PRENATAL DETERMINANTS OF MOTOR DISORDERS

Cerebral palsies (CP) are the commonest childhood motor disorders, ori ginating in early childhood as a result of interference in the develop ing brain. Identifying prenatal factors in CP is a challenge because t here is a considerable period of time (years) between the causal event (s) and diagnosis. Four fascinating ''natural'' situations provided a unique opportunity to identify and measure prenatal exposures in relat ion to motor disorders, thus establishing the unequivocal role of some factors. However, the majority of studies determining adverse reprodu ctive effects of environmental factors require a retrospective case-co ntrol approach, which present considerable problems. Studies based on the Western Australian CP register suggest that prenatal factors singl y or in complex sequences are more common as causes than those occurri ng perinatally or postnatally. In future, better diagnosis of motor di sorders, use of sophisticated scientific techniques to identify marker s of neuronal development and the accurate linkage of these findings t o clinical patterns of motor dysfunction are required.