Brain magnetic resonance imaging and motor and intellectual functioning in 86 patients born at term with spastic diplegia
Article first published online: 1 NOV 2012
© The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press
Developmental Medicine & Child Neurology
Volume 55, Issue 2, pages 167–172, February 2013
How to Cite
NUMATA, Y., ONUMA, A., KOBAYASHI, Y., SATO-SHIRAI, I., TANAKA, S., KOBAYASHI, S., WAKUSAWA, K., INUI, T., KURE, S. and HAGINOYA, K. (2013), Brain magnetic resonance imaging and motor and intellectual functioning in 86 patients born at term with spastic diplegia. Developmental Medicine & Child Neurology, 55: 167–172. doi: 10.1111/dmcn.12013
- Issue published online: 16 JAN 2013
- Article first published online: 1 NOV 2012
- Accepted for publication 5th August 2012. Published online.
Aim To investigate the association between magnetic resonance imaging (MRI) patterns and motor function, epileptic episodes, and IQ or developmental quotient in patients born at term with spastic diplegia.
Method Eighty-six patients born at term with cerebral palsy (CP) and spastic diplegia (54 males, 32 females; median age 20y, range 7–42y) among 829 patients with CP underwent brain MRI between 1990 and 2008. The MRI and clinical findings were analysed retrospectively. Intellectual disability was classified according to the Enjoji developmental test or the Wechsler Intelligence Scale for Children (3rd edition).
Results The median ages at diagnosis of CP, assignment of Gross Motor Function Classification System (GMFCS) level, cognitive assessment, and MRI were 2 years (range 5mo–8y), 6 years (2y 8mo–19y), 6 years (1y 4mo–19y), and 7 years (10mo–30y) respectively. MRI included normal findings (41.9%), periventricular leukomalacia, hypomyelination, and porencephaly/periventricular venous infarction. The frequency of patients in GMFCS levels III to V and intellectual disability did not differ between those with normal and abnormal MRI findings. Patients with normal MRI findings had significantly fewer epileptic episodes than those with abnormal ones (p=0.001).
Interpretation Varied MRI findings, as well as the presence of severe motor dysfunction and intellectual disability (despite normal MRI), suggest that patients born at term with spastic diplegia had heterogeneous and unidentified pathophysiology.