Talk:Ataxic cerebral palsy
|WikiProject Medicine / Neurology||(Rated B-class, Mid-importance)|
The article contains a lot of valuable information but the initial section that gives an introduction to the topic contains details and explanations that would better suffice to be placed later in the article. A lot of sentences are drawn out and could simply be shortened to be more to the point. For instance the sentence “cerebral palsy is observed in approximately 1 out of 750 births” isn’t really necessary because a reader could get that from clicking on the “cerebral palsy” hyperlink. The article should simply focus on the specific subtype that is ataxic cerebral palsy. I would rearrange and shorten the first paragraph to something like this, “Ataxic cerebral palsy is observed in approximately 5-10% of all cases of cerebral palsy. It is caused by damage to cerebellar structures, which differentiates it from spastic cerebral palsy (damage to cortical motor areas and underlying white matter) and choreoatheotic cerebral palsy (damage to basal ganglia) .” This same concept could be used in the next five paragraphs of the introduction and would serve to make the introduction more concise and specific to the topic itself.
The introduction section was very clear and thorough. I would possibly reduce this section to more of an overview instead of presenting specific information. There were a few (more than one or two) grammatical and/or spelling errors. For instance, “in voluntary” was used instead of “involuntary” and the sentence, “Current forms of prevention are either focused during the pregnancy or immediately post birth” has a grammatical error.
The “Treatment” section contained some information that seemed out of place. For instance, the sentence, “Providing a primary care medical home to support children suffering from common symptoms of nutritional deficiencies, pain, dental care, bowel and bladder continence, and orthopedic complications is an essential aspect of treatment” seems to not fit with the rest of this section, which focused more on clinical treatment options and new research approaches to ataxic cerebral palsy.
In the last section of your article, you mention that there is a genetic link in 50% of cases of ataxic cerebral palsy, but do not go into any more depth regarding the genetic linkage of the disease. This seems to be a pretty significant finding and I think it would be good to add some more information about it. For instance, the article "A gene for ataxic cerebral palsy maps to chromosome 9p12-q12" by McHale, et. al indicates that ataxic cerebral palsy is linked to chromosome 9p12-q12 .
Lastly, I would move the “History” section from last to first. It would seem more logical to present the history of the disease and it’s legal and research beginnings before you present the newer information.
Hi, I think your article provides a good overview of the disorder, and I hope you find my comments helpful:
I agree with the other peer reviewers that the first section of the article should be condensed. Much of the information contained within this section can be redistributed to the appropriate sections below. For example, the fourth paragraph in the introduction provides specifics about treatments currently available, but it may be best to move this info down to section 4.1 (current methods of treatment) and keep only the first sentence (“There is no cure for ataxic cerebral palsy, however there are a number of diverse treatments which have been used to limit the negative effects of the disease.”) in the introduction.
Secondly, I think some sentences need to be reworded or expanded for clarity. For example, you state that “Incidence increases with decreasing gestational period—fewer than 32 weeks of gestation and birth weight less than 5 Ib 8 Oz or 2500g,” but how much impact does gestational period have on incidence? Is this a very significant factor? If a baby is born at 32 weeks, how much more likely is ataxic cerebral palsy? The article “Cerebral Palsy Among Very Preterm Children in Relation to Gestational Age and Neonatal Ultrasound Abnormalities: The EPIPAGE Cohort Study” may help to further elucidate this point. Also, the sentence “Moreover, hypotonia is greatest during this period, even though muscle tone increases with age, it never reaches normal” needs a noun at the end – perhaps “it never reaches normal levels.”
Thirdly, in the diagnosis section, you mention that cerebral imaging techniques are not as helpful as clinical assessments. Why is this? Does diagnosis typically involve a combination of imaging and clinical assessment? Also, you do not mention the genetic component of the disorder until the end of the article; you may wish to include this earlier in the causes section. Since there is a genetic component, are there any genetic tests involved in diagnosis?
Finally, is there any way you could include a video relating to the ataxic cerebral palsy so readers could better understand/visualize the effects of the disorder? RNewmiller (talk) 20:06, 18 November 2012 (UTC)
Overall it is a very good article. I particularly like how it is well laid out and easy to follow—not “intimidating” at all (my only structural suggestion which I see that someone else already mentioned would be to move the history section to the top).
