Introduction: The major treatment goal for cerebral palsy children is to provide independence mainly in those treated with botulinum neurotoxin type A (BoNT-A).

Methods: Cross-sectional study evaluated clinical measures, quality of life and biopsychosocial profile (CBCL) among patients with hemiplegic cerebral palsy (HCP) treated with BoNT-A in a cohort study. Data were obtained from charts and by actual evaluation. All patients had encephalic magnetic resonance image (EMRI) and Wechsler Intelligence Scale for Children (WISC-III). Fisher test, Chi-square, Mann-Whitney, ANOVA, Kruskal-Wallis and Spearman coefficient were used and all analyses used a significance level of p<0.05.

Results: Ninety-nine patients were consecutively enrolled and sixty-six concluded all evaluations. Mean age was 135±55.79 months (57 to 268). Male predominates (60%).  Mean age of follow up beginning was 52.1±42.7 months (4 to 188). Fifty-one (77.3%) were level I on GMFCS-ER and remaining level II. Eleven patients (16.7%) had their EMRI showing Maldevelopment (MD), 24 (36.4%) Periventricular Atrophy, 22 (36.4%) Cortical/Subcortical Atrophy (CSA), 3 (4.5%) Miscellany and six (9.1%) were Normal. CSA patients had epilepsy more frequently and were submitted more times to BoNT-A; also had worst results in upper extremity evaluations, more sensory alterations and worst scores in social and affective problems on CBCL. MD patients had worst results in dimension E on GMFM and in self-care, sphincters control, cognition and total WeeFIM scores.

Results/Discussion: Neuroimage is an important prognostic tool in HCP children, being CSA worst to upper extremity and MD to gross motor function and functional independence.