Diagnosis making of Cerebral Palsy

Cerebral Palsy is a complex disorder so diagnosis making is always difficult. There is no specific test which can confirm the presence of CP. CP is diagnosed through observations, assessments and clinical investigations. Generally cerebral palsy is suspected, when a child has the following features:

• Delayed milestones, mostly gross motors and fine motors
• Persistence of primitive reflexes
• No evidence of progressive disease / No loss of milestones achieved previously
• There is motor delay- variation by more than 50% with abnormal movements and poor postural control
• A child with CP may have a combination of associated disorders such as Epilepsy, Visual deficits, Hearing Deficits, Drooling, Feeding problems, Poor Cognition, Poor speech, etc

We have observed that family members are the first to notice the problems and help to make the diagnosis. Concerned parents visit a child specialist first to seek advice about the child condition. Generally child specialists are not trained in developmental disability management; they miss the diagnosis which ultimately delays early intervention. Sometimes, a pediatrician notices the abnormal pattern of postures /movements while examining the child and refer the child to a CP specialist / CP management professional’s team.
It is always better to meet a developmental pediatrician / pediatric neurologist / developmental specialist to get the diagnosis done. At ICD, diagnosis is made systematically with the help of following tests / examinations

• Observation  and documentation ( Videography)of the child while the child is in static, dynamic and transitory postures during play, etc
• Documenting medical history starting from pregnancy. Medical issues related to prenatal, perinatal and postnatal to establish a good scientific basis of the diagnosis
• Getting X-rays or Ultrasound (Skull / Hips / Spine),
• Getting MRI / CT scan of the Brain / Spine
• Getting EEG -to rule out epileptic syndrome
• Getting Blood Tests -to rule out other diseases
• Getting Chromosomal Study -to rule out genetic disorder
• Getting Vision Test, Hearing Test, etc to have a baseline

Simultaneously, a cerebral palsy therapist (must be a developmental therapist or a specially trained pediatric physiotherapist / occupational therapist) is asked for physical examination. The CP therapist  / early interventionist generally examines and assesses Tone, Spasm, Tightness, Contracture, Deformity, ROM, Muscle Strength, Selective Motor Control, Sensation, etc. The child undergoes postural evaluation, gross motor evaluation, fine motor evaluation, cognition evaluation, communication evaluation, social-Emotional evaluation, and evaluation of activities of daily living ( Feeding, Toileting, Tooth brushing, Bathing, Undressing – Dressing and Grooming)  to have a baseline for therapeutic planning and programming

Differential Diagnosis- Is it really CP or something else
As lot of disorder look like (mimics) cerebral palsy so it is very important to have a differential diagnosis. Differential diagnoses help a child to get required and right treatments in time. Other conditions that should be considered when evaluating a patient with suspected cerebral palsy include

• Metabolic and genetic diseases, hereditary spastic paraplegias, Rett’s syndrome, and tethered spinal cord, etc.
• Inherited Metabolic Disorders,
• Metabolic Myopathies, Metabolic Neuropathy
• Traumatic Peripheral Nerve Lesions
• Tumors of the Conus and Cauda Equina
• Vascular Malformations of the Spinal Cord,etc

All of the above conditions are not cerebral palsy.

If you suspect that your child has something like cerebral palsy, please contact us for making the diagnosis and right guidance at:
Mail ID: helpicd@gmail.com, Whatsapp No: +91-7838809241, Landline No: +91-11-41012124

---

RELATED LINKS

Cerebral Palsy Introduction   Causes of Cerebral Palsy     Types of Cerebral Palsy  Treatments of Cerebral Palsy Dyskinetic Cerebral Palsy  Hypotonic Cerebral Palsy

Signs and symptoms of Cerebral Palsy Associated Problems with Cerebral Palsy Diagnosis of Cerebral Palsy Spastic Cerebral Palsy Ataxic Cerebral Palsy