My first suggestion is that maybe you could find the paper that you reference: “familial spino-cerebellar degeneration.” and link it. It appears to be a very important article and it would be nice if the reader could easily refer to it.
Also, it is not formal to write a number to start a sentence (i.e. 50%). This is minor and technical but it is something that I have always been taught not to do.
It would be nice if you could explain what an intention (action) tremor is by either linking it to the Wikipedia page (which exists, I checked) or explaining it in the text of the article. Since it is a disorder that involves medical treatment maybe you could look at the cost of treatment and what kind of financial burden it puts on the family.
Maybe you could explain how it results from meningitis—you mention that it does a couple times but not exactly how? (not sure if they even really know).
I would also include more information from the last article that you cited about neuroimaging. For instance the article states “Most (83%) children with cerebral palsy have abnormal neuroradiological findings, with white matter damage the most common abnormality. Combined gray and white matter abnormalities are more common among children with the disease”. This to me seems to be an example of some critical information that should be included in your Wikipedia page.
Maybe you could even show an image of a brain that has the disease versus one that does not just to add some visual context Hope these suggestions help! Message me if you have any questions!
The article is very interesting and provides a lot of information about a disorder that is not very well known. I agree with the other reviews that the Introduction section is somewhat long and details from this section could be moved to other sections of the article. The information contained in the introduction is valuable but could be better organized within the article. I also agree that it would be a good idea to move the History section to the beginning of the article. It also might make sense to move the paragraph about medical research from the History section to the Treatment section.
In the second section, symptoms that occur during the neonatal period are discussed. It might be helpful to define this term within the article, as there is not a Wikipedia page describing the neonatal period that you could hyperlink it to. Also, in the diagnosis section, diagnosis in adults and children is discussed. If possible, it might be a good idea to elaborate on diagnosis in adults and specify how the disease is usually caused in adults.
One final suggestion would be to try to include more information about the damage in the brain that can cause ataxic cerebral palsy. Some information about this can be found in the article “Cerebral Palsy Hope Through Research” from the National Institute of Neurological Disorders and Stroke. You could also elaborate on the genetic forms of the disease. The article “Ataxic Cerebral Palsy and Genetic Predisposition” by G Miller could provide some useful information. This is a primary source, but I didn’t find any secondary source information about genetic forms of the disease. Ekeena (talk) 02:34, 19 November 2012 (UTC)
Hey guys, I thought you were off to a great start with this article - it provided a lot of really interesting information. However, I do think there are small changes which could make the article easier to read and some larger additions that could augment the article.
The article’s introduction provides a good overview of the disease, however its organization could be improved and it could be made more succinct. I often find the Introduction sections of Wikipedia articles to be very useful in order to obtain very short but very helpful overviews of a given topic. I would alter the first sentences of the introduction to provide a definition of ataxic cerebral palsy rather than statistics describing the epidemiology of the disease. Though I think that it is important to note in this paragraph that it is the least common form of cerebral palsy, I do not think exact percentages are necessary here. Overall, the Introduction needs to be rid of details unnecessary at this point. For example, I think all that is necessary of paragraph 3 is the first part of the first sentence. In addition, I think that the last paragraph of the introduction should be moved into the Symptom section.
The article’s Causes section was well written – however, the first two sentences would be better placed in an epidemiology section and are not a suitable opening for this section. In addition, I would link the word “cerebellum” to its Wikipedia page in order to make the article easier to read for those who do not have a background in neuroanatomy. In the article’s Symptom section, I would link the words “ataxia” and “gait” to their Wikipedia pages. I would also include information regarding the possibility of contractures, or when rigid muscles cause attached bones to become deformed. After briefly researching ataxic cerebral palsy, I found that this is a serious possible complication of the disease. In the article’s Diagnosis section, the Romberg test was misspelled as “Romburg Test.” I would also link this to its Wikipedia page. I found that throughout the article, there were cases where information was unnecessary and could be removed or made more succinct. For example, the Treatment section states “treatment by such teams involves multiple approaches” – I think this sentence can be removed completely. I also think that the last sentence of the legal section can be removed.
