Peripheral Neuropathy In Children With Cerebral Palsy

ObjectiveTo investigate the characteristics of peripheral nerve electrophysiologyand clinical manifestations of peripheral neuropathy in children withcerebral palsy.MethodGathering the clinical manifestations、 peripheral nerveelectrophysiology results and cerebral magnetic resonance imaging of140children with cerebral palsy who were diagnosed in Department ofNeurological Rehabilitation in Children’s Hospital of Chongqing MedicalUniversity for the first time during July2008to January2013.Results1.105of140children had abnormal peripheral nerve conductionvelocity results,yet only20children showed weaken or disappeared oftenden reflex and muscle hypotonia.2. The gross motor retardation began youngest at the mean age of13month and had the least retardation-about8month in average in hypotoniccerebral palsy with peripheral neuropathy.3. The abnormal rate of H-reflex or F-wave was77.1%which washigher than other items of NCV. 4. The abnormal rate of action potential(CMAP、SNAP)(CMAP28.9%,SNAP44.4%)was higher than that of Nerve conductionvelocity (MCV,SCV) and distal motor latency(DML)(MCV6.7%，SCV2.2%，MDML6.7%）.5. The dilation of ventricle and cerebral extracellular space&cerebraldysplasia and deformity have correlation with abnormal SNAP.ConclusionsThe abnormal rate of peripheral nerve conduction is high in Childrenwith cerebral palsy,yet typical clinical manifestations are not typical，it’seasier to be misdiagnosed. The gross motor retardation began youngest andhad the least retardation in hypotonic cerebral palsy with peripheralneuropathy. H-reflex and F-wave may be the most sensitive items forperipheral neuropathy in children with cerebral palsy.Peripheral neuropathymay locate in the proximal end of peripheral nerve or Spinal cord ventralhorn.Axonal degeneration is more often seen than myelinization.Thechildren with cerebral palsy who have dilation of ventricle and cerebralextracellular space&cerebral dysplasia and deformity may have dysplasiaof nerve fibers both in central nervous system and peripheral nervoussystem.