{"id":8025,"date":"2025-12-25T19:41:21","date_gmt":"2025-12-25T19:41:21","guid":{"rendered":"https:\/\/neuropediatoolkit.org\/?p=8025"},"modified":"2026-09-02T16:14:36","modified_gmt":"2026-09-02T16:14:36","slug":"paralisis-cerebral-infantil-y-rm-normal","status":"publish","type":"post","link":"https:\/\/neuropediatoolkit.org\/en\/paralisis-cerebral-infantil-y-rm-normal\/","title":{"rendered":"Infantile cerebral palsy and MRI. When to request genetic studies."},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">1. Introducci\u00f3n y Relevancia de la Neuroimagen<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">La <strong>Resonancia Magn\u00e9tica Cerebral (RM)<\/strong> constituye la prueba complementaria de primera l\u00ednea tras la anamnesis y la exploraci\u00f3n neurol\u00f3gica detallada en todo ni\u00f1o con sospecha de <em>Par\u00e1lisis Cerebral Infantil (PCI)<\/em>. Se estima que la RM revela anomal\u00edas patog\u00e9nicas en m\u00e1s del <strong>80% de los casos<\/strong>, orientando sobre el momento temporal y la naturaleza de la noxa cerebral.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">2. Clasificaci\u00f3n SCPE seg\u00fan Patrones de Neuroimagen<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">La red de <em>Surveillance of Cerebral Palsy in Europe (SCPE)<\/em> estratifica los hallazgos de neuroimagen en 5 categor\u00edas esenciales:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Lesiones predominantes de la sustancia blanca (aprox. 50%):<\/strong> Leucomalacia periventricular, secundarias t\u00edpicamente a eventos isqu\u00e9micos o infecciosos perinatales en prematuros.<\/li>\n\n\n\n<li><strong>Lesiones de sustancia gris cortical y ganglios basales (aprox. 20%):<\/strong> Lesiones hip\u00f3xico-isqu\u00e9micas a t\u00e9rmino o encefalopat\u00edas perinatales agudas.<\/li>\n\n\n\n<li><strong>Malformaciones del desarrollo cerebral (aprox. 11%):<\/strong> Trastornos de migraci\u00f3n, polimicrogiria, esquicencefalia o lisencefalia.<\/li>\n\n\n\n<li><strong>Resonancia Magn\u00e9tica Normal (aprox. 11%):<\/strong> Ausencia de da\u00f1o estructural adquirido evidente.<\/li>\n\n\n\n<li><strong>Miscel\u00e1nea \/ Inespec\u00edficos:<\/strong> Otras alteraciones anat\u00f3micas no categorizables en los grupos anteriores.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">3. \u00bfCu\u00e1ndo Indicar Estudios Gen\u00e9ticos en PCI?<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">El rendimiento diagn\u00f3stico del estudio gen\u00e9tico (microarrays cromos\u00f3micos, paneles de secuenciaci\u00f3n masiva o exoma completo) var\u00eda dr\u00e1sticamente seg\u00fan el patr\u00f3n de neuroimagen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Indicaci\u00f3n Prioritaria y Alta Sospecha Monog\u00e9nica:<\/strong> En pacientes con <strong>RM normal<\/strong> o con <strong>malformaciones del desarrollo cerebral<\/strong>, la probabilidad de una etiolog\u00eda monog\u00e9nica subyacente es muy elevada. En estos casos, el estudio gen\u00e9tico est\u00e1 formalmente indicado.<\/li>\n\n\n\n<li><strong>Vulnerabilidad Gen\u00e9tica en Lesiones Adquiridas:<\/strong> En casos con lesiones de sustancia blanca o gris adquiridas sin antecedentes claros de asfixia o factores de riesgo perinatales, debe considerarse la predisposici\u00f3n gen\u00e9tica que aumenta la vulnerabilidad celular ante noxas m\u00ednimas.<\/li>\n<\/ul>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img fetchpriority=\"high\" decoding=\"async\" width=\"728\" height=\"668\" src=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/12\/image-1.png\" alt=\"Neuroimagen y Gen\u00e9tica en Par\u00e1lisis Cerebral\" class=\"wp-image-8117\" srcset=\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/12\/image-1.png 728w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/12\/image-1-300x275.png 300w, https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2025\/12\/image-1-13x12.png 13w\" sizes=\"(max-width: 728px) 100vw, 728px\" \/><\/figure>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\">4. Recomendaciones Pr\u00e1cticas para la Consulta<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Ante un paciente con cl\u00ednica de par\u00e1lisis cerebral sin antecedentes perinatales claros o con una neuroimagen at\u00edpica o normal, se debe evitar asumir una causa lesional no documentada e iniciar de forma precoz el algoritmo gen\u00e9tico diagn\u00f3stico.