الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Cerebral Palsy is a group of disorders of development of movement and posture that are attributed to non-progressive disturbances that occurred in developing fetal and infant brain. Motor disturbances of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behavior and/or a seizure disorder (Rosenbaum et al., 2007). Helicobacter Pylori is a common bacterial infection that is associated with significant morbidity and mortality worldwide. H. pylori incidence is high among Egyptian schoolchildren aged 6–15 years, with an overall prevalence of (72%) (Mohammad et al., 2008). Children with cerebral palsy are highly liable to H Pylori infection. They could be asymptomatic or suffer from gastro-enteric manifestations as abdominal pain, anemia not responding to treatment, recurrent vomiting, and upper gastrointestinal bleeding (Eren et al., 2015). The present study was carried out on 100 patients diagnosed as cerebral palsy who were attending pediatric neurology outpatient clinic of Tanta University Hospital .The study period extended from August 2021 till March 2023. Inclusion criteria: All cases are pediatric patients with cerebral palsy that were diagnosed based on the history and clinical examination according to proposed definition of cerebral palsy (Rosenbaum et al., 2007). Exclusion criteria: 1. Age below 2 years. 2. Age above 17 years. 3. Previous gastric or duodenal operations or malignancy. 4. Previous treatment for H. pylori. 5. Current use of antacids: proton pump inhibitors, H2 receptor blockers, use of anticoagulant, or recent use of antibiotics (within 6 weeks before enrollment). All children in this study were subjected to the following after informed consents from their care givers and approval from the Ethical committee of Tanta University Hospital. F- Complete history taking including personal history, past history and cause of insult, developmental history, family history, social history, dietetic history and detailed history about GIT disorders. G- Complete physical and neurological examination including assessment of ability of eating and drinking EDACS. And assessment of motor disabilities by GMFCS. H- Investigations included: 1. CBC 2. Liver Function 3. EEG 4. MRI Brain 5. Pelvi-abdominal ultrasound 6. Upper GI endoscope 7. H. pylori Antigen in stool
This study demonstrated that: - According to weight for age percentile for the studied children with CP there were (17%) below 10th percentile, (37%) were between 10th - 50thpercentile, 25% were between 50th-90th percentile and (21%) were above 90th percentile. - Spastic CP is the most frequent type of CP (60%), and mixed CP was (28%). - The prevalence of H. Pylori infection in CP children was (45%) compared to (55%) negative cases. - H. Pylori infection was more prevalent among patients with low to moderate socioeconomic status. - Regarding GMFCS class 5 was more prevalent (37%) and represented (37.8%) of H. Pylori positive patients. - The main associated disorders with studied children with CP were epilepsy, speech, visual disorders, intellectual disability. - There were relationship between H. Pylori infection and the associated medical problems as; intellectual disability and recurrent infections. - There is a significant association between type of diet and feeding and infection by H. Pylori. Patients who depend on soft diet and smashed food were (51.1%) of positive cases, (20%) were depending on normal diet. - There was a significant association between vomiting in CP patients and H. Pylori as (71.1%) of positive H. Pylori patients suffered from vomiting. - There was a significant association between abdominal pain in CP patients and H. Pylori as 66.7% of positive H. Pylori patients suffered from abdominal pain. - There was a significant association between bleeding from GIT and H. Pylori infection as 22.2% of positive H. Pylori patients suffered from GIT bleeding.