Niemann G, Grodd W, Schöning M
Department of Child Neurology, University Hospital of Tübingen, Germany.
Neuropediatrics. 1996 Aug;27(4):197-201. doi: 10.1055/s-2007-973787.
In our department of neuropediatrics we made a definite diagnosis of congenital hemiparesis in a total of 123 patients born between 1974 and 1985. This diagnosis was always made or confirmed at a point after the patient's first birthday. Recently, we were able to follow up on 102 of them (83%) to determine whether their symptoms persist, that is, if the initial diagnosis of cerebral palsy (CP) was correct or not. Now, at the age of 9 to 18 years, 94 of these 102 patients (92%) still suffer from hemiparesis. We were able to perform MRI on 44 of them. A lesion consistent with the neurological symptoms was found in 43. Only one patient had normal findings-a false negative, so to speak. Of the 102 patients, eight (8%) had no hemiparesis, i.e. no disability at all at the time of the follow-up. All eight had in common the fact that the former functional involvement had been slight and not arm-dominated. Seven of them were also examined with MRI. Six had normal findings; MRI revealed a periventricular lesion consistent with the earlier hemiparetic symptoms in only one patient (a false positive, so to speak). We conclude that some children "outgrow" a hemiparetic cerebral palsy, even in later childhood years. In our patient group this happened between the ages of 3 and 10. We further propose that MRI could be useful in distinguishing between transitory and persistent hemiparesis.
在我们的神经儿科，我们对1974年至1985年间出生的123例患者明确诊断为先天性偏瘫。该诊断总是在患者满一岁之后的某个时间做出或得到确认。最近，我们得以对其中102例患者（83%）进行随访，以确定他们的症状是否持续存在，即最初的脑瘫（CP）诊断是否正确。现在，在这些患者9至18岁时，这102例患者中有94例（92%）仍患有偏瘫。我们能够对其中44例患者进行MRI检查。43例发现了与神经症状相符的病变。只有1例患者检查结果正常，可以说是假阴性。在这102例患者中，8例（8%）没有偏瘫，即在随访时完全没有残疾。这8例患者的共同之处在于，以前的功能受累轻微且不是以手臂为主。其中7例也接受了MRI检查。6例结果正常；MRI仅在1例患者中显示了与早期偏瘫症状相符的脑室周围病变（可以说是假阳性）。我们得出结论，一些儿童即使在童年后期也会“摆脱”偏瘫型脑瘫。在我们的患者组中，这种情况发生在3至10岁之间。我们还提出，MRI可能有助于区分短暂性和持续性偏瘫。
