A HYPOTHESIS FOR THE ETIOLOGY OF SPASTIC CEREBRAL-PALSY - THE VANISHING TWIN

The aetiology of spastic cerebral palsy (GP), in the majority of cases , is not known but the general consensus is that cerebral impairment o ccurs prepartum, In monochorionic twin pregnancies, death of one twin late in gestation is recognised as being an important risk factor for the surviving cotwin to have CP, It has been suggested that a signific ant proportion of singletons with spastic CP may be the result of deat h of a cotwin in the second half of gestation. In this paper it is hyp othesised that spastic CP of unknown aetiology is the result of the de ath of a monochorionic cotwin and that the death of the cotwin may imp air the neurological development of the survivor throughout gestation, If so, vanishing-twin syndrome, which is now a recognised phenomenon revealed by ultrasound examination in early pregnancy, is important in the aetiology of spastic CP.