MRI and clinical characteristics of children with hemiplegic cerebral palsy

Magnetic resonance imagings of 91 children with hemiplegic cerebral palsy w ere analysed with the aim of clustering their features into fairly homogene ous forms. In addition, the different clinical patterns of each form were d escribed. Four main types of lesion were distinguished: form 1 (13 cases), which comprised brain malformations, form 2 (41 subjects), which grouped ab normalities of the periventricular white matter, form 3 (27 children), whic h was represented by cortical-subcortical lesions, and form 4 (10 subjects) , which grouped non-progressive postnatal brain injuries. None of the child ren had normal MRI and a high incidence of bilateral lesions was found, esp ecially in form 2, A left motor involvement was prevalent in the sample and was noted in all but the third form. The severity of impairment was mainly moderate in forms 1 and 3, mild in the others. The upper limb was found to be more affected in all forms except the second one, which presented a gre ater involvement of the lower limb. Mental retardation occurred in about on e-third of the children with forms 1 and 4, less often in the other two. Se izures occurred in about half of the children with forms 1 or 3, while the incidence was lower in forms 4 and 2. A strong correlation between the pres ence of seizures and mental retardation was observed. The results of this s tudy show the importance of MRI in the evaluation of children with hemipleg ic cerebral palsy.