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Complexity of the Cerebral Palsy Syndromes
Toward a Developmental Neuroscience Approach
Michael E. Msall, MD
JAMA. 2006;296:1650-1652.
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Over the past 2 decades, major advances in obstetrics, genetics, maternal fetal medicine, neonatology, developmental neurosciences, and reproductive epidemiology1-12 have resulted in unprecedented low rates of infant mortality. In 2004, the overall US infant mortality rate was 7 per 1000, with 90% survival of children born very prematurely at 28 to 32 weeks of gestation and survival as high as 80% for children born extremely prematurely at 24 to 28 weeks.13-14 In addition, a new consensus definition of cerebral palsy (CP) has been proposed,15 advances in neuroimaging16-20 have allowed for the examination of central nervous system structure, and a gross motor function classification system21-22 has given neurodevelopmental pediatricians, orthopedic surgeons, and physical therapists a common language for interdisciplinary collaboration.
In 2000, Stanley et al23 proposed that etiologic research on single factors needed a more comprehensive framework of causal pathways in order to understand the complexity of . . . [Full Text of this Article]
Author Affiliations: Kennedy Mental Retardation Center and the Institute of Molecular Pediatrics, University of Chicago Pritzker School of Medicine, University of Chicago Comer Children's and LaRabida Children's Hospitals, Chicago, Ill.
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