الفهرس 
CEREBRAL PALSYOnly 14 pages are availabe for public view
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Abstract
Cerebral palsy (CP) is a common form of neurodevelopmental disability and estimates place its prevalence at 2.4 per 1,000 children aged 3–10 years. These patients known to have associated gastrointestinal problems making them at more risk of developing secondary malnutrition.
These patients have changes in lipid profile secondary to malnutrition, AEDs or the CP disease itself.
This study aimed to evaluate the lipid profile in malnourished cerebral palsy patients and delineate its relation to induce cardiovascular atherosclerosis.
This study was conducted on 30 patients suffering from cerebral palsy, their ages ranged between 1.5- 5 years, with a mean age of 3.36 1.18 they were 24 males, and 6 females. They were recruited from the neurology Clinic, Children’s Hospital, Faculty of Medicine, Ain Shams University.
They were subdivided into 2 groups according to AED therapy; 10 were receiving Valproat and 10 were on Carbamazepine therapy .
All patients were subjected to the following:
• Full history taking, thorough clinical and anthropometric examination.
• Laboratory investigations including (serum total proteins and albumin, lipid profile: total cholesterol,TG,LDL and HDL).
• Neurological examination and full systemic evaluation.
• Radiological evaluation by:
- Carotid intima media thickness U/S.
- Abdominal hepatic U/S .
Controls were subjected to the previous steps.
The results of our study revealed that, all the anthropometric measurements were significantly lower among all CP patients compared to controls.
Regarding total proteins and serum albumin, they were significantly lower among patients with CP as compared to controls.
As for the lipid profile, our results revealed that triglycerides (TG), total cholesterol, high density lipoproteins (HDL) and low density lipoproteins LDL were significantly higher among patients with CP as compared to controls. Moreover, TG and total cholesterol levels were significantly and negatively correlated with skin fold thickness (SFT) z score.
Our results revealed that the atherogenic ratios (cholesterol/ HDL and LDL/HDL ratio) were significantly higher in patients with CP as compared to controls. We also demonstrated significantly increased mean values of carotid intema media thickness (CIMT) among patients with CP as compared to controls. Further, this increase was significantly positively correlated with all fractions of lipid profile except for HDL were the correlation didn’t show significance.
Our results also showed that the mean values of CIMT were significantly and negatively correlated with SFTz score. Again, this shows the increased risk of developing atherosclerosis with worsening of the nutritional status among patients with CP.
Our results revealed that the liver span was significantly higher in patients with CP as compared to controls, where, 23.3 %, 53.3% and 23.3% had mild, moderate and severe degrees of hepatic fatty infiltration, respectively. Moreover, this hepatic fatty infiltration was significantly positively correlated with all fractions of lipid profile except for HDL where the correlation didn’t show significance. On the other hand, it was negatively correlated with total proteins, serum albumin and significantly negatively correlated with SFT z score.
Our results revealed that hepatic fatty infiltration was significantly positively correlated with CIMT.
On comparing patients with CP as regards their AEDs, our results revealed the following:
Regarding the anthropometric measurements, our results showed all anthropometric measurements were higher in patients receiving VPA as compared to those receiving CBZ therapy, yet they didn’t reach statistical significance.
Regarding the total proteins and serum albumin, they were not significantly different between those receiving CBZ and those receiving VPA therapy.
Concerning the lipid profile, our results revealed that TG, total cholesterol, HDL and LDL levels were significantly higher in patients receiving CBZ as compared to those receiving VPA therapy. However, both had higher levels than that of controls.
Moreover, our results revealed that the atherogenic ratios (Cholesterol/HDL and LDL/HDL) were higher in patients on CBZ as compared to VPA yet statistically insignificant.
Concerning the mean values of CIMT, they were significantly higher in patients receiving CBZ as compared to those receiving VPA therapy.
Concerning the liver span, our results showed that it was significantly higher in patients on CBZ as compared to those on VPA therapy. Among those receiving CBZ 60 % and 40 % had moderate and severe degrees while, those on VPA 70% and 30% had mild and severe degrees of hepatic fatty infiltration, respectively.