This study was planned to evaluate the clinical significance of MRI(Magnetic Resonance Imaging) findings in assessment of the children with developmental motor delay or motor pathology. Brain MRI study was performed in 34 children with developmental motor delay or motor pathology evaluated at Department of Rehabilitation Medicine, St. Mary's Hospital, Catholic University Medical College, between March 1991 and March 1993. Of the 34 children 18 were boys and 16 were girls. Their ages ranged from 4 months to 4 years 5 months(mean 12.9 months). Besides brain MRI, evaluation consisted of patients' (1) medical, developmental, family and pregnancy histories, (2) physical examination, (3) developmental assessment(MFED: Munchener Functionelle Entwichlungs Diagnostik). Excluded from this study were children with lower motor neuron disorders, known to primarily cause developmental motor delay or motor pathology. To analyze the relationship between MRI findings and motor delay, MRI findings were divided into 4 groups: Group 1: Cases showing normal myelination without associated abnormality and white matter pathology. Group 2: Cases showing normal myelination with associated abnormality or white matter pathology Group 3: Cases showing delayed myelination with or without associated abnormality and white matter pathology. Group 4: Cases showing myelination disorder such as leukodystrophy. Range and mean±standard deviation(S.D.) of Motor Quotient(M.Q.) were obtained in each group. Motor age and the age estimated by myelination on MRI were compared in group 3. The results were as follows: 1) 26(76.5%) of 34 children with developmental motor delay or motor pathology had significant abnormalities on brain MRI. 2) The number of cases in each group was 8 cases(23.5%) in group 1,16 cases(47%) in group 2,9 cases(26.5%) in group 3, and 1 case(2.9%) in group 4. 3) Range and mean±S.D. of motor quotient in each group were 50~73(63.6±6.8) in group 1,7~73(29.5±19.4) in group 2, 14~66(35.7±19.9) in group 3, under 10 in group 4. 4) In group 3 with delayed myelination, motor age corresponded to the age estimated by myelination on MRI in 7 out of 9 cases. 5) The findings observed in children under 6 months of age were white matter pathology, associated abnormality or myelination disorder and those in children over 6 months of age were delayed myelination as well as white matter pathology or associated abnormality. In summary, the data obtained in this study were helpful for identifying and assessing the children with developmental motor delay or motor pathology. |