CORRELATION OF NEUROLOGICAL DEFICITS AND NEUROIMAGING FINDINGS IN CEREBRAL PALSY

Objectives: Cerebral palsy (cp) is a common static motor neurological disorder of childhood with wide spectrum of underlying etiologies, which can be demonstrated with different euro imaging techniques. For diagnosis of interacranial lesion in children with cp and correlation of clinical deficits and neuroradiological findings, we decided do this study.

Methods: In this prospective, Hospital based study, 120 patients blow 18 years with diagnosis of CP during 3 years In Neurological clinic of Ali Ashgar Children Hospital of Iranian Medical Since University in Tehran of Iran, were examined neurologically. Their cranial neuroimagins (CT scan or MRI) findings and association between the gestational ages, perinal history and neurological deficits were studied.

Results: 72 patients (%60) of this study were male. %75 belong to age group under 7 years. The common predisposing factors were perinatal asphyxia, LBW, prematurity and toxemia of pregnancy. Spastic cp formed 88%(109) of our cases, With Quadriplegic type being the commonest %60 (65/109) and %25 (26/109) of them had spaticdiplegia which 60% (16/26) had significant periventricular Leucomalasia (PVL) which was more common among pre-term born. 16 patients were hemiplegics cp which 14 (%85) of them had unilateral lesion on brain MRI imaging. Extra pyramidal CP were 10 (%8) of study which were more common among term born infant and %72 (6/10) of them showed significant abnormalities on the basal ganglia. Cerebral atrophy was seen in 50% (60/120) of patients, PVL 20%, encephalomalasia, gliosis, MRI imaging. Middle cerebral artery infarts and PVL and gliosis suggested hypoxia as risk factor for CP. Extension of MRI lesions correlated with the severity of neurological deficits in CP lesions were more extensive in Quadriplegic and double Hemiplegic than diplegic and in preterm than terme born.

Conclusion: The radiological findings were closely related to the type of CP and neurological deficits and gestational age of patients with brain insult. We believe that MRI and CT imaging specially MRI are helpful in delineating the underlying etiology, extent, severity and timing of insult to developing brain and prognostication in CP patient.