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To the Editor: The study of clinical and MRI findings by Dr Bax and colleagues¹ helps in understanding the neuroanatomical correlates of CP. However, we are concerned with their conclusion that all children with CP should have an MRI scan. That goes beyond the recommendation of the American Academy of Neurology: neuroimaging should be a part of the evaluation of a child with CP if the etiology has not been established (Level A, class I and II evidence).² Indeed, current definition and classification of CP³ does not mandate neurocorrelates because most children with CP have abnormal brain structure, and MRI findings in these children have strong correlations with clinical findings.

Bax et al found normal MRI scans in only 11.7% of their cohort of 351 children. Studies that included a total of 1426 children with CP who underwent computed tomography or MRI scans revealed a brain abnormality in 62% to . . . [Full Text of this Article]

Opher Caspi, MD, PhD
ocaspi@ahsc.arizona.edu
Rabin Medical Center
Petah-Tikva, Israel

Burris Duncan, MD
University of Arizona
Tucson

Tong Li Han, MD; Li-Ping Zou, MD, PhD
Beijing Children Hospital
Beijing, China

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