Is cerebral palsy a genetic problem?
Cerebral palsy can occur because of many reasons. It can be attributed to a wide number of intrauterine, perinatal and post-natal factors which can present as an isolated single factor or sometimes a combination of many risk factors. Premature delivery, low birth weight, birth asphyxia, maternal infection, multiple gestations, and ischemic stroke in a fetus or newborn are some common factors.
Despite a large number of known causes, specific idiopathic mechanisms remain elusive in maximum cases of cerebral palsy. Various research with the latest technology in many countries has shown that birth asphyxia accounts for less than 10% of cases with cerebral palsy. The genetic cause is one of the reasons.
Cerebral palsy can occur because of mis-happening during the intrauterine period or time of delivery and afterwards. Genetic causes are the most common in developed countries where good antenatal monitoring and institutional delivery are common.
But in developing countries like India where antenatal monitoring and institutional-based delivery are not so prevalent other causes are also common.
We have several pieces of evidence showing that multiple genetic factors contribute to cerebral palsy. First mutations in multiple genes result in Mendelian disorder that presents with cerebral palsy-like features. Second the prevalence of congenital anomalies in children with cerebral palsy is higher in comparison to the normal population.
A third higher percentage of cerebral palsy affection in monozygotic twins compared to dizygotic twins. Fourth is risk of cerebral palsy is 2.5 times higher in consanguineous marriages.
But most of the time genetic causes are sporadic so there is a lesser chance of transferring to other siblings except in a few cases which tend to transfer to another sibling. Various tests can determine the genetic cause of cerebral palsy but it is not available so frequently and is a 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 the course of action for the present and next issues. Gene therapy can come in the future to manage genetic issues that cause cerebral palsy.