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Bibliograf\u00eda y Referencias<\/h2>\n\n\n<div id=\"zotpress-54eed3233d3292e4ed06eb26df14c65f\" class=\"zp-Zotpress zp-Zotpress-Bib wp-block-group\">\n\n\t\t<span class=\"ZP_API_USER_ID ZP_ATTR\">19955111<\/span>\n\t\t<span class=\"ZP_ITEM_KEY ZP_ATTR\">{19955111:NMMWTEGD}<\/span>\n\t\t<span class=\"ZP_COLLECTION_ID ZP_ATTR\"><\/span>\n\t\t<span class=\"ZP_TAG_ID ZP_ATTR\"><\/span>\n\t\t<span class=\"ZP_AUTHOR ZP_ATTR\"><\/span>\n\t\t<span class=\"ZP_YEAR ZP_ATTR\"><\/span>\n        <span class=\"ZP_ITEMTYPE ZP_ATTR\"><\/span>\n\t\t<span class=\"ZP_INCLUSIVE 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id=\"zp-ID-8025-19955111-NMMWTEGD\" data-zp-author-date='Horber-et-al.-2021-02-09' data-zp-date-author='2021-02-09-Horber-et-al.' data-zp-date='2021-02-09' data-zp-year='2021' data-zp-itemtype='journalArticle' class=\"zp-Entry zpSearchResultsItem\">\n<div class=\"csl-bib-body\" style=\"line-height: 1.35; \">\n  <div class=\"csl-entry\" style=\"clear: left; \">\n    <div class=\"csl-left-margin\" style=\"float: left; padding-right: 0.5em; text-align: right; width: 1em;\">1.<\/div><div class=\"csl-right-inline\" style=\"margin: 0 .4em 0 1.5em;\">Horber V, Grasshoff U, Sellier E, Arnaud C, Kr\u00e4geloh-Mann I, Himmelmann K. The Role of Neuroimaging and Genetic Analysis in the Diagnosis of Children With Cerebral Palsy. Front Neurol [Internet]. 2021 Feb 9 [cited 2026 Jan 4];11. Available from: <a class='zp-ItemURL' href='https:\/\/www.frontiersin.org\/journals\/neurology\/articles\/10.3389\/fneur.2020.628075\/full'>https:\/\/www.frontiersin.org\/journals\/neurology\/articles\/10.3389\/fneur.2020.628075\/full<\/a><\/div>\n  <\/div>\n<\/div>\n\t\t\t\t<\/div><!-- .zp-Entry .zpSearchResultsItem -->\n\t\t\t<\/div><!-- .zp-zp-SEO-Content -->\n\t\t<\/div><!-- .zp-List -->\n\t<\/div><!--.zp-Zotpress-->\n\n\n","protected":false},"excerpt":{"rendered":"<p>1. Introduction and Relevance of Neuroimaging Brain Magnetic Resonance (MRI) constitutes the first-line complementary test after the anamnesis and detailed neurological examination in all children with suspected Childhood Cerebral Palsy (CPI). It is estimated that MRI reveals pathogenic abnormalities in more than 80% of cases, providing guidance on the... <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/neuropediatoolkit.org\/en\/paralisis-cerebral-infantil-y-rm-normal\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> \u00abChildhood cerebral palsy and MRI. When to request genetic studies.<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":8027,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"categories":[10,12],"tags":[],"class_list":["post-8025","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neurogenetica","category-neurorradiologia","entry"],"_links":{"self":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/8025","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/comments?post=8025"}],"version-history":[{"count":8,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/8025\/revisions"}],"predecessor-version":[{"id":8613,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/posts\/8025\/revisions\/8613"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media\/8027"}],"wp:attachment":[{"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/media?parent=8025"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/categories?post=8025"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neuropediatoolkit.org\/en\/wp-json\/wp\/v2\/tags?post=8025"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}