Need for Ongoing Neurologic Care in CP

Adults with Cerebral Palsy Require Ongoing Neurologic Care: A Systematic Review

Citation: Smith SE, Gannotti M, Hurvitz EA, Jensen FE, Krach LE, Kruer MC, Msall ME, Noritz G, Rajan DS, and Aravamuthan BR. Adults with cerebral palsy require ongoing neurologic care:  A systematic review. Annuals of Neurology 2021; 89(5):860-71. doi:10.1002/ana.26040

Study type/Population: Qualitative systematic review of articles (1950-2020) investigating conditions of aging in people with CP aged 18 years and older. A total of 2,621 articles were screened and 109 articles were included in the review.

Key findings: As individuals with CP age, new and changing neurologic symptoms occur, including increased risk and/or earlier ages of stroke (2X the risk), myelopathy (8X the risk), loss of mobility (33% of population loses one GMFCS level), dementia, chronic pain (60% of population), and chronic fatigue (65% of population).  Further research is needed to determine prevalence and characteristics of symptoms and to identify modifiable risk factors and interventions.

Translation to practice:  Neurologic symptoms in adults with CP, if untreated, could lead to earlier functional decline.  Adults with CP should receive ongoing care from a neurologist with regular neurological screenings.  The authors argue that neurologists should be part of the “team” of specialists that provide consistent care for adults with CP which includes, physical medicine and rehabilitation specialists, orthopaedics, primary care, and physical and occupational therapy. Telemedicine may facilitate this.