Help me make sense of Consultant's report on my daughter

[Albaba]

Hi there. I have posted before about concerns about my daughter, 21 months old and not walking. We met the consultant this morning to discuss the results of her MRI scan. Clinical details were: Ex premature baby, significant gross motor delay, global delay and hypotonia. Reason for referral: PVL/IVH.
The findings of the scan were: There is increased T2 and FLAIR signal involving the periventricular white matter bilaterally but most marked posteriorly. There is underlying dilation of the posterior horns. Abnormal signal extends postero superiorly to involve the posterior deep white matter. There is the impression of generalised deep white matter loss. The corpus callosum is slightly thinned posteriorly. There is some loss of normal signal within the dorsal aspect of the posterior limb of the internal capsule bilaterally. There is no other intercranial abnormality demonstrated. There is no evidence of obstructive hydrocephalous. Extra axial fluid spaces are not enlarged and there are normal cerebal flow voids demonstrated. Posterior fossa structures are unremarkable in appearences. Conclusion: Evidence of white matter injury of prematurity. No other significant lesion.
Consultant asked loads of questions and thought it was good that she had a good appetite and slept well. Also she appeared bright and was interacting well. She also has come on well with her physio and has gone from not being able to sit unaided to pulling up on to furniture and side stepping. She is to be referred to orthopaedics for special footwear as her feet are turning in.
Husband asked about a diagnosis and she said that it is a form of cerebal palsy but mild. She couldn't give us a definitive answer on whether or not she would walk normally but seemed to be relatively positive. I knew she had cerebal palsy but was imagining the worst case scenario of wheelchairs etc. Knew that once she had passed 18 months that it wasn't normal that she wasn't walking. Hasn't affected her mind. Just the lower half of her body is weak.
Can anyone interpret the Consultants report and let me know if it is good or bad? Thanks Albaba.

I can't interpret the scan very well but I can tell you my DD started pulling up at the same time and walked almost exactly on her second birthday, so I would expect walking soon :)

She also had special shoes and has hypotonia

DD1 also pulled up and cruised on furniture around that time and walked at 23 months, as Fanjo's DD.

The MRI can't tell you whether it's good or bad, tbh. DD1 has a huge list of 'abnormalities' on MRI, none severe but in lots of areas. She goes to special school but walks, talks, etc. There are other children with no abnormality on MRI that are worse affected than DD1.

Hi albaba

personally i can't make that much out of that report, however PVL/IVH does indicate likely CP expecially the PVL in an ex prem. IVH may or may not do as bleeds don't seem to correlate as much. But to be honest i don't know as I decided that I did not want an MRI of my DS (who has CP) as actually MRI can show significant damage, and you canhave a seemingly perfectly normal and healthy child, or no damage on a MRI and a child with quite severe CP. I therefore concluded in our case that i would learn nothing from the MRI and did not do one.

In our case ds could crawl at about 13 months and pull up and walk with a walker at 21 months. He has spastic diplegia CP and his lower bidy is weak. he is also hypermobile which does not help and he is however no closer to walking in the conventional sense now than he was 15 months ago. In fact he is it is just taking avery long time as he is now just over 3. To be honest we all thought he would have made much much more progress by now but he hasn't and that is ok. Not what i wanted but OK. However all children are different and that includes those with CP and it is just as likely given your consultant's report that your child will walk and will walk much sooner.

There are many many children who has a similar initial run on gross motor who walk at or before they are 2 or shortly thereafter and many of their parent post here.

www.mumsnet.com/Talk/special_needs/1671211-Support-information-sharing-thread-for-parents-of-children-with-Cerebral-Palsy-Part-2

yes..my DD being one of them :)

x-posted, that was addressed to Lougle of course :)

We were told that if a child could sit independently by 2, the chance that they would walk was excellent. She might have an unusual gait, but I think if she is side stepping at 21 months, her chances of walking are very good.

Agree about an MRI. We did the MRI and were told they were expecting to find PVL/IVH evidence and found nothing. DD still has mild CP (spastic diplegia) either way. She is coming up to 3 and whilst doesn't walk indepently yet is an expert in cruising around and is quite good with her walker. She tires easily which does not help but is fiercely stubborn to try...again....and again...etc!
Our paed reports always read more negatively than the actual appointments. In reality our paed thinks she is doing brilliantly but for paperworking listing delays and abnormalities looks very black and white.

Alternately, Bee has a friend who was a 24 week prem whose MRI is "pristine" - no PVL, no volume loss, nothing abnormal at all.

She is so severely dystonic that she has no control over any of her limbs and gets around with a control array in the headrest of her power wheelchair. Her twin's MRI looks awful, but aside from some hearing loss secondary to meningitis, is doing beautifully. For CP especially, the MRI is more effective in ruling out other diseases that can mimic CP early than predicting outcome.