Author Archives: Stuart G. Hall

About Stuart G. Hall

Making a positive difference one day at a time. #London #Leicester

Clinical and MRI correlates of cerebral palsy identified

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Clinical and MRI correlates of cerebral palsy identified

Last Updated: 2006-10-03 16:00:20 -0400 (Reuters Health)

NEW YORK (Reuters Health) – In a population-based study, researchers at eight European centers shed light on the clinical and MRI findings that characterize children with cerebral palsy. The results suggest that obstetrical mishaps play a role in a small proportion of cases.

According to the report in the Journal of the American Medical Association for October 4, previous studies looking at the clinical and MRI correlates of cerebral palsy have been confined to certain disease subgroups or lesion types. Thus, there is need for studies investigating the correlates in a large population of children with all types of cerebral palsy.

The current study involved 585 children with cerebral palsy (CP) who were born at one of the eight centers between 1996 and 1999. Of these children, 431 were clinically evaluated and 351 received a brain MRI scan.

The children included 26.2% with hemiplegia, 34.4% with diplegia, 18.6% had quadriplegia, 14.4% had dyskinesia, 3.9% had ataxia, and 2.6% had other forms of cerebral palsy, Dr. Martin Bax, from Imperial College in London, and colleagues note.

The most common finding on MRI, periventricular leukomalacia, was seen in 42.5% of subjects, the team found. The next most common finding was basal ganglia lesions, noted in 12.8% of children. A completely normal MRI was found in just 11.7% of subjects.

The MRI findings correlate well with the clinical observations and “help reveal the pathologic basis of the condition,” the investigators say. They add that this may help “parents, clinicians and others involved in the care of children with CP to understand the nature of the children’s condition and to predict their needs in the future.”

Dr. Bax and colleagues conclude that all children with CP should therefore have an MRI scan.

In a related editorial, Dr. Michael E. Msall, from the University of Chicago, calls the present study “a major advance” that makes several “important observations.” In particular, he points to the neuroimaging data as being “most informative.”

JAMA 2006;296:1602-1608,1650-1652.

Simple rule, rule of thumb

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A recurrent theme of my design is the potential cross-over between complexity science and the ability of people to deal with complex reality as often captured in sayings and metaphor. A very nice example of this occured to me just now: rule of thumb/simple rule

This also underpins my argument that it is possible to have a ‘social’ version of complexity, based on people’s ability to practically deal with complexity using this intuitive/rule of thumb/ rather than the traditional technical-science approach. Of course don’t think for one minute that anyone out there is going to buy this approach, accept perhaps in design of systems which have no option but deal with messy reality, rather than force control onto that reality.

For example from knowledge management: it’s better to take the risk of repeating a question, than not say it at all; yes, it’s (much) better to take the risk of repeating a question, than not say it at all.

Systems that don’t take account of messy reality exhibit the classic ‘push down, pop up’ effect (itself a nice social complexity term). The effect of targets in the NHS is a well known example of this.