Evaluation and diagnosis of cerebral palsy
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
Cerebral palsy (CP) is a heterogeneous group of clinical syndromes that range in severity and are characterized by abnormal muscle tone, posture, and movement. These conditions are due to abnormalities of the developing brain resulting from a variety of causes. Although the disorder itself is not progressive, the clinical expression may change over time as the brain matures.
The evaluation and diagnosis of CP are discussed here. The epidemiology, etiology, classification, clinical features, management, and prevention of CP are discussed separately:
- Schaefer GB. Genetics considerations in cerebral palsy. Semin Pediatr Neurol 2008; 15:21.
- Noritz GH, Murphy NA, Neuromotor Screening Expert Panel. Motor delays: early identification and evaluation. Pediatrics 2013; 131:e2016.
- Gupta R, Appleton RE. Cerebral palsy: not always what it seems. Arch Dis Child 2001; 85:356.
- NICE guideline: Cerebral palsy in under 25s: assessment and management, 2017. Available at: https://www.nice.org.uk/guidance/ng62/resources/cerebral-palsy-in-under-25s-assessment-and-management-1837570402501 (Accessed on January 30, 2017).
- Ashwal S, Russman BS, Blasco PA, et al. Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 2004; 62:851.
- Truwit CL, Barkovich AJ, Koch TK, Ferriero DM. Cerebral palsy: MR findings in 40 patients. AJNR Am J Neuroradiol 1992; 13:67.
- Krägeloh-Mann I, Petersen D, Hagberg G, et al. Bilateral spastic cerebral palsy--MRI pathology and origin. Analysis from a representative series of 56 cases. Dev Med Child Neurol 1995; 37:379.
- Miller G, Cala LA. Ataxic cerebral palsy--clinico-radiologic correlations. Neuropediatrics 1989; 20:84.
- Pons R, Collins A, Rotstein M, et al. The spectrum of movement disorders in Glut-1 deficiency. Mov Disord 2010; 25:275.
- Senbil N, Yüksel D, Yilmaz D, Gürer YK. Prothrombotic risk factors in children with hemiplegic cerebral palsy. Pediatr Int 2007; 49:600.
- Simchen MJ, Goldstein G, Lubetsky A, et al. Factor v Leiden and antiphospholipid antibodies in either mothers or infants increase the risk for perinatal arterial ischemic stroke. Stroke 2009; 40:65.
- Altshuler G. Some placental considerations related to neurodevelopmental and other disorders. J Child Neurol 1993; 8:78.
- Strand KM, Dahlseng MO, Lydersen S, et al. Growth during infancy and early childhood in children with cerebral palsy: a population-based study. Dev Med Child Neurol 2016; 58:924.
- Stanek JL, Emerson JA, Murdock FA, Petroski GF. Growth characteristics in cerebral palsy subtypes: a comparative assessment. Dev Med Child Neurol 2016; 58:931.
- Brooks J, Day S, Shavelle R, Strauss D. Low weight, morbidity, and mortality in children with cerebral palsy: new clinical growth charts. Pediatrics 2011; 128:e299.
- Granild-Jensen JB, Rackauskaite G, Flachs EM, Uldall P. Predictors for early diagnosis of cerebral palsy from national registry data. Dev Med Child Neurol 2015; 57:931.
- Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109:8.
- Burns YR, O'Callaghan M, Tudehope DI. Early identification of cerebral palsy in high risk infants. Aust Paediatr J 1989; 25:215.
- History and physical examination
- Findings suggesting an alternative diagnosis
- Diagnostic evaluation
- - Neuroimaging
- - Electroencephalography
- - Lumbar puncture
- - Metabolic and genetic testing
- - Screening for thrombophilia
- - Examination of the placenta
- Screening for associated conditions
- - Intellectual disability
- - Vision impairment
- - Hearing impairment
- - Speech and language impairment
- - Nutrition and growth
- DIFFERENTIAL DIAGNOSIS
- Muscle weakness
- Spastic diplegia or quadriplegia
- Dystonia and choreoathetosis
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS