The aim of this study was to describe the epidemiology, aetiology, and clinical findings in dyskinetic cerebral palsy (CP)in a population-based follow-up study of children born between 1991 and 1998. Age range at ascertainment was 4 to 8 years and prevalence was 0.27 per 1000 live-births. Fortyeight children were examined (27 males, 21 females; mean age 9y, range 5-13y). Thirty-nine had dystonic CP and nine a choreo-athetotic subtype. Primitive reflexes were present in 43 children and spasticity in 33. Gross Motor Function Classification System levels were: Level IV, n=10 and Level V, n=28. The rate of learning disability (n=35) and epilepsy (n=30) increased with the severity of the motor disability. Thirty-eight children had anarthria. Peri-or neonatal adverse events had been present in 34 of 42 children born at ≥ ≥34 weeks' gestation. Motor impairment was most severe in this group. Placental abruption or uterine rupture had occurred in 8 participants and 19 of the 42 near-term/term children required assisted ventilation, compared with 1% and 12% respectively in other CP types. Neuroimaging in 39 children born at ≥ ≥34 weeks revealed isolated, late third trimester lesions in 24 and a combination of early and late third trimester lesions in seven. Dyskinetic CP is the dominant type of CP found in term-born, appropriate-for-gestational-age children with severe impairments who have frequently experienced adverse perinatal events.Cerebral palsy (CP) is the most common cause of motor disability in children and affects about 2 per 1000 live-births. 1,2 Spastic CP is by far the most common, constituting 80 to 85% of most cases, while 15% of the children in the latest Swedish study had dyskinetic CP. 1 In that study, the overall prevalence of CP had decreased, but the prevalence of dyskinetic CP had not. Motor disability in dyskinetic CP is often severe and is characterized by changes in muscle tone and posture, with a varying element of involuntary movement. Primitive reflexes persist and spasticity is often present, but not as a dominating feature. Accompanying impairments such as learning disability* and epilepsy are frequent. 3 Anarthria and dysarthria are also common, necessitating alternative communication aids. Growth is often hampered due to feeding difficulties and enhanced energy costs. Kyllerman et al. described 116 children with dyskinetic CP born between 1959 and 1970. 4 In 70% of the children, dystonic features dominated, while 30% were predominantly choreoathetotic. The main aetiological factors were found to be perinatal in two-thirds of the children and prenatal in about one in five. Modern magnetic resonance imaging (MRI) has improved the ability to visualize and date brain lesions in CP, which in dyskinetic CP are typically located in the basal ganglia. [5][6][7] Adverse events in the peri-or neonatal period or late gestation in the term or near-term infant may cause injury to the basal ganglia, which are vulnerable due to high metabolic demands at this stage of development. 9 Kernicterus is known t...

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The incidence of post-haemorrhagic hydrocephalus in children born extremely preterm increased; a group running a high risk of neurological sequelae. Ophthalmological abnormalities were frequent and need to be assessed in all children with hydrocephalus. The high rate of morbidity and complications necessitates the further development of preventive and treatment methods.

This study has analysed the results of CT scans of the brains in children with congenital hemiplegia. The material consists of 111 out of a total of 151 children with this cerebral palsy syndrome in a population-based series. We have classified the morphological findings in five groups. The groups are designed to reflect the phase of maturation of the brain when the insult happened. The groups are: 1. Maldevelopment, 2. Periventricular atrophy, 3. Cortical-/subcortical atrophy, 4. Miscellaneous, 5. Normal. In contrast to previous reports we found a high proportion (17%) with maldevelopment. However the dominating morphological pattern was periventricular atrophy, consistent with a hypoxic-ischemic insult to the immature brain, seen in 42%. Cortical and/or subcortical atrophy was found in 12%. Three children (3%) presented with morphological patterns not possible to classify. The group with no pathology according to CT was 26%.

SUMMARY Morphological findings on CT were compared with clinical features of 111 children with hemiplegic cerebral palsy. Periventricular atrophy, interpreted as periventricular leukomalacia, was the most prevalent CT finding, although this type of lesion did not indicate severity of neurological impairment. Maldevelopments were associated with arm‐dominated hemiplegia and with a wider range of clinical impairments than previously described. Cortical/subcortical atrophy, less common than presumed, indicated arm‐dominated hemiplegia and was associated with more severe impairment than were other CT findings. A normal CT scan indicated leg‐dominated hemiplegia and mild impairment. The morphological information obtained by CT was found to be useful for predicting clinical outcome, and was considered an important adjunct to clinical history and findings in these children. RÉSUMÉ I.M.C. à forme hémiplégique: corrélations entre la tnorphologie au scanner et les données cliniques Les données morphologiques de scanner ont été comparées avec les caracteristiques cliniques chez 111 enfants I.M.C. hémiplégiques. L'atrophie périventriculaire interprétée comme une leucomalacie périventriculaire, était la donnée de scanner la plus fréquente bien que ce type de lésion ne soit pas significatif de la gravité des troubles neurologiques. Les anomalies de développement étaient associées à une hémiplégie prédominant aux membres supérieurs et avec une plus grande étendue d'altération clinique qu'il n'a été décrit antérieurement. L'atrophie corticale/sous‐corticale, moins habituelle qu'il n'était pensé, indiquait une hémiplégie prédominant aux membres supérieurs associée à des altérations plus graves qu'avec les autres donnees de scanner. Un scanner normal indiquait une hémiplégie prédominant aux membres inférieurs et des atteintes modérees. L'information morphologique donnée par le scanner s'est révélée utile pour prédire le devenir clinique et fut considérée comme un complément important à I'histoire clinique et aux données d'examens chez ces enfants. ZUSAMMENFASSUNG Hemiplegische Cerebralparese: Korrelation zwischen CT Morphologie und klinischen Befunden Von 111 Kindern mit hemiplegischer Cerebralparese wurden die morphologischen Befunde im CT mit den klinischen Symptomen verglichen. Der häufigste CT Befund war eine periventrikuläre Atrophie, interpretiert als periventrikuläre Leukomalazie, obwohl diese Läsion nichts über den Schweregrad der neurologischen Ausfälle aussagte. Entwicklungsstörungen waren mit einer vorwiegend die obere Extremität betreffenden Hemiplegie und mit umfassenderen klinischen Störungen, als zuvor beschrieben, verbunden. Kortikal/subkortikale Atrophie, die seltener war als angenommen, deutete auf eine vorwiegend die obere Extremität betreffende Hemiplegie hin und war mit schwereren Behinderungen verbunden als andere CT Befunde. Ein normales CT wies auf eine hauptsächlich die untere Extremität betreffende Hemiplegie und leichte Behinderungen hin. Die morphologische Information durch das CT ist für die Prognose d...