Some possible additions to the article which I think could be very helpful include a Prognosis section to describe the probable course of the disease, information regarding Genetic linkage, an epidemiology section, and a video or picture which could help visual learners. Overall the article was very well done – keep up the good work.
The article looks like it has been immensely improved from its original status. As mentioned previously, some parts of the introduction contain a bit too much detail which would still be beneficial if it was placed in the appropriate corresponding sections of the article. The introduction could also be improved by making sure it follows the same chronology as the table of contents, as it jumps between topics at present.
In the “Causes” section, the article you used to substantiate the claim that the etiology of ataxic cerebral palsy is unknown dates to 1962. Has there been research done since then that has proposed a mechanism for the disease, and is there any ongoing research? Since preventative measures for treatment are included, I assumed that there is a hypothesis as to what the mechanism involves and the treatment attempts to avoid the outcome of disease. How are the preventative methods believed to reduce a child’s risk of acquiring ataxic cerebral palsy? Overall, the article is informative and the writing style is well executed.
I also wanted to say that the .gif of the skull highlighting the cerebellum is really cool and helps with visualization of the brain area involved in ataxic cerebral palsy.
Your introduction flows well, but is also very specific. I think that you can actually divide the introduction information into other sections. For example, the paragraph that begins with "There is no cure for ataxic cerebral palsy..." can be moved to the treatments section since the paragraph reveals a possible treatment for ataxic cerebral palsy. Also, the last paragraph of the introduction can be moved to the "symptoms" section.
The "legal" subsection under "history" should be modified to appear more objective. For example, the following statement is too subjective and does not enhance the scientific nature of the article: "A growing concern is the unmet needs of young adults suffering from ataxic cerebral palsy. Community service providers often do not sufficiently support young adults as they attempt to integrate themselves into a larger community. Just like treatment to ataxic cerebral palsy, the answer does not lie within one source, but will need to be a collaborative effort involving service providers, educators, prospective employers, and policy makers." It should be eliminated or modified in a way that corresponds to scientific literature.
In addition, check for grammatical errors (i.e. "in voluntary" instead of "involuntary" in the "symptoms" section); there are a number of them throughout the article. Also, make sure to cite statements such as "Medications like primidone and benzodiazepine, while not recommended for long term use, can alleviate some of the tremor symptoms" (under the "current methods" subsection) immediately following the end of the sentence, so the reader may readily refer to the cited article.
Overall, I really enjoyed reading your article on ataxic cerebral palsy. Its organization makes it an easy article to read.
Peer Review for BI481
First off, good start to the page. Obviously there have been big improvements to this page. I just wanted to name off a few recommendations that could be good for this site.
One, I thought the treatment sections as spot on but one sentence threw me off. “Providing a primary care medical home to support children suffering from common symptoms of nutritional deficiencies, pain, dental care, bowel and bladder continence, and orthopedic complications is an essential aspect of treatment." I don't think this flows at all with the paragraph/section and should be taken out.
Two, At the end of the article, you state there is a genetic link in 50% of the cases of ataxic cerebral palsy. I think this needs to be a section of its own and it should be brought up earlier in the page.
Third, in the causes section, you bring up the gestational period. How important is this period in terms of ataxic cerebral palsy. Fourth, why cerebral imaging techniques nots as helpful as clinical assessments of this disease? You state it but never elaborate on it.
Fifth, What is the neonatal period? You state it but never give a brief explanation of it to complement the section. Sixth, you talk about diagnosis of cerebral palsy in adults and children. Is it possible for this disease not to be detected until adulthood? If so, explain the reasoning of why it took so long for symptoms to occur.
Seventh, I think it is necessary that you speak more about the damage in the brain that ultimately causes this disease. Lastly, you misspelled Romberg! I hope this helps! Good luck Lakkisn (talk) 03:31, 20 November 2012 (UTC)
The first question I have is to watch your facts. In the first paragraph you say the incidence of Cerebral Palsy is 1 in 750 deaths, but later on in the causes section, you say 2-2.5% of western born children have cerebral palsy, these rates are far different from each other. Are you inferring then that the eastern world has a much lower rate of cerebral palsy? This may cause some problems in the future, just make sure you double check the numbers.
