FAMILIAL CEREBRAL PALSY: RECURRENCE OF CEREBRAL PALSY IN THE PRESENCE OF MULTIPLE RISK FACTORS
Bibliographic record
Abstract
Objectives: To identify risk factors involved in the familial recurrence of cerebral palsy (CP) within individual families. Methods: The records of two families with two or more affected siblings with cerebral palsy (CP) were reviewed. A detailed medical record abstraction was performed to identify possible factors contributing to the recurrence of cerebral palsy within these families. Results: Family 1: A married, Metis mother delivered three sequential children with spastic quadriplegic CP between the maternal age of 26 and 29. Prior to these pregnancies she delivered three healthy children at term. No specific genetic factor or clinical syndrome was identified following extensive investigation of the children and the mother. Multiple hematological abnormalities (AT III, protein S, elevated Factor VIII, 'low to medium positive' anticardiolipin) were identified in the mother whom also later suffered a cerebrovascular accident. Placental pathology was abnormal in the only child on which it was performed. Pre-eclampsia and intra-uterine growth restriction (IUGR) were additional indicators of feto-placental dysfunction. Family 2: The second family includes two children with right hemiparetic CP. The pregnancies for both children were complicated by pre-eclampsia and insulin-dependent diabetes mellitus. A left middle cerebral artery territory infarct and right hemiplegic cerebral palsy was diagnosed in both children. The older boy was later diagnosed with insulin-dependent diabetes mellitus and celiac disease, while his sister was diagnosed with a presumably immune related dilated cardiomyopathy. Conclusion: Our case series highlights the risk of recurrent CP in families in whom multiple risk factors exist. The overall risk of recurrent CP is low, but we hypothesize that the degree of risk is modified by the number of risk factors present. Our ability to council parents and families appropriately will depend on the depth of our search for known risk factors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".