Subtype, severity and age at formal diagnosis in children with cerebral palsy
Sarnat stage of HIE | Subtype of cerebral palsy | Findings on neonatal MRI | Age at diagnosis | BSID-III motor composite score percentile | Additional neurological comorbidities |
Severe | Bilateral spastic, GMFCS 1 | Moderate–severe bilateral basal ganglia/thalamic abnormalities. Moderate–severe bilateral cortical and white matter abnormalities. Bilateral optic radiation abnormalities. | 3 years 7 months | 5th percentile | |
Severe | Dyskinetic, GMFCS 5 | Moderate–severe bilateral basal ganglia abnormalities. | 11 months | No BSID-III performed | Epilepsy, CVI |
Moderate | Unilateral spastic, GMFCS 1 | Near-total (watershed-predominant) abnormalities. Bilateral optic radiation abnormalities. | 1 year 8 months | 5th percentile | Epilepsy, CVI, FSIQ<85 |
Moderate | Dyskinetic, GMFCS 5 | Near-total abnormalities. Severe bilateral basal ganglia/thalamic abnormalities. Severe bilateral cortical and white matter abnormalities. Bilateral optic radiation abnormalities. Minor unilateral cerebellum haemorrhage. | 9 months | No BSID-III performed | Epilepsy, severe intellectual disability |
Moderate | Unilateral spastic, GMFCS 1 | No obvious hypoxic–ischaemic injury. No sign of neonatal stroke. | 2 years 7 months | 75th percentile | |
Moderate | Unilateral spastic, GMFCS 1 | No obvious hypoxic–ischaemic injury. No sign of neonatal stroke. | 2 years 8 months | 12th percentile | ASD |
Moderate | Unilateral spastic, GMFCS 1 | Perinatal acute ischaemic stroke. Moderate–severe unilateral basal ganglia/thalamic abnormalities. Focal, unilateral brainstem abnormalities. Moderate–severe unilateral cortical and white matter abnormalities. Unilateral optic radiation abnormalities. | 6 months | No BSID-III performed | Epilepsy, mild intellectual disability |
Moderate | Dyskinetic, GMFCS 3 | Moderate–severe bilateral basal ganglia/thalamic abnormalities. Moderate–severe bilateral cortical and white matter abnormalities. | 1 year 1 month | No BSID-III performed | |
Moderate | Bilateral spastic, GMFCS 5 | Severe bilateral basal ganglia/thalamic abnormalities. Severe extensive bilateral cortical and white matter abnormalities. Mild bilateral optic radiation abnormalities. | 6 months | No BSID-III performed | Epilepsy, ad mortem at 1 year of age |
Moderate | Dyskinetic, mixed form, GMFCS 5 | Severe bilateral basal ganglia/thalamic abnormalities. Moderate white matter abnormalities. Bilateral optic radiation abnormalities. | 7 months | No BSID-III performed | Epilepsy, severe intellectual disability |
Any additional neurological comorbidities are also listed here along with the findings on MRI of the brain in the neonatal period as well as motor composite score percentile on the BSID-III, when available.
ASD, autism spectrum disorder; BSID-III, Bayley Scales of Infant and Toddler Development, Third Edition; CVI, central/cortical visual impairment; FSIQ, full-scale IQ; GMFCS, Gross Motor Function Classification System; HIE, hypoxic–ischaemic encephalopathy;