THE DETERMINATION OF SENSORY DEFICITS IN CHILDREN WITH HEMIPLEGIC CEREBRAL-PALSY

Therapeutic intervention for children with cerebral palsy begins with accurate appraisal of abilities and disabilities. Currently, treatment focuses on the identified motor deficits, with any underlying sensory deficits often being overlooked. Sensory input is an essential compon ent of motor function and motor control. Therefore, the objective of t his study was to determine the presence and extent of sensory deficits in school-aged hemiplegic children using a formal clinical sensory ba ttery, as well as somatosensory evoked potentials. A cross-sectional c omparative study was performed comparing sensory function in hemiplegi c children and healthy controls. Nine hemiplegic children and 41 healt hy controls between 4 and 19 years of age were assessed. Hemiplegic ch ildren were included if they had a minimum level of receptive language function of 30 to 33 months and expressive language ability of 24 to 27 months, and no severe limitation of joint range of the hand. Signif icant bilateral sensory deficits (88.8%) were ascertained in hemiplegi c children (P < .05), when compared to the performance of the healthy controls. Stereognosis and proprioception were the chief modalities af fected bilaterally. The extent of sensory loss did not mirror the seve rity of motor deficit. Conversely, findings on somatosensory evoked po tentials were closely related to motor function. Thus, a clinical sens ory evaluation should be an integral part of the assessment of childre n with cerebral palsy. The likelihood of sensory impairment in one or more modalities on the hemiplegic or nonhemiplegic side is underapprec iated and needs to be identified by rehabilitation specialists to maxi mize the functional potential of these children.