AIM: To investigate the association between magnetic resonance imaging (MRI) 
patterns and motor function, epileptic episodes, and IQ or developmental 
quotient in patients born at term with spastic diplegia.
METHOD: Eighty-six patients born at term with cerebral palsy (CP) and spastic 
diplegia (54 males, 32 females; median age 20 y, range 7-42 y) among 829 
patients with CP underwent brain MRI between 1990 and 2008. The MRI and clinical 
findings were analysed retrospectively. Intellectual disability was classified 
according to the Enjoji developmental test or the Wechsler Intelligence Scale 
for Children (3rd edition).
RESULTS: The median ages at diagnosis of CP, assignment of Gross Motor Function 
Classification System (GMFCS) level, cognitive assessment, and MRI were 2 years 
(range 5 mo-8 y), 6 years (2 y 8 mo-19 y), 6 years (1 y 4 mo-19 y), and 7 years 
(10 mo-30 y) respectively. MRI included normal findings (41.9%), periventricular 
leukomalacia, hypomyelination, and porencephaly/periventricular venous 
infarction. The frequency of patients in GMFCS levels III to V and intellectual 
disability did not differ between those with normal and abnormal MRI findings. 
Patients with normal MRI findings had significantly fewer epileptic episodes 
than those with abnormal ones (p=0.001).
INTERPRETATION: Varied MRI findings, as well as the presence of severe motor 
dysfunction and intellectual disability (despite normal MRI), suggest that 
patients born at term with spastic diplegia had heterogeneous and unidentified 
pathophysiology.