Spastic diplegia with nonperinatal asphyxia in pediatric population

Spastic diplegia is characterized by spasticity in the upper or lower extremities whereby the lower extremities usually are more affected. Cerebral palsy (CP) with prematurity is highly associated with spastic diplegia.1 In the European Cerebral Palsy Study, spastic diplegia was the most common subtype of CP.2 Perinatal asphyxia events lead to bilateral periventricular white matter injury and disruption of corticospinal tracts controlling predominantly the lower extremities. A retrospective review study showed 44.4% of the children with CP spastic diplegia had periventricular leukomalacia.3 On the other hand, 46.3% of the children with CP spastic diplegia did not have identifiable etiologies for spastic diplegia.4 Since we frequently encounter spastic diplegia with unknown etiology in a clinical setting, it is important to keep in mind other etiologies causing this entity. There are numerous etiologies causing spastic diplegia except for cerebral palsy. We searched potential differential diagnoses on the internet with search terms “spastic diplegia” and reviewed the differential diagnoses that seem to be relevant to be considered in a clinical setting. This review deals with spastic diplegia with nonperinatal asphyxia.