Neurophysiological and Neuroradiological Characteristics of Children With Hemiplegic Cerebral Palsy With Regard to Gender and Laterality of Hemiparesis

Abstract

Objective: This study aims to analyze the neurophysiological and neuroimaging characteristics of children diagnosed with hemiplegic cerebral palsy (HCP) while considering the impact of gender and laterality of hemiparesis. Methods: We analyzed 125 children between the ages of 7-9 (with a mean age of 8.2±0.9 years) diagnosed with HCP (ICD-10 Code: G80.2). Our analysis focused on the lateralization of cerebral injury. The patients were divided into 2 groups based on the hemispheric focus lateralization. In each group, subgroups were distinguished by gender. After examining the patients, it was found that the most prevalent were male children, children aged eight years, and those with left-sided hemiparesis. Results: The EEG of patients with HCP showed diffuse changes and signs of brainstem dysfunction (disorganization of the α-rhythm at a reduced amplitude level). Furthermore, there were fluctuations in the brain's bioelectrical activity (BEA) of varying degrees of intensity. Residual organic disorders (slowing down of the cortical rhythm) were found in 64 (88.9%) children of group I and in 42 (79.2%) children of group II (p>0.05; χ2 =1.52). MRI data analysis revealed brain pathological changes in all examined patients. In group I, periventricular lesions of the white matter were present in 36.4% (12) and 38.5% (15) of female and male pediatric patients, respectively. In both female and male pediatric patients, atrophic and subatrophic changes were detected in the cerebral cortex with a prevalence of 51.5% (17) and 53.8% (21), respectively. Brain scans revealed that 84.8% (28) of female and 89.7% (35) of male pediatric patients had focal brain lesions. In group II, periventricular lesions of the white matter occurred in 34.8% (8) and 36.7% (11) of female and male pediatric patients, respectively. Gray matter atrophy in both female and male pediatric patients was detected in 47.8% (11) and 53.3% (16) cases, respectively. Focal brain lesions were in 65.2% (1 5) and 76.7% (23) of female and male pediatric patients, respectively. Conclusion: There is no correlation between the neurophysiological and neuroimaging characteristics of children with HCP and their hemiparesis laterality or gender. From the available data, it can be inferred that HCP is likely caused by focal cerebral damage and brain malformations.Keywords: Cerebral palsy, electroencephalogram, brain bioelectrical activity, magnetic resonance imaging, slow sensorimotor rhythm.