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Advanced Neurology Neonatal encephalopathy and cerebral palsy

of AAC may be insufficient for CP children with a limited improvement in abnormalities of functional
history of NE. Concurrently, these patients also exhibit a connectivity in the brain . The efficacy of therapeutic
[70]
heightened incidence of swallowing difficulties. Current hypothermia in reducing the prevalence of CP remains
clinical therapies primarily focus on physical training, inconclusive. While several studies have reported a
which proves inadequate for supporting improvements significant reduction in CP incidence with therapeutic
in oral feeding . Previous randomized controlled hypothermia [71-73] , another study found no clear differences
[59]
trials of oral feeding interventions for children with CP in CP rates among children aged six to seven who underwent
demonstrated potential for improvement in oral motor therapeutic hypothermia compared to those who did
function. However, these interventions did not yield not . This inconsistency underscores the imperative need
[74]
significant enhancements in feeding efficiency or weight for further research, especially in investigating the impact
gain [60-62] , indicating the necessity for further development of therapeutic hypothermia on CP patients with a history
in this domain. Moreover, our analysis revealed a notably of NE. Our recent meta-analysis study has demonstrated
higher rate of cognitive impairment in CP patients with that the combination of therapeutic hypothermia with
an NE history. Assessments of cognitive abilities in these neuroprotective adjuvants not only shows promise in
children often rely on assumptions rather than providing reducing the length of hospital stay for infants diagnosed
an accurate evaluation of intellectual ability. This reliance with NE but also opens avenues for further exploration.
[75]
on assumptions may result in potential erroneous Delving into the effects of these combined therapeutic
determinations of intellectual disability , consequently approaches on CP patients with a history of NE may pave
[63]
limiting their opportunities for treatment , intellectual the way for a new direction in the management of CP.
[64]
growth, and mainstream schooling [65,66] . Taken together, In summary, our analysis identifies an increased
our findings suggest the pressing need for the development incidence of specific, commonly reported CP comorbidities
of new therapeutic strategies specifically targeted at CP in patients with preceding NE conditions, particularly
patients with an NE history. Future research should encompassing communication challenges, swallowing
prioritize addressing complications exacerbated by NE.
difficulties, and cognitive impairment. Thus, therapeutic
The present analysis also furnishes evidence indicating strategies should extend beyond addressing mobility issues
a significantly higher incidence of the spastic quadriplegic and emphasize the preservation of speech, swallowing, and
subtype of CP in cases where the patient has a history cognitive functions. For future clinical studies, there should
of NE. A recent review highlighted that CP spastic be a strategic focus on monitoring a more comprehensive
quadriplegic children often develop atypical movement range of characteristics in CP patients with preceding NE
patterns leading to multisystem consequences, aggravating conditions, with a particular emphasis on gender-specific
the condition and diminishing their quality of life . Given differences. This targeted approach aims to refine the
[67]
that physical disability is a shared characteristic across all profiling of NE-induced symptoms and characteristics
CP cases, established therapies such as standard physical in CP, consequently better informing the customization
therapy, treadmill training, and functional gait training of new treatment initiatives. Additionally, further
have proven effective interventions clinically employed to research should delve into the mechanisms underlying
improve walking ability in patients with CP [35,36] . However, NE-induced neurological impairments. This exploration
an individual case report involving a non-ambulatory holds the potential to contribute to the development of
young adult with spastic quadriplegic CP revealed a 9.4% more effective therapies designed not only to alleviate
decrease in the distance covered in a walking endurance mobility impairments but also to address additional
test after 6 weeks of gait training. This case report suggests cognitive and motor impairments in CP patients with an
that while physical therapies have demonstrated efficacy NE history. A more favorable clinical prognosis entails
in improving movement ability in CP patients overall, a early interventions and improved access to rehabilitation
combination of interventions or novel approaches may resources, potentially aiding in the survival and improving
be necessary to effectively support the physical health of neurological outcomes for children with CP. This, in
patients with the spastic quadriplegic subtype of CP, which turn, contributes to a more enriched daily life experience
was observed to be a predominant subtype following NE. extending from childhood and into the future.
Therapeutic hypothermia is the currently recognized
standard of care for NE and has demonstrated efficacy in 5. Conclusion
improving the survival rate and neurological outcomes Children with CP following NE conditions at birth are more
in affected neonates [68,69] . However, despite undergoing inclined to exhibit the most severe spastic quadriplegic
this treatment, a substantial number of patients continue subtype. Those CP patients with an NE history show a
to experience long-term neurological disorders, showing significant increase in the incidence of comorbidities,

Volume 2 Issue 4 (2023) 9 https://doi.org/10.36922/an.1719