Abstract
The aim of this study was to evaluate whether children with congenital hemiplegia
show abnormal hand function on the non-hemiplegic side and whether this, if present,
can be related to the type and extent of brain lesions on MRI. Twenty-two children
with congenital hemiplegia of age ranging between 4.8 and 12.3 years, were assessed
with a clinical and MRI assessment. Clinical assessment included a structured neurological
examination, assessment of hand grips and the Movement Assessment Battery for Children
which also includes one item assessing speed and accuracy in each hand.
The results showed that 64 % of the children studied showed some degree of functional
impairment of the non-hemiplegic hand. Manual dexterity 1 from the Movement ABC was,
in our experience, a more sensitive tool to detect minor functional abnormalities
than the evaluation of hand grips.
The severity of the impairment on the non-hemiplegic side was not significantly related
to the severity of impairment in the hemiplegic hand (p > 0.05). In contrast, a significant
association was found with the site of lesions as hand function in the non-hemiplegic
hand was always normal in children with unilateral lesion and abnormal in the ones
with bilateral parenchymal lesions (p < 0.05). Children with predominantly unilateral
lesions but with bilateral ventricular dilatation or periventricular changes showed
more variable results.
Key words
Hemiplegia - MRI - Movement ABC - Hand function
