CLINICAL AND MR CORRELATES IN CHILDREN WITH EXTRAPYRAMIDAL CEREBRAL-PALSY

PURPOSE: To identify the characteristic MR findings in extrapyramidal cerebral palsy. METHOD: Six patients who had suffered intrapartum asph yxia and who subsequently developed extrapyramidal cerebral palsy were identified. Asphyxia was evidenced by severe neonatal systemic acidos is as documented by a venous cord pH of less than 7.0 whenever availab le, or acidosis in subsequent arterial blood gas samples, and clinical signs of an acute hypoxic-ischemic encephalopathy during the neonatal period. In addition, 1- and 5-minute Apgar scores were 3 or less, and there had been need for intubation or vigorous resuscitation in the d elivery room. There were three boys and three girls, all born at term, with birth weight appropriate for gestational age, and without a hist ory of bilirubin levels above 15 mg/dL. MR imaging at 1.5 T was perfor med between 1 and 19 years of age. RESULTS: In all subjects focal high signal abnormality was demonstrated in the posterior putamen and the anterior or posterior thalamus. There were no other findings in most c ases. CONCLUSION: MR demonstrated lesions in the putamen and thalamus in all of our six patients with severe extrapyramidal cerebral palsy w ho had suffered intrapartum asphyxia.