The European cerebral palsy study: magnetic resonance imaging (MRI) and clinical findings

Aim: To investigate underlying causes of CP using MRI and clinical data in order to facilitate intervention Methods: Six European Centres participated in the study. Clinical and MRI data of 256 children with CP (born 1997–1999) were collected in a standardised way. The children were examined by one neuropediatrician in each center, for collecting the other data are used the same questionnaires in all centres. Each patient had at least one MR examination of the brain after the age of 18 months. Conventional MR images were evaluated in a standardised way by two independent investigators. Results: 73% of the MRI images showed abnormal results. 104 (40,6%) were periventricular, 46 (17,9%) cortico-subcortical lesions. In 37 (14,4%) of the images basal ganglia lesions were present and miscellaneous or unclassifiable lesions were present in 20 (7,8%) of the images. Malformations were rare: 19 (7,4%). Periventricular lesions were predominantely associated with bilateral spastic paresis and lesions of the basal ganglia with dyscinetic CP. Infarcts were mainly associated with hemiplagia. Ataxic CP was mainly associated with normal or unclassifiable MR findings. Conclusion: This European multicentre study confirms in a large sample that CP are mainly of lesional origin and that only the ataxic type is an exception. It also confirms that the severity of the lesion is correlated with the severity of motor function impairment. The result that most of the CP are of lesional origin is of importance with regards to possible preventive strategies. Keywords: cerebral palsy, MRI, aetiology