Cerebral Palsy Heterogeneity: Clinical Characteristics and Diagnostic Significance from a Large Sample Analysis.

Abstract

INTRODUCTION Cerebral palsy (CP) is a nonprogressive movement disorder resulting from prenatal or perinatal brain injury that benefits from early diagnosis and intervention. The timing of early CP diagnosis remains controversial, necessitating analysis of clinical features in a substantial cohort. METHODS We retrospectively reviewed medical records from a university hospital, focusing on children aged >24 months or followed up for ≥24 months, and adhered to the International classification of diseases-10 for diagnosis and Subtyping. RESULTS Among the 2012 confirmed CP cases, 68.8% were male and 51.44% had spastic diplegia. Based on the Gross Motor Function Classification System (GMFCS), 62.38% were levels I and II, and 19.88% were levels IV and V. Hemiplegic and diplegic subtypes predominantly fell into levels I and II, while quadriplegic and mixed types were mainly levels IV and V. White matter injuries appeared in 46.58% of cranial MRI findings, while maldevelopment was rare (7.05%). Intellectual disability co-occurred in 43.44% of the CP cases, with hemiplegia having the lowest (20.28%, 58/286) and mixed types (73.85%, 48/65). Additionally, 51.67% (697/1349) of the children with CP aged ≥48 months had comorbidities. CONCLUSIONS This study underscores white matter injury as the primary CP pathology and identifies intellectual disability as a common comorbidity. Although CP can be identified in infants under one year old, precision in diagnosis improves with development. These insights inform early detection and tailored interventios, emphasizing their crucial role in CP management.