Neurophysiological assessment of central sensory perception among children with bilateral spastic cerebral palsy.

Somatosensory deficits have gained growing attention in cerebral palsy; therefore, it is of interest to evaluate the central perceptual abnormalities in children with bilateral spastic cerebral palsy (CP). Seventy children (35 children with CP and 35 controls, age-range: 6 months-10 years) were evaluated by somatosensory evoked potentials (SSEP), visual evoked potentials (VEP) and brainstem auditory evoked potentials (BAEP) and the association with electroencephalography (EEG), clinical and radiologic findings was sought for. Tibial SSEPs and median SSEPs revealed abnormal cortical response in 77.14 % (27 of 35) and 65.22 % (15 of 23) respectively, 14.29 % (5 of 35) had abnormal BAEP, 18 of 35 (51.4 %) had abnormal VEP, 14 patients (40 %) demonstrated abnormal EEG and 91.43 % had abnormal brain magnetic resonance imaging (MRI). Abnormal tibial SSEPs were statistically correlated with abnormal EEG (p=0.005) and perinatal asphyxia (p=0.01) while abnormal median SSEPs were statistically correlated with abnormal VEP (p=0.0098) and perinatal asphyxia (p=0.03) (chi-square test). Evidences of sensory cortical involvement in CP can help in designing better treatment plans. Cortical SSEPs may further be evaluated in prospective studies to assess their potential utility as a prognostic tool in children with CP.