Autonomic dysfunction in children with cerebral palsy

Rajkumar G¹, Anbarasi M²
¹Associate Professor of Paediatrics, ²Professor, Department of Physiology, Dhanalakshmi Srinivasan Medical College & Hospital, Perambalur, Tamil Nadu, India

  • Background: Cerebral palsy is a group of disorder that affects the motor function. Some children with cerebral palsy (CP) were also found to have symptoms of autonomic dysfunction like high heart rate, bowel and bladder disturbances, hyperhidrosis, altered salivary parameters and others. This study is done to investigate the specific degree and type of autonomic dysfunction (AD) in the children with cerebral palsy and correlate with their clinical symptoms.
  • Methods: The study is done after getting approval from Institutional Ethics Committee and written consent from the parents. 20 children with CP (age, 5 – 12 years and of both genders) were included. Children with known history of cardiac diseases were excluded. A detailed history regarding the antenatal, perinatal and postnatal period were elicited form the mother and autonomic symptom scoring was done. After recording the baseline vital signs, the children were subjected to resting Heart Rate Variability (HRV) analysis. Time domain and frequency domain parameters were analyzed and correlated with autonomic symptom scores. Statistical analysis was done using SPSS version 17.0.
  • Results: Out of 20 children with CP, 65% had mild autonomic dysfunction and 15% had moderate AD. Time domain parameters of HRV were reduced in comparison with the standards. Frequency domain analysis showed increased Low Frequency (LF), decreased High Frequency (HF) and increased LF/HF ratio. A positive correlation was observed between absolute power of LF and autonomic symptom scores (rho – 0.484, p = 0.03).
  • Conclusion: This study has brought out the subjective and objective evidences of autonomic dysfunction in children with cerebral palsy.

Keywords: autonomic dysfunction, cerebral palsy, heart rate