Feature article

The importance of MR imaging for Cerebral Palsy

Cerebral palsy: the most prevalent disability among children in the United States. The Center for Disease Control (CDC) estimates that one in every 323 children are identified with this disorder. However, many people who are unfamiliar with cerebral palsy (CP) misidentify this condition as a mobility disorder, when in fact, it is a neurological issue.

A child who has cerebral palsy will face many challenges throughout their life; challenges that will impact their families as well. The CDC estimates that the lifetime cost of care for an individual with CP is approximately $1.3 million dollars.1 These costs are necessary to provide those with CP the therapy and treatment they need to manage the disorder they were born with.

What is Cerebral Palsy?

Cerebral palsy is a disorder that is caused by two possible events:

  1. An abnormality or disruption in brain development before a child is born.
  2. An injury to the motor areas of the brain sustained during fetal development or birth.

Such disruptions or injuries include maternal infections, fetal stroke, infant infections, traumatic head injury, or lack of oxygen to the fetus. When these events occur during pregnancy or labor, the physician may predict future disabilities in the infant, however it is impossible to diagnose a child with CP until they begin to show symptoms.  

Symptoms of cerebral palsy are impaired movement, abnormal reflexes, floppiness or rigidity of the limbs, abnormal posture, involuntary movements, unsteady balance, or a combination of these manifestations.2 Muscle stiffness also often occurs, causing a reduced range of motion in various body parts.

Many of cerebral palsy symptoms are related to mobility and muscle development, therefore, signs and symptoms of CP are generally noted when a child is around 15 months old. However, depending on the severity of the symptoms, physicians typically establish a diagnosis of CP when a child is closer to two to five years old. This is largely due to the need to rule out any copycat neurological conditions, or because a child's brain is not yet thoroughly developed.

It is important to get an early or prompt diagnosis of CP, so the child can begin treatment and therapy as soon as possible. Symptoms such as muscle weakness, spasticity, and coordination problems can worsen as they grow older, and can contribute to many other complications later in life. For example, contracture can occur, which inhibits bone growth, causing bones to bend and resulting in deformities. In addition, neurological conditions, eye muscle imbalances, and malnutrition can develop if treatment is not individualized or aggressive enough.

Buyers Guide_950x250.jpg

Diagnosing Cerebral Palsy

To establish a diagnosis for your child’s condition, a pediatrician will evaluate their symptoms, review their medical history, and conduct a physical evaluation. A series of neurological tests will also be ordered, as these are essential to making a diagnosis and ruling out other possible causes of your child’s symptoms.

Neurological imaging provides critical information when establishing a diagnosis of CP. Usually, an MRI is the preferred method of imaging infants and children, because it can provide extremely high-quality images of abnormal areas of the brain or spinal cord, without exposing the child to radiation. A Magnetic Resonance Imaging (MRI) machine is a scanner that uses radio frequency waves and a magnetic field to generate a highly detailed 3-D image of your child’s brain. An MRI often provides different information about structures in the brain that cannot be viewed using an X-ray, ultrasound, or CT scan.

 A brain MRI will help a neurologist identify any lesions or abnormalities in your child’s brain, where damage and inflammation exist. It may also provide information regarding the timing of the injury. This is important when determining if the lesions are associated with hypoxic-ischemic encephalopathy, an injury caused by oxygen deprivation to the newborn, which often predicts CP.

An MRI of a child’s head usually takes about 30 to 60 minutes and is entirely painless for the patient.3 However, they may have to undergo a slight sedative, since it is imperative that they remain completely still during the scan. This process ensures that the child does not move, which causes motion artifacts to appear in the scan and makes it more difficult for a physician to detect lesions. 

While cerebral palsy is a lifetime condition, receiving a prompt diagnosis at the first signs of a movement disorder or delays in development can make a positive impact on their quality of life and overall mobility. Discuss any questions or concerns you may have with your child’s physician as soon as possible. As advances in MRI technology and imaging quality continue to improve, doctors strive to establish a diagnosis of CP as early as possible, and provide the best care for their patients.

 

References:

  1. Data Statistics for Cerebral Palsy. https://www.cdc.gov/NCBDDD/cp/data.html
  2. Cerebral Palsy. https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/symptoms-causes/syc-20353999
  3. Harkin, M. (2017, March, 29) Head MRI. https://www.healthline.com/health/head-mri#procedure
  4. What tests are used to diagnose cerebral palsy? https://www.abclawcenters.com/frequently-asked-questions/what-tests-are-used-to-identify-cerebral-palsy/