Cerebral Palsy (CP) is defined as a group of disorders of development of movement and posture, which limits activity that is attributed to non-progressive disturbances that occur in the developing fetal or infant brain.

Our study investigated the etiology, clinical features and outcome of a cohort of children with hemiplegic CP recruited from 3 medical centers in Israel.

The cohort includes 135 children, aged between 4 to 28 years: 71 (53%) males, 58% full-term and 42% who were premature, out of which 16% were born at 30 weeks and below. Nineteen (14%) children were twins, of whom 17 were preterm and 2 were full-term (p<0.001). The right side was involved in 60% of the cases and left side in 40% of the cases. Apgar scores after 1 minute were 8±2.4 at full-term and 6.8±2.8 in premature (p<0.05). There was no difference in the 5 minute Apgar score.

The overall frequency of epilepsy in the cohort was 26%. There was no difference in the frequency at full-term compared to premature cases. Eighty-five children (64%) in the cohort had a normal cognitive level and 36% were below the normal level. No statistical significant difference was found when comparing the cognitive level of full-term to premature children. However, the percentage of normal cognitive children was higher in the CP children without epilepsy as compared to the group with epilepsy (p<0.05).

The most common etiologies were: prenatal stroke (17%), perinatal stroke (16%), periventricular leucomalacia (PVL, 13%) and intraventricular hemorrhage (IVH, 13%).

In conclusion, prematurity plays a significant role in hemiplegic CP. Preterm children do not differ from full-term in their outcome in terms of the prevalence of epilepsy and cognitive dysfunction. PVL and IVH are common causes for hemiplegic CP after pre- and perinatal stroke.