Di- and Hemiplegic infants: clinical-MRI correlation and pathogenetic considerations

We studied 48 infants with cerebral palsy (24 diplegic and 24 hemiplegic) by MRI and correlated the findings with clinical status, pregnancy and delivery events. All hemiplegic infants were born at term, 18 diplegic were premature. MRI proved useful, showing that hemiplegia is often due to a malformation, mainly schizencephaly and cortical dysplasia, making it possible to demonstrate its prenatal origin. Only children with congenital defects developed late epilepsy. White and grey matter infarcts are the most frequent MRI findings, as on CT, and their extent does not correlate with the severity of the neurological deficit; there is no proof of a prenatal origin. Diplegic infants showed the typical periventricular white matter lesions which, when asymmetrical, did not correlate with the predominant side of plegic motor signs.