Late Remission of Congenital Hemiparesis: The Value of MRI

Abstract

In our department of neuropediatrics we made a definite diagnosis of congenital hemiparesis in a total of 123 patients born between 1974 and 1985. This diagnosis was always made or confirmed at a point after the patient's first birthday. Recently, we were able to follow up on 102 of them (83 %) to determine whether their symptoms persist, that is, if the initial diagnosis of cerebral palsy (CP) was correct or not.

Now, at the age of 9 to 18 years, 94 of these 102 patients (92 %) still suffer from hemiparesis. We were able to perform MRI on 44 of them. A lesion consistent with the neurological symptoms was found in 43. Only one patient had normal findings - a false negative, so to speak.

Of the 102 patients, eight (8 %) had no hemiparesis, i.e. no disability at all at the time of the follow-up. All eight had in common the fact that the former functional involvement had been slight and not arm-dominated. Seven of them were also examined with MRI. Six had normal findings; MRI revealed a periventricular lesion consistent with the earlier hemiparetic symptoms in only one patient (a false positive, so to speak).

We conclude that some children "outgrow" a hemiparetic cerebral palsy, even in later childhood years. In our patient group this happened between the ages of 3 and 10. We further propose that MRI could be useful in distinguishing between transitory and persistent hemiparesis.

Key words

Congenital hemiparesis - Spontaneous remission - MRI