A Comparison of Spastic Diplegia in Term and Preterm-Born Children

Abstract

This study compared the risk factors and clinical and radiologic profile of children with spastic diplegic cerebral palsy born at term (≥37 weeks) with those born preterm. Children (2-14 years) with cerebral palsy meeting the study criteria for spastic diplegia were enrolled. Antecedent risk factors, clinical profile, and magnetic resonance imaging (MRI) findings were recorded. Spasticity, functional ability, intellectual ability, and social quotient were assessed using standard scales. Ninety-three children met the study inclusion criteria (45 term, 48 preterm). Moderate to severe intellectual disability (53% vs 21%, P = .001) and epilepsy (51% vs 33%) were significantly more common in term-born children, whereas periventricular white matter injury was less common in term-born children (64%vs 89.4%, P = .004). Term spastic diplegia was associated with cortical/subcortical involvement in (11/42 (26%) vs 3/47(6.4%); P = .01). We conclude that term-spastic-diplegia is clinicopathologically different from preterm-spastic-diplegia. Their neuroradiologic pattern also differs with more frequent involvement of cortical/subcortical areas.