Clinical,Neuroimaging,and Functional Profile of Children With Hemiplegic Cerebral Palsy: A Cross-Sectional Study From a Tertiary Care Center

Abstract

Objective

To characterize the clinical profile, functional and developmental status, radiologic patterns, and comorbidity burden in children aged 1-14 years diagnosed with hemiplegic cerebral palsy (HCP) at a tertiary pediatric neurology center.

Methods

This cross-sectional study included 70 children with HCP. Functional assessments were done with the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and the Quality of Upper Extremity Skills Test (QUEST). Development was evaluated using Developmental Profile-3 (DP-3), whereas caregiver-reported health-related quality of life was assessed through the Caregiver Questionnaire (CQ). Correlations among functional measures, developmental scores, and epilepsy were examined.

Results

The mean age was 62.4 ± 38.3 months, with a male predominance (71.4%) and more right-sided involvement. Antenatal complications were present in 30% of pregnancies, and 41% of children required resuscitation at birth. Postnatal complications, including respiratory distress and neonatal seizures, occurred in 43%. Most children demonstrated mild to moderate motor impairment, with 73% classified as GMFCS levels I and II, and reduced hand function was common, with 88% falling within MACS levels II and III. The mean QUEST score was 68.1 ± 6.7, indicating mild to moderate impairment of upper-extremity quality, particularly in dissociated movements and grasp. Epilepsy occurred in 38.5%, visual impairment in 31%, and hearing loss in 7%. Poorer manual ability corresponded with higher GMFCS levels and lower developmental scores.

Conclusion

Children with HCP exhibit a consistent pattern of structural brain injury, substantial comorbidity burden, and measurable functional limitations, underscoring the need for early, targeted multidisciplinary intervention.