LATE REMISSION OF CONGENITAL HEMIPARESIS - THE VALUE OF MRI

In our department of neuropediatrics we made a definite diagnosis of c ongenital hemiparesis in a total of 123 patients born between 1974 and 1985. This diagnosis was always made or confirmed at a point after th e patient's first birthday. Recently, we were able to follow up on 102 of them (83%) to determine whether their symptoms persist, that is, i f the initial diagnosis of cerebral palsy (CP) was correct or not. Now , at the age of 9 to 18 years, 94 of these 102 patients (92%) still su ffer from hemiparesis. We were able to perform MRI on 44 of them. A le sion consistent with the neurological symptoms was found in 43. Only o ne patient had normal findings-a false negative, so to speak. Of the 1 02 patients, eight (8%) had no hemiparesis, i.e. no disability at all at the time of the follow-up. All eight had in common the fact that th e former functional involvement had been slight and not arm-dominated. Seven of them were also examined with MRI. Six had normal findings; M RI revealed a periventricular lesion consistent with the earlier hemip aretic symptoms in only one patient (a false positive, so to speak). W e conclude that some children ''outgrow'' a hemiparetic cerebral palsy , even in later childhood years. In our patient group this happened be tween the ages of 3 and 10. We further propose that MRT could be usefu l in distinguishing between transitory and persistent hemiparesis.