Prenatal origin of congenital spastic hemiparesis.

Using Prechtl's concept of optimal conditions, 13 out of 20 children suffering from congenital spastic hemiparesis presented reduced optimal obstetric and postnatal conditions which were within the 3rd and 80th percentiles of the reduced optimal conditions found in a population of 400 randomly selected newborns. In the 7 children with higher numbers of reduced optimal scores only items indicating perinatal asphyxia accounted for the higher risk. But no correlation could be found between the severity of handicap and perinatal complications. Therefore one may argue that newborns with prenatal cerebral lesions are more likely to suffer perinatal asphyxia, which does not necessarily cause a further damage to the brain. No specific peri- or postnatal complications could be found which would explain the origin of the hemiparesis in the 20 children. CAT-scan examinations in some children showed lesions of the gray or the white matter, but there were also scans without any abnormal findings at all. No correlation between the kind of cerebral lesion and the neurological findings could be drawn.