Magnetic resonance imaging, risk factors and co-morbidities in children with cerebral palsy

Abstract

Cerebral palsy (CP) continues to be a major problem in India. The present study provides an insight into the various clinical and neuroradiological correlates of CP. The study included 102 children with CP and was subjected to magnetic resonance imaging (MRI) of the brain. Forty-seven (46%) patients belonged to the 1-3 years age group and 84 (82%) were born at term. Of 102 children, 39 (38%) were delivered at home. Based on their tone and topographic pattern of weakness, it was found that 47 (46%) had spastic diplegia and 35 (34%) spastic quadriplegia. Hemiplegic, dystonic, and atonic CP accounted for the remaining 20%. The occurrence of severe birth asphyxia, which is rarely seen in developed countries, continues to be a major problem in developing countries, and accounted 64 (62%) of the patients. Cognitive delay (82%) was the most common co-morbidity, followed by seizure disorder (52%), feeding difficulties (22%) and visual abnormalities (29%). Ninety-one (89%) children had an abnormal MRI. Periventricular white matter injury (PWMI) was observed in 48 (47.1%), followed by diffuse encephalopathy (29%). Focal lesions (6%) and malformations (3%) were less common. In children with spastic diplegia, PWMI was the most common MRI abnormality, whereas in spastic quadriplegia, diffuse encephalopathy was most common. MRI scans help in revealing the pathologic basis of CP and had strong correlations with clinical findings.

Localization of Basal Ganglia and Thalamic Damage in Dyskinetic Cerebral Palsy

“…[26][27][28][29] These cases could not be isolated from the larger cohort because their imaging findings were not distinguished from the imaging findings in patients without neonatal hyperbilirubinemia. [26][27][28][29] Three studies specifically noted that subjects had no evidence of hyperbilirubinemia. 12,14,15 Two autopsy studies met initial inclusion criteria.…”

“…Seven studies did not clearly indicate the number of subjects with damage to a specific area. 13,16,18,[25][26][27][28] For example, four of these studies noted that the basal ganglia or thalamus were damaged in a certain number of subjects without noting how many subjects had basal ganglia damage alone, thalamic damage alone, or coincident basal ganglia and thalamic damage. [25][26][27][28] The subjects from these seven studies were therefore excluded from the subsequent summation portion of the analysis (Table 1).…”

Anatomical characterization of athetotic and spastic cerebral palsy using an atlas‐based analysis

“…The majority of CP children have various types of abnormalities on brain magnetic resonance imaging (MRI) (6)(7)(8)(9)(10). The two most important roles for MRI are identification of the anatomical features that predict adverse neurodevelopmental outcomes, and an accurate and informative definition of the nature of cerebral injury in this population (6).…”

“…The two most important roles for MRI are identification of the anatomical features that predict adverse neurodevelopmental outcomes, and an accurate and informative definition of the nature of cerebral injury in this population (6). However, the highly variable nature of the location and the extent of the injuries in CP make a systematic anatomical analysis by subjective observation very challenging (6)(7)(8)(9)(10).…”

Ermittlung des Aktivitätslevels bei Patienten mit infantiler Zerebralparese

“…Die klinischen Befunde und die Schwere der Behinderung stehen dabei in engem Zusammenhang mit den MRT-Befunden. So konnte in einer Studie von Prasad [2] gezeigt werden, dass bei Patienten mit schweren bilateralen spastischen Zerebralparesen die Befunde im MRT häufig diffuse Enzephalopathien zeigen. Für die Einteilung des Schweregrads der Körperbehinderung hat sich international der GMFCS nach Rosenbaum [3] …”