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Diagnosis and Management of Orthopedic Problems in Children with Cerebral Palsy
Antije L. Greenfield1, Freeman Miller, George W. Gross
1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Insights
Cerebral palsy involves abnormal brain control of motor function, affecting movement and posture. Lesions in the immature brain cause these issues, detectable only after brain pathway myelination.
Area of Science:
- Neurology
- Developmental Neuroscience
Background:
- Cerebral palsy (CP) is a group of clinical syndromes characterized by impaired motor function due to brain abnormalities.
- It affects the immature brain, typically before age two, with neuropathologic changes that are static over time.
Purpose of the Study:
- To define cerebral palsy and its underlying neuropathologic basis.
- To explain the temporal aspects of lesion detection in relation to brain development.
Main Methods:
- Review of the clinical and neuropathologic features of cerebral palsy.
- Discussion of brain myelination processes and their role in lesion detection.
Main Results:
- Cerebral palsy presents as disorders of movement and posturing, often with sensory deficits.
- Brain lesions causing CP occur in immature brains and do not progress.
Conclusions:
- Detection of brain lesions underlying cerebral palsy is dependent on the myelination process.
- Myelination, a progressive process, must occur before the pattern of abnormality from brain lesions can be identified.
Abstract:
Cerebral palsy is a term applied to a variety of clinical syndromes that have as a common feature the abnormal control of motor function by the brain, resulting in disorders of movement and posturing. Sensory function is often affected as well. Cerebral palsy afflicts the immature brain (under 2 years of age) and usually produces neuropathologic changes that do not progress with increasing age. Because myelination of the brain is a progressive process that begins late in the third trimester and continues into adolescence in a well defined pattern, only after the neuronal pathways from brain lesions have become myelinated and the pattern of abnormality determined, can the brain lesions forming the basis of cerebral palsy be detected.