• Neuropediatrics · Apr 2020

    The Origin of the Cerebral Palsies: Contribution of Population-Based Neuroimaging Data.

    • Veronka Horber, Elodie Sellier, Karen Horridge, Gija Rackauskaite, Guro L Andersen, Daniel Virella, Els Ortibus, Ivana Dakovic, Owen Hensey, Anja Radsel, Antigone Papavasiliou, Javier Cruz De la, Catherine Arnaud, Ingeborg Krägeloh-Mann, and Kate Himmelmann.
    • Department of Paediatric Neurology, University Children's Hospital, Tübingen, Germany.
    • Neuropediatrics. 2020 Apr 1; 51 (2): 113-119.

    BackgroundSurveillance of cerebral palsy in Europe (SCPE) presents the first population-based results on neuroimaging findings in children with cerebral palsy (CP) using a magnetic resonance imaging classification system (MRICS).MethodMRIs of children with CP born between 1999 and 2009 from 18 European countries were analyzed. MRICS identifies patterns of brain pathology according to timing during brain development which was analyzed with respect to CP subtypes and gestational age.ResultsMRIs or written reports from 3,818 children were available. The main clinical characteristics were similar to the 5,415 without such data. Most frequent was predominant white matter injury (49%), followed by predominant gray matter injury (21%). Maldevelopments were found in 11% of cases. Miscellaneous findings were present in 8.5% and normal findings in 10.6%. MRI patterns of children with unilateral spastic, bilateral spastic, and dyskinetic CP were mainly lesional (77, 71, and 59%, respectively), whereas children with ataxic CP had more maldevelopments, miscellaneous, and normal findings (25, 21, and 32%, respectively). In children born preterm, predominant white matter injury was most prevalent (80% in children born <32 weeks of gestation).ConclusionAnalysis of MRI in the European CP database identified CP as a mainly lesional condition on a large population basis, maldevelopments were relatively uncommon. An exception was ataxic CP. Children born preterm mostly presented with a lesion typical for their gestational age (GA) at birth. The decreasing prevalence of CP in this group suggests that progress in perinatal and neonatal medicine may lead to a reduction of these lesions.Georg Thieme Verlag KG Stuttgart · New York.

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