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Spastic hemiplegia — RACP Paediatrics MCQ

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ModerateNeurologySpastic hemiplegiaRACP Paediatrics

A 12-month-old has asymmetric hand use from early infancy with a persistent fisted left hand. MRI brain shows a right middle cerebral artery territory infarct. The child was born at term. What is the most likely CP classification?

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Correct answer: A — Spastic hemiplegic CP

Unilateral motor impairment (hemiplegia) with a contralateral MCA territory infarct is spastic hemiplegic CP. Early hand preference before 12 months is a red flag for asymmetric neurological pathology. In term infants, the most common cause is perinatal stroke. Upper limb is typically more affected than lower limb.

Reference: RCH Melbourne – 2023 – Cerebral Palsy CPG; RACP Paediatric Curriculum – Neurology