Objective: To estimate the probable cause and the time of cerebral insult in cerebral palsy (CP) based on MRI findings and risk factors.

Method: The subjects comprised all sixty-seven patients with CP showing abnormal MRI findings between March 1999 and September 2001 at the Catholic University of Korea, St. Mary's Hospital. A detailed medical history was available for all patients including those not born in our hospital. They ranged in age from two months to five years. We analyzed the brain magnetic resonance (MR) findings of patients with CP to correlate the probable cause and the time of cerebral insult through the consideration of medical histories including prenatal, perinatal and postnatal histories.

Results: Of the 67 MRIs, abnormalities were the followings; periventricular leukomalacias (PVLs) in 49 cases, cortical or subcortical infarction in 4 cases, brain atrophy in 7 cases, neuronal migration disorder in 4 cases, and delayed myelination in 3 cases. Among the patients with PVL, perinatal risk factors were responsible for cerebral insult in preterm, but pre- and perinatal contribution were similar in patients born at full term. Among the patients with cerebral infarction, only one case with meningitis at 11 months was suspected for cerebral insult. These patients had no risk factor as a peri- or post-natal etiology. Four patients with neuronal migration disorder had no risk factor for peri- or postnatal etiology except for the one who was a twin.

Conclusion: Review of brain MRI findings such as PVL, infarct, neuronal migration disorder and a detailed medical history including prenatal and perinatal etiology would be a useful method to estimate the probable cause and the time of cerebral insult in CP. (Korean Acad Rehab Med 2002; 26: 508-513)

Objective: To investigate the correlation between magnetic resonance imaging (MRI) findings for children with cerebral palsy (CP) and the severity of their developmental disability.

Method: MRI and Münchener Funktionelle Entwicklungs Diagnostik (MFED) were used for the evaluation of 52 children with CP. MFED quotient (MFED age/corrected age⁓100) was compared to the MRI findings.

Results: Of the 52 MRIs, no abnormalities were found in 7 cases (13%), periventricular leukomalacias (PVLs) in 37 cases (71.2%), corpus callosum abnormalities in 33 cases (63.5%), delayed myelinations in 8 cases (15.4%), congenital brain abnormalities in 6 cases (11.5%), and central sulcus abnormalities in 3 cases (5.8%). Among 27 patients who were born preterm, the major MRI finding was PVL (100%), indicative of a hypoxic brain injury. All patients with a normal MRI were born at term. There were significant correlations between the MFED quotient and the severity of PVL. The ratio of corpus callosum length/brain anteroposterior diameter was correlated with a developmental disability.

Conclusion: MRI findings for the patients with CP are well correlated with the developmental disabilities and the timing of brain insult.

Objective: The present study was undertaken to evaluate the findings of multimodality evoked potentials, brain MRI and EEG in cerebral palsy children and to identify the correlations between these findings.

Method: We examined Brain MRI, EEG and evoked potentials including visual evoked potentials(VEPs), brainstem auditory evoked potentials(BAEPs) and somatosensory evoked potentials(SSEPs) in 80 cerebral palsy children.

Results: 1) Abnormal findings of brain MRI and EEG were 79.4% and 81% respectively.

2) Abnormal responses of VEPs and BAEPs were 28.1% and 18.8%.

3) In the median and tibial nerve SSEPs, abnormal responses were 14.6% and 28.6%. Abnormal findings of the tibial nerve SSEPs were more frequent than the median nerve SSEPs.

4) In children with spastic hemiplegia, the abnormal SSEPs were much greater in the affected limb than unaffected limbs.

5) There was a significant correlation between the SSEP abnormalities and brain MRI or EEG abnormalities in cerebral palsy children.

Conclusion: The data obtained in this study would be helpful for identifying and assessing the central nervous system deficits of cerebral palsy children.

The authors studied 60 children (aged 4 months to 9 years) with cerebral palsy by means of magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT) of the brain. MRI showed normal in 15 cases (25.0%) and deep white matter pathology in 37 cases (61.7%), corpus callosum abnormality in 29 cases (48.3%). In addition, abnormal intensity of thalamus or basal ganglia and delayed myelination were found in minor cases. In all of the patients except for 1 case, SPECT showed the abnormal findings SPECT demonstrated hypoperfusion of thalamus in 58 cases (96.7%), cerebellum in 27 cases (45.0%), frontal and parietal lobe in 26 cases (43.3%), basal ganglia in 23 cases (38.3%) and temporal lobe in 22 cases (36.7%). There was no significant correlation between the severity of motor developmental impairment and the radiologic findings. The results of this study suggest that MRI of the brain provides the anatomical information such as deep white matter and corpus callosum pathologies resulted from the hypoxic-ischemic insult and SPECT of the brain is a very sensitive tool for the assessment of the functional abnormalities in cerebral palsy.