Magnetic resonance imaging findings and the clinical characteristics of children with cerebral palsy at a public sector hospital in Gauteng South Africa

Nel, C
Nel, Christelle
Bezuidenhout, J K
Thomson, H C
Meyer, P W A
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Background. Cerebral palsy (CP) is a common cause of physical impairment in children. Brain MRI can define different neuropathological patterns of brain injury in CP. There is limited data available on the MRI findings of children with CP in Africa. Objective. To describe the clinical characteristics, risk factors and MRI findings of children with CP attending a developmental clinic at a tertiary hospital in South Africa. To assess possible associations between the clinical characteristics and pathogenic neuroimaging patterns. Methods. This was a retrospective cross-sectional study. The cohort of 112 children were identified from the clinic’s REDcap® database. Clinical information was obtained from the existing medical records of the patients. Findings from the brain MRI reports were classified according to the MRI classification system (MRICS) for CP. The MRI reports were rated independently by two study investigators. Descriptive analysis was conducted. Results A total of 112 patient files and MRI brain reports were reviewed. Spastic cerebral palsy was the most common type of CP (n=75%). The most common perinatal risk factors included prematurity (31%) and low-birth weight (28%). Nineteen (17%) children acquired CP after the neonatal period. CP sub-type showed a significant association with functional motor impairment classified as GMFCS, p < 0.001. Predominant grey matter injury (PGMI) was the most common pathogenic MRI pattern identified (30%). The radiological findings (MRICS) had a significant association with both the CP sub-type (p<0.005) and functional impairment according to GMFCS (p<0.001). Conclusion Standardized classification of neuro-imaging findings can assist in defining the pathogenesis and clinical manifestations of CP
A research report submitted in partial fulfilment of the requirements for the degree Master of Science in Medicine, Child Health Neurodevelopment for the School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, 2021