Article

The aim of this population-based study was to describe function in cerebral
palsy (CP) in relation to neuroimaging. Method Motor function, accompanying
impairments, and neuroimaging (86 by magnetic resonance imaging, 74 by computed
tomography) were studied in 186 children born in western Sweden between 1999 and
2002 (96 males, 90 females;
age range at data collection 4-8y). Results Forty per
cent of the children had unilateral spastic CP, 39% bilateral, 16% dyskinetic CP,
and 5% ataxia. Fifty-one per cent were in level I of the Gross Motor Function
Classification System (GMFCS), 14% in level II, 3% in level III, 11% in level IV,
and 22% level V. Forty per cent of the children were in level I of the Manual
Ability Classification System 19% were in II, 9% at III, 8% in IV, and 24% in
level V. Seventy-six per cent of the children with white-matter lesions were in
GMFCS levels I and II, whereas 67% with basal ganglia lesions were in levels IV
and V. Learning disability* (45%), epilepsy (44%), and visual impairment (17%)
were most common in children with brain maldevelopment, and cortical/subcortical
or basal ganglia lesions. Speech was impaired in 49% of the children, absent in
30%, and 6% had a neuropsychiatric diagnosis. Compared with children born between
1991 and 1998, the numbers of those in GMFCS level I increased (p=0.007), as did
those with epilepsy (p=0.015). Interpretation Neuroimaging improves the
understanding of the neuroanatomical basis for function in CP. Type and severity
of motor impairment and accompanying impairments are related to the timing of lesions.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2011 Mac Keith
Press.

Langue : ANGLAIS