Secondly this statement "Brain development normally occurs in the first two years of life" you have to give specifics on what you're talking about; specifically development of what? Some will argue that the brain is always developing and changing over time, while others will say that growth of the brain is an indication of development. You talk later in the diagnosis section about what you mean by it, but I would put it earlier on in the article.
Overall you're on the right track, you have some good secondary sources that provide a lot of information which is good. Also you give a good narrative on the history including the legal background which is an important thing to think about. AdamMJenks (talk) 19:51, 28 November 2012 (UTC) — Preceding unsigned comment added by AdamMJenks (talk • contribs) 19:35, 28 November 2012 (UTC)
Response to Peer Reviews
Thank you to everyone who made comments and suggestions on our article. It was very helpful to us, and we hope that you will find the revised version of the article to be a much more comprehensive review of ataxic cerebral palsy. Below you will find an explanation as to why we either did (or did not) make the changes you suggested. Thanks again!
Whitenp: We removed the sentence regarding the 1 in 750 births, we agree with you that it is more relevant to have that stat just on the page for cerebral palsy in general. We also shortened some of the paragraphs within the introduction, and removed others completely. We hope you find this new introduction to be much more concise!
Kelly Barry0531: Using your requests and similar ones from many others, we shortened the introduction section. In voluntary was meant to be written like that, it was not supposed to be discussion involuntary movements but rather results seen during voluntary movements. We also rewrote the other sentence you pointed out to make it more clear. Regarding the sentence on treatment you felt was out of place, we did decide to keep that sentence. Our goal was to provide a holistic view of treatment, and seeing as there is no cure for ataxic cerebral palsy, different methods of care are pivotal. We did move the history section from last to first. We did not include the statistic you mentioned for genetic linkage as that stat came from a primary resource and not a review article.
RNewmiller: We condensed the introduction, and moved the specific section of treatment you mentioned down into the treatment section like you mentioned. Every article we looked at (including the one you suggested) did not mention any specifics about ataxic cerebral palsy, they just discuss the increased incidence in decreasing gestational period (as mentioned in our article). We made some of the grammatical suggestions you made, added the noun to the end of the sentence, etc. WE did not further discuss the genetic component of the disease because all of the current published research that we found was just primary resources, not secondary.
CorinneMarieClifford: We linked to the page on Friedreich in case people want to research further. We also made the grammatical error you mentioned with the 50%. We explained tremors and linked to it.
Ekeena: We shortened the intro, moved the history section, and moved the paragraph about medical research. We also defined and linked neonatal to its page. We did not elaborate on the genetic piece because, to the best of our knowledge, all published sources on this topic are still primary papers.
Bethanychaves: We fixed most of what you mentioned on the intro, but do think it is very important to note that ataxic cerebral palsy is the least common form of the disease, so we kept that piece. We moved the last paragraph of the intro into the symptoms section, like you mentioned; we also linked ataxia and gait to their pages. We also linked the cerebellum like you suggested. We fixed the spelling of Romberg. We did not include additional info than what we had on the genetic linkage of the disease because all of the published research we could find were in primary papers. We kept the additional details we had in the legal and treatment sections, as we thought they helped provide a holistic, balanced view of both pieces of the disease.
Carrolni: We shortened the intro, and reorganized it to better fit the chronology of our paper. We also elaborated on more of the current research that has occurred since 1962, and cited another article (which came to the same general conclusions as the one from 1962) which was published in 2006.
Kwakda: We took many of the specific facts from the intro and either deleted them or moved them into lower sections. We kept the statement about their being no cure because we think it is essential to the different treatment methods of the disease. We also cited the facts you mentioned. The way we presented the information in the legal section is congruent with how the secondary review papers we read presented it.
Lakkisn: We feel that sentence in the treatment section really provides a holistic view of how the disease is currently being treated, as there is no cure, so we decided to keep it. We did not elaborate on the genetic linkage of the disease because, to the best of our knowledge, there is yet to be a secondary source that describes it in detail. We defined and linked the neonatal period. We also fixed the spelling of Romberg.
AdamMJenks: We removed some of the facts and fixed others in order to ensure that all of our numbers match throughout the article. We addressed the specifics of brain development that you mentioned; we added a piece about motor and adaptive skills, which (during their development) is when you start to see the signs and symptoms of the disease. We moved this up to earlier in the article like you suggested.