Article

Much variation is found in the development of hand function in
children with unilateral cerebral palsy (CP). OBJECTIVE: . To explore how
anatomic brain abnormalities can be used to predict the development of hand
function. METHODS: A total of 32 children with unilateral CP (16 boys and 16
girls) were evaluated at least once a year by the Assisting Hand Assessment
(AHA). The data collection covered an age range from 18 months to 8 years (mean
time in study, 4 years and 6 months). Computerized tomography or magnetic
resonance imaging of the brain were assessed for patterns of brain damage,
including the location of gray and extent of white-matter damage. The children
were divided into groups according to lesion characteristics, and a series of
univariate models were analyzed with a nonlinear mixed-effects model. The rate
and maximum limit of development were calculated. RESULTS: The highest predictive
power of better development of hand function was the absence of a concurrent
lesion to the basal ganglia and thalamus, independent of the basic type of brain
lesion. This model predicted both the rate of increasing ability and hand
function at age 8 years. Hand function was also predicted by the basic pattern of
damage and by the extent of white-matter damage. The presence of unilateral or
bilateral damage had no predictive value. CONCLUSIONS: Neuroradiological findings
can be used to make a crude prediction of the future development of the use of
the affected hand in young children with unilateral CP.

Langue : ANGLAIS