About Cerebral Palsy
Cerebral palsy involves a lifelong set of symptoms that affect a patient’s motor functions. The disease is non-progressive; however, the symptoms can change over time. Caused by damage to the brain during development, be it from trauma or an effect of ischemia while in vitro or shortly after birth, cerebral palsy affects each patient differently. Clinical symptoms can include abnormal posture, abnormal oral function (making it difficult for infants to feed or, later, transition to textured foods), crossed eyes (called strabismus), abnormal muscular tone, slow reflexes and involuntary muscular contractions.
A cerebral palsy diagnosis usually occurs early; generally, the more severe the case, the earlier a diagnosis can be made. Approximately 5,000 babies and infants are diagnosed with cerebral palsy, annually. Diagnosis is based upon delay in reaching certain motor function milestones, which are are common developmental markers seen in healthy infants. These alone, though, are not solely indicative of a cerebral palsy diagnosis. There are several other tests that may be performed during the differential diagnosis process.
The first step in a cerebral palsy diagnosis is the physical examination. The child’s physician will use reflex tests, walking tests and feeding studies to determine if the