The determination of sensory deficits in children with hemiplegic cerebral palsy.
Therapeutic intervention for children with cerebral palsy begins with accurate appraisal of abilities and disabilities. Currently, treatment focuses on the identified motor deficits, with any underlying sensory deficits often being overlooked. Sensory input is an essential component of motor function and motor control. Therefore, the objective of this study was to determine the presence and extent of sensory deficits in school-aged hemiplegic children using a formal clinical sensory battery, as well as somatosensory evoked potentials. A cross-sectional comparative study was performed comparing sensory function in hemiplegic children and healthy controls. Nine hemiplegic children and 41 healthy controls between 4 and 19 years of age were assessed. Hemiplegic children were included if they had a minimum level of receptive language function of 30 to 33 months and expressive language ability of 24 to 27 months, and no severe limitation of joint range of the hand. Significant bilateral sensory deficits (88.8%) were ascertained in hemiplegic children (P < .05), when compared to the performance of the healthy controls. Stereognosis and proprioception were the chief modalities affected bilaterally. The extent of sensory loss did not mirror the severity of motor deficit. Conversely, findings on somatosensory evoked potentials were closely related to motor function. Thus, a clinical sensory evaluation should be an integral part of the assessment of children with cerebral palsy. The likelihood of sensory impairment in one or more modalities on the hemiplegic or nonhemiplegic side is underappreciated and needs to be identified by rehabilitation specialists to maximize the functional potential of these children.
Cooper
J
J
Department of Occupational Therapy, Montreal Children's Hospital, School of Physical and Occupational Therapy, Quebec, Canada.
Majnemer
A
A
Rosenblatt
B
B
Birnbaum
R
R
D000293:Adolescent; D001921:Brain / Q000503:physiopathology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004292:Dominance, Cerebral / Q000502:physiology; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006429:Hemiplegia / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009949:Orientation / Q000502:physiology; D011434:Proprioception / Q000502:physiology; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000503:physiopathology; D012678:Sensation Disorders / Q000175:diagnosis / Q000503:physiopathology*; D012684:Sensory Thresholds / Q000502:physiology; D013236:Stereognosis / Q000502:physiology; D014110:Touch / Q000502:physiology