Relationship Between the Level of Gross Motor Function and Magnetic Resonance Imaging Findings in Children with Cerebral Palsy in a Tertiary Care Hospital

Aims: Assessment of the relationship between the level of gross motor function and MRI of brain findings among the children with cerebral palsy.

Methods: This cross-sectional study was carried out at the department of Pediatric Neurology, BSMMU, Dhaka. The duration of the study was 12 months. All the CP cases who met the selection criteria were enrolled. Detailed history taking and physical examination was done. The gross motor functions of all patients were evaluated according to GMFCS . MRI was done in all the patients and reports were evaluated by qualified radiologists and cross checked by assigned neurologists. MRI findings were classified as maldevelopment, cortical and subcortical gray matter lesion, periventricular white matter injury, basal ganglia lesion, normal and other findings.

Results: A total of 45 children with CP were included in this study. Mean age of the children was 4.73 (+3.17) years. Functionally, majority patients (26.7%) were in GMFCS level IV. MRI findings were abnormal in 35 cases (77.78%) cases. Most common abnormal findings were cortical and subcortical grey matter lesion 22(48.9%). This study revealed that cortical and subcortical gray matter lesions were significantly associated with higher level of GMFCS (IV-V)(p = 0.038) and maldevelopment of brain was also significantly associated with severely functionally impaired children (GMFCS) (IV-V)(p = 0.01). Conclusion: A significant relationship was found between gross motor function and MRI findings of children with CP. This finding indicated that more severe motor impairment was associated with cortical and subcortical gray matter lesions and maldevelopment of brain.
Keywords: CP, GMFCS, MRI findings.