Format

Send to

Choose Destination
Neurology. 2019 Jul 2;93(1):e88-e96. doi: 10.1212/WNL.0000000000007726. Epub 2019 May 24.

Profile of children with cerebral palsy spectrum disorder and a normal MRI study.

Author information

1
From the Faculty of Medicine (A.S.) and Departments of Pediatrics (M.O., M.S.) and Neurology & Neurosurgery (M.O., M.S.), McGill University; Canadian Cerebral Palsy Registry (S.D.H.), Research Institute of the McGill University Health Centre, Montreal; Department of Pediatrics (J.A.), University of Alberta, Edmonton; Janeway Children's Hospital (D.B.), St. John's; Department of Paediatrics (D.F.), Bloorview Research Institute, University of Toronto; Departments of Pediatrics and Clinical Neurosciences (A.K.), Cumming School of Medicine, University of Calgary; Centre de Réadaptation Marie Enfant du CHU Sainte-Justine (L.K.), Montreal; Centre Hospitalier Universitaire de Sherbrooke (N.P.); BC Children's Hospital (E.V.R.), Vancouver; and IWK Health Centre (E.W.), Halifax, Canada.
2
From the Faculty of Medicine (A.S.) and Departments of Pediatrics (M.O., M.S.) and Neurology & Neurosurgery (M.O., M.S.), McGill University; Canadian Cerebral Palsy Registry (S.D.H.), Research Institute of the McGill University Health Centre, Montreal; Department of Pediatrics (J.A.), University of Alberta, Edmonton; Janeway Children's Hospital (D.B.), St. John's; Department of Paediatrics (D.F.), Bloorview Research Institute, University of Toronto; Departments of Pediatrics and Clinical Neurosciences (A.K.), Cumming School of Medicine, University of Calgary; Centre de Réadaptation Marie Enfant du CHU Sainte-Justine (L.K.), Montreal; Centre Hospitalier Universitaire de Sherbrooke (N.P.); BC Children's Hospital (E.V.R.), Vancouver; and IWK Health Centre (E.W.), Halifax, Canada. michael.shevell@muhc.mcgill.ca.

Abstract

OBJECTIVE:

This study looks at what profile can be expected in children with cerebral palsy spectrum disorder (CP) and a normal MRI.

METHODS:

The data were excerpted from the Canadian Cerebral Palsy Registry database. Only patients who had undergone MRI were included in the analysis. Neuroimaging classification was ascertained by university-based pediatric neuroradiologists and split into 2 categories: normal and abnormal MRIs. Six factors were then compared between those 2 groups: prematurity, perinatal adversity, presence of more than 1 comorbidity, CP subtype, bimanual dexterity (Manual Ability Classification System [MACS]), and gross motor function (Gross Motor Function Classification System [GMFCS]).

RESULTS:

Participants with no perinatal adversity were 5.518 times more likely to have a normal MRI (p < 0.0001, 95% confidence interval [CI] 4.153-7.330). Furthermore, participants with dyskinetic, ataxic/hypotonic, and spastic diplegic forms of CP were 2.045 times more likely to have a normal MRI than those with hemiplegia, triplegia, and quadriplegia (p < 0.0001, 95% CI 1.506-2.778). No significant difference was found in prematurity, GMFCS levels, MACS levels, and the number of comorbidities.

CONCLUSIONS:

Normal MRIs were associated with lack of perinatal adversity as well as with the dyskinetic, ataxic/hypotonic, and spastic diplegic CP subtypes. As MRI normality is not strongly associated with the severity of CP, continuous follow-up in children with normal imaging appears warranted. Further advanced imaging modalities, as well as strong consideration for metabolic and genetic testing, may provide additional insights into causal pathways in this population.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center