Arab Educational Information Network

قامت الدراسة الحالية باختبار وفحص مجموعة من العوامل المتنوعة التي من شأنها التأثير على مقاييس كثافة المعدن بالعظام لدى مرضى الشلل الدماغي. وقد تساعد مقاييس كثافة المعدن بالعظام خلال العلاج في التنبؤ وتحديد العلاج والوقاية من الكسور المرضية لدى مرضى الشلل الدماغي. ويذكر هنا ضرورة متابعة المرضى المعرضين لعوامل الخطورة المتمثلة في خلل الوظيفة الحركية للفم والأنف الشديد والشلل البصلي الكاذب ووضعهم تحت الملاحظة الدقيقة. ولذلك، فإن أولى خطوات علاج تخلخل العظام لدى الأطفال المصابين بالشلل الدماغي تتمثل في الحد من عوامل الخطورة المعروفة والتي يمكن علاجها والتوقي منها. وحيثما أمكن يجب تجنب بعض الأدوية كمضادات الاختلاج (أو التشنجات) والتي لها تأثير كبير على كثافة المعدن بالعظام، فضلًا عن ضرورة الحد من تناول المشروبات الغازية، وتفادي سوء الحالة الغذائية وضعف التعرض للشمس وقلة جرعات الفيتامين. (الملخص المنشور)

Background: Brain development continues during the first two years of life, so that cerebral palsy can result from brain injury occurring during the prenatal, Perinatal, or postnatal periods. Cerebral palsy is characterized by motor impairment and can present with global physical and mental dysfimction. Markedly reduced bone mass in non- ambulatory children with spastic quadriplegia has been reported to place these persons at risk of osteopenia, osteoporosis, and fracture. Aim of the study: This study evaluated the relation between retarded growth patterns and reduced vertebral bone mineral content in non¬-ambulatory cerebral palsy patients. Methodology: A descriptive analytical study of 30 children with cerebral palsy of both genders, between 5 and 8 years of age, attending the Special Needs Care Center of the Institute of Postgraduate Childhood Studies, Ain Shams University and also those attending the Unit for Children with Special Need at Agouza Military Rehabilitation Center, recruited over a 6 months period, and classified according to the Gross Motor Function classification system. All cases were subjected to a foil history taking, a full clinical examination, dual- energy x- ray absorptiometry (DXA) scan to measure bone mineral content (BMC) using Hologic QDR series Discovery (TM) and Lunar Prodigy DXA machines and blood samples were collected for bone profile laboratory test. Results: Lower bone mineral density (BMD) Z- scores were associated with greater severity of CP Gross Motor Functional Measure (GMFCS level), feeding difficulty, and poorer growth and nutrition as judged by weight Z- scores. A negative correlation between BMD and GMFS confirmed this observation. Conclusion: In conclusion the first step in the management of osteoporosis in children with CP is to reduce the known manageable risk factors. When possible, medications such as anticonvulsants with high impact on BMD, carbonated beverages, low nutritional status, low sun exposure and low vitamin intake should be eliminated. (Published abstract)