Is cerebral palsy genetic problem?
Cerebral palsy can occur because of many reasons. It can be attributed to wide number of intrauterine, perinatal and post natal factors which can present as isolated single factor or some time combination of many risk factors. Premature delivery, low birth weight, birth asphyxia, maternal infection, multiple gestations, and ischemic stroke to fetus or newborn are some common factors. Despite of large number of known causes, specific idiopathic mechanisms still remain elusive in maximum cases of cerebral palsy. Various researches with latest technology in many countries have shown that birth asphyxia accounts for less than 10% cases with cerebral palsy. Genetic cause is one of the reasons. Cerebral palsy can occur because of mis-happening during intrauterine period or time of delivery and afterwards. Genetic causes are commonest one in developed countries where good antenatal monitoring and institutional delivery is common. But in developing country like India where antenatal monitoring and institutional based delivery are not so prevalent other causes are also common.
We have several evidences that show that multiple genetic factors contribute to the occurrence of cerebral palsy. First mutations in multiple genes results in mendalian disorder that present with cerebral palsy like features. Second the prevalence of congenital anomaly in children with cerebral palsy is higher in comparison to normal population. Third higher percentage of cerebral palsy affection in monozygotic twins compare to dizygotic twins. Fourth is risk of cerebral palsy is 2.5 time higher in consanguineous marriage. But most of the time genetic causes are sporadic so there is lesser chance of transferring to other sibling except in few cases which have tendency to transfer in other sibling. Genetic cause of cerebral palsy can be determined by various tests but it is not available so frequently and is costly affair. Lots of progress has been made in the genetic evaluation of CP children. With the availability of genetic evaluation it will be easier for us to decide course of action in present and next issues. Gene therapy can come in future to manage genetic issues which cause cerebral palsy.