Postnatal cerebral infection leading to hemiplegic cerebral palsy: functional limitations and disability of 13 children in Sweden.

Purpose: To describe the motor function and disability of children with postnatal cerebral infection leading to hemiplegia, and to determine the severity of their motor disability.

Method: The disablement process was used to describe these children. Participants included 13 children (7 girls and 6 boys, mean age 9.8 years). Traditional neurological assessment methods, together with the Movement Assessment Battery for Children and Paediatric Evaluation of Disability Inventory, were used. The children's non-hemiplegic sides were also tested. To determine severity of motor disability, new definitions were created that reflected the child's balance and fine-motor ability in relation to expected performance at his or her age.

Results: The children had involvement of the non-hemiplegic leg and arm in all but one case. Balance and hand function was impaired in all. Hypotonicity was present in 10 children, weakness of hip muscles in 9. There was great variation in grip function. Motor difficulties dominated during pre-school years, whereas the dominant problem of all school-age children was social and communication skills. Behavioural, communicative, and chewing and swallowing problems were common.

Conclusions: A postnatal infectious aetiology influences function on both the hemiplegic and non-hemiplegic side. In school-age children, social skills and communication difficulties are more pronounced than motor problems. The results of this study encourage the use of methods standardized for age where force dynamics and quality of movement are assessed.