Editorials

What causes cerebral palsy?

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g4514 (Published 15 July 2014) Cite this as: BMJ 2014;349:g4514
  1. Peter Rosenbaum, professor of paediatrics and Canada Research Chair in Childhood Disability
  1. 1CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Hamilton ON, Canada L8S 1C7
  1. Correspondence to: rosenbau{at}mcmaster.ca

A genetic or familial component now looks likely

What causes neurodisabilities such as cerebral palsy? This is one of the most challenging questions facing affected families and the health professionals who advise and care for people with these disparate conditions.

Traditionally, we believed that if a mother had a “difficult” delivery and a newborn adapted poorly to postnatal life and was subsequently found to have cerebral palsy, these events were causally linked. The cerebral palsy was intuitively connected to adverse preceding events, and doctors and other health professionals were easily blamed for poor care that supposedly led to the poor outcome. As perinatal medicine advanced with the aid of new technologies such as prenatal imaging,1 we have realised that impairments in brain development, structure, and function very often precede adverse perinatal or postnatal events, and may even “cause” them.

The original work by Tollånes and colleagues (doi:10.1136/bmj.g4294) takes advantage of a remarkable resource—the Medical Birth Registry of Norway, with its links to the Norwegian social insurance scheme—to explore the risk of recurrence (and perhaps heritability) of cerebral palsy in a cohort of more than two million Norwegians …

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