Interest in the etiology of infantile spastic diplegia has been keen since its first description as a clinical entity by Little, and discussion of the possible factors has been carried on with interest and spirit. Little himself apparently considered, at first, that the same entity might be congenital or acquired, as he stated in his classic description that "you may meet with rare cases in which the whole of the muscles of the extremities... appear conjointly spastically affected... sometimes flexion predominates in the trunk, sometimes extension. Every form of contracture may present itself either as a congenital affection, or as the result of disease during infancy. A common accompaniment of (congenital or acquired) contractures, and particularly when at the same time muscles of the face are involved, is an impairment of the intellectual powers."1 In a later publication,2 however, he gave as the etiologic factors: prematurity, difficult labor
POWDERMAKER F. FAMILIAL CONGENITAL SPASTIC DIPLEGIAREPORT OF THREE CASES IN ONE FAMILY. Am J Dis Child. 1930;39(1):148–156. doi:10.1001/archpedi.1930.01930130160017
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