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Antecedents and neuroimaging patterns in cerebral palsy with epilepsy and cognitive impairment: a population-based study in children born at term.

Journal article
Authors Kristina Ahlin
Bo Jacobsson
Staffan Nilsson
Kate Himmelmann
Published in Acta obstetricia et gynecologica Scandinavica
Volume 96
Issue 7
Pages 828–836
ISSN 1600-0412
Publication year 2017
Published at Department of Mathematical Sciences
Institute of Clinical Sciences, Section for the Health of Women and Children, Department of Obstetrics and Gynecology
Institute of Clinical Sciences, Section for the Health of Women and Children, Department of Pediatrics
Pages 828–836
Language en
Links dx.doi.org/10.1111/aogs.13128
Subject categories Clinical Medicine


Antecedents of accompanying impairments in cerebral palsy (CP) and their relation to neuroimaging patterns need to be explored.A population-based study of 309 children with CP born at term in 1983-1994. Pre-, intra- and postpartum variables previously studied as antecedents of CP type and motor severity were analysed in children with CP and cognitive impairment and/or epilepsy, and in children with CP without these accompanying impairments. Neuroimaging patterns and their relation to identified antecedents were analysed. Data were retrieved from the CP register of western Sweden, obstetric and neonatal records.Children with CP and accompanying impairments more often had low birth weight (kg) (OR 0.5 95% CI; 0.3-0.8), brain maldevelopment known at birth (p=0.007, OR ∞) and neonatal infection (OR 5.4 (1.04-28.4). Moreover, neuroimaging patterns of maldevelopment (OR 7.2 95% CI; 2.9-17.2), cortical/subcortical lesions (OR 5.3 95% CI; 2.3-12.2) and basal ganglia lesions (OR 7.6 95% CI; 1.4-41.3) were more common, wheras white matter injury was found significantly less often (OR 0.2 95% CI; 0.1-0.5). In most children with maldevelopment, the intra- and postpartum period was uneventful (p<0.05). Cerebral maldevelopment was associated with prepartum antecedents,while subcortical/cortical and basal ganglia lesions were associated with intra- and postpartum antecedents.No additional factor other than those related to motor impairment was associated with epilepsy and cognitive impairment in CP. Timing of antecedents deemed important for the development of CP with accompanying impairments were supported by neuroimaging patterns. This article is protected by copyright. All rights reserved.

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