Evaluation of the relationship between cranial magnetic resonance imaging findings and clinical status in children with cerebral palsy

Abstract

Background/aim: The objective of this study was to evaluate the relationship between cranial magnetic resonance imaging (MRI) findings and clinical features in cerebral palsy (CP). Methods: Children aged 3 to 18 years, who were followed with the diagnosis of CP between January 2012 and September 2015, were included. The type of CP was classified using the European Cerebral Palsy Monitoring Group's classification system and then, patients were divided into two groups as spastic or non-spastic groups. The Gross Motor Function Classification System (GMFCS) was used to determine the level of mobility. According to the GMFCS, levels 1, 2, and 3 were grouped as mobile, and levels 4 and 5 were grouped as immobile. Cranial MRI findings were reevaluated by a voluntarily radiologist and grouped as periventricular leukomalacia (PVL) (grades 1, 2, and 3), cerebral atrophy, migration anomaly, cerebellar involvement, basal ganglion involvement, and normal MRI findings. Results: Sixty-two patients were enrolled. The rate of mobile patients did not differ between the spastic and non-spastic groups. The incidence of PVL was significantly higher in cases of prematurity and spastic CP (p<0.05). The rate of mobilization was significantly lower and the rate of epilepsy was significantly higher in patients with PVL. Immobile patients were more common among cases of grade 3 PVL (p<0.05). Conclusion: The most common cranial MRI pathology was PVL, and the presence of PVL and its grade might help clinically assess the patient's CP type and level of mobilization. While pathology was observed mostly in cranial MRI in cases of CP with similar clinical features, the 2 fact that cranial MRI was completely normal for 14.5% of the cases suggests that there may be some pathologies that we could not identify with today's imaging technology.

Evaluation of Brain MRI in Cerebral Palsy Patients in the Children’s Hospital Lahore

“…15,16 A Turkish cohort showed PVL as the commonest finding in 33% patients followed by cerebral atrophy (12.9%), migration anomaly (9.7%), cerebellar involvement (3.2%) and basal ganglion involvement in 4 cases (6.4%). 17 Our study results were in accordance with this published data except brain malformations which were found to be rare in our study population. A south African study concluded basal ganglion lesions as most frequent in 27.6% study population however PVL and cystic encephalomacia were found in only 3.6 and 7.8% patients respectively.…”

Prevalence and related factors of epilepsy in children and adolescents with cerebral palsy: a systematic review and meta-analysis

“…Cognitive/intellectual disability was uncommon in diplegia because it generally did not damage brain gray matter. In contrast, epilepsy and cognitive/intellectual disability were more common and severe in quadriplegia because of extensive brain injury (36). Although cognitive/intellectual disability is more common in children with CP with severe brain injury, and the possibility of seizures is higher, some children with severe brain injury have normal intelligence and do not often accompany by epilepsy.…”