Which cerebral palsy subtype presents with spastic hemiparesis, with face and arms greater than legs, often due to MCA stroke, and may show premature handedness?

• A. Extrapyramidal cerebral palsy
• B. Hemiplegic cerebral palsy
• C. Diplegic cerebral palsy
• D. Quadriplegic cerebral palsy

Answer: (B)

The pattern described is unilateral motor involvement with spasticity affecting the face and arm more than the leg, which defines hemiplegic cerebral palsy. This form often stems from a lesion in the motor pathways supplied by the middle cerebral artery, such as perinatal MCA stroke, matching the scenario given. Premature handedness can occur because the affected side is weaker, so the child relies on the other hand earlier than typical.

The other patterns don’t fit as well: extrapyramidal CP is characterized by dystonia or choreoathetoid movements rather than a unilateral spastic pattern; diplegic CP primarily affects the legs more than the arms; quadriplegic CP involves all four limbs and trunk.