When cerebral palsy was first defined in England in the mid-19th century, it was noticed that it was associated with premature birth, difficult labour, head and neck injuries during birth, seizures after birth, and asphyxia (lack of oxygen) around the time of birth. It became a widespread belief that this was always the cause of cerebral palsy. It was Sigmund Freud, in 1897, who first questioned this idea. He suggested that if there was difficulty at birth, there might be an underlying condition already present.
Later research has shown that both beliefs are partly right. The brain damage or disorder leading to cerebral palsy may be already present at birth; or acquired at or after birth; or both. It can be difficult to discern when the damage / disorder occurred in an individual child, but research is shedding light on some of it. In the 1980s, the U.S. National Institute of Neurological Disorders and Stroke (NINDS) analysed data from about 35,000 babies and their mothers, and found that complications during birth and labour appeared to be connected with about 10% of cerebral palsy cases. Since then, they have funded and co-ordinated a research programme to find out more about the causes of cerebral palsy, collated by the Brain Resources and Information Network (BRAIN), National Institute of Neurological Disorders & Stroke, P.O. Box 5801, Bethesda, MD 20824, tel: 800-352-9424, email: braininfo@ninds.nig.gov, web site: www.ninds.nih.gov
Other published research on causes is available through the “Pubmed” database and other research collections, and the cerebral palsy registers and the major cerebral palsy organisations that encourage research in a number of countries. Many journals carry information about it but the major English language journal where research is discussed, on causes and other aspects of cerebral palsy, is Developmental Medicine and Child Neurology, held by major libraries and published by Blackwell Publishing Ltd., tel: 01865 778315, http://journals.cambridge.org/action/displayJournal?jid=DMC (for issues up to 2006) and http://www.blackwellpublishing.com/journal.asp?ref=0012-1622&site=1 (for later issues).
The NINDS study is one of the few large-scale collaborative studies that have been done on causes. It is recognised that cerebral palsy research over-all is moving more slowly than research in some higher-profile fields such as spinal injury. The stage is set for more large-scale collaboration. (From the UK the Castang Foundation,
www.castangfoundation.net, are currently co-ordinating a multicentre European study.) The biological processes that lead to the outcome of cerebral palsy are also being researched but this is very expensive. The third need is for more consistent measurement tools so that the research can be accurately done and interpreted. There has been recent progress in this area.
