Neuro-Imaging Changes in Cerebral Palsy: A Cross Sectional Study
1Dr Gopen Kumar Kundu, Associate Professor, Department of Paediatric Neurology & IPNA, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Insights
Neuroimaging reveals frequent abnormalities in children with cerebral palsy (CP), most commonly diffuse cerebral atrophy and encephalomalacic changes. These findings aid in understanding CP
Area of Science:
- Pediatric Neurology
- Radiology
- Developmental Neuroscience
Background:
- Cerebral palsy (CP) is the most common childhood physical disability, resulting from brain lesions affecting movement and posture.
- Neuroimaging is a recommended standard for evaluating children diagnosed with CP.
- Understanding neuroimaging patterns is crucial for diagnosing CP and identifying its underlying causes.
Purpose of the Study:
- To determine the frequency and patterns of neuroimaging findings in children diagnosed with cerebral palsy.
- To correlate neuroimaging results with CP types and patient demographics.
- To assess the utility of CT scans in identifying CP-related brain abnormalities.
Main Methods:
- A cross-sectional study involving 130 children diagnosed with cerebral palsy.
- Data collected through clinical assessment, history, and neurodevelopmental evaluation.
- All participants underwent a CT scan of the brain at a tertiary care hospital.
Main Results:
- 84.7% of CP patients exhibited cerebral neuroimaging abnormalities on CT scans.
- The most frequent findings were diffuse cortical atrophy (46.9%) and encephalomalacic changes (19.9%).
- Spastic quadriplegic CP was the most common type, frequently associated with diffuse cerebral atrophy and encephalomalacic changes.
Conclusions:
- Neuroimaging, particularly CT scans, reveals significant abnormalities in the majority of children with cerebral palsy.
- Diffuse cerebral atrophy and encephalomalacic changes are common findings, especially in quadriplegic CP.
- While CP diagnosis is clinical, neuroimaging enhances understanding of neuro-anatomical basis, etiology, and motor impairments.
Abstract:
Cerebral palsy (CP) is a non- progressive disorder of movement and posture due to a lesion of the developing brain. It is the commonest physical disability in childhood that affects function and development. Neuro imaging is currently recommended as a standard evaluation in children with cerebral palsy. This hospital based cross-sectional study was conducted in Paediatric Neurology out-patient department of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from July 2015 to December 2015 to see the frequency and pattern of neuro-imaging findings in children with cerebral palsy. A total of 130 cases those who were attended and diagnosed as cerebral palsy based on history, clinical examination and neuro developmental assessment included in this study. All patients were sent to radiology & imaging department of same hospital for CT scan of brain. Among total 130 cerebral palsy patients male were more affected than female (88 boys and 42 girls) with male to female ratio 2.09: 1. Their ages ranged between 6-72 months with a mean age 25.6 months. The commonest age group was 6-24 months (46.9%). Common mode of delivery was normal vaginal delivery (62.3%) & Perinatal asphyxia (PNA) occurred in 66.9% cases. The commonest type of cerebral palsy was spastic form. Among them most cases were quadriplegic type, 64 cases (53.3%). Other cases were hemiplegic 27(20.7%) diplegic 13(10.0%). Total 84.7% had documented cerebral neuroimaging abnormalities; among them, diffuse cortical atrophy (46.9%), encephalomalacic change (19.9%), malformation (6.1%), and calcification (5.3%). CT scan was normal in 15.3% cases of cerebral palsy. The commonest co morbidity was speech delay (50%). Most of the patient with CP had abnormal CT scan finding though some patient had normal CT scan. Diffuse cerebral atrophy and encephalomalacic changes constitute frequent CT neuroimaging findings and commonly found in quadriplegic type of cerebral pulsy patients. Though diagnosis of cerebral palsy is essentially clinical, neuro imaging improves the understanding of the neuro-anatomical basis for function in CP. Etiology, type of CP and extent of motor impairments can easily be identified by the neuro imaging.
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