Abstract:
BACKGROUND. Cerebral palsy (CP) is a common cause of physical impairment in children. Brain magnetic resonance imaging (MRI) can define
different neuropathological patterns of brain injury in CP. There are limited data available on 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; and to assess possible associations between the clinical characteristics and pathogenic neuro-imaging
patterns.
METHODS. This was a retrospective cross-sectional study. The cohort of 112 children was identified from the clinic’s REDcap database. Clinical
information was obtained from existing medical records of the patients. Findings from brain MRI reports were classified according to the
MRI classification system (MRICS) for CP. The MRI reports were rated independently by two study investigators. A descriptive analysis was
conducted.
RESULTS. A total of 112 patient files and MRI brain reports were reviewed. Spastic CP was the most common type of CP (n=75%). The most
common perinatal risk factors included prematurity (31%) and low birthweight (28%). Nineteen (17%) children acquired CP after the
neonatal period. CP sub-type showed a significant association with functional motor impairment classified as per the gross motor function
classification system (GMFCS), p<0.001. Predominant grey matter injury (PGMI) was the most common pathogenic MRI pattern identified
(30%). The radiological findings (per MRICS) had a significant association with both the CP sub-type (p<0.005) and functional impairment
according to the GMFCS (p<0.001).
CONCLUSION. Standardised classification of neuro-imaging findings can assist in defining the pathogenesis and clinical manifestations of CP.
