:214–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eve Blair .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Blair, E., Cans, C., Sellier, E. (2018). Epidemiology of the Cerebral Palsies. In: Panteliadis, C. (eds) Cerebral Palsy. Springer, Cham. https://doi.org/10.1007/978-3-319-67858-0_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-67858-0_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-67857-3

  • Online ISBN: 978-3-319-67858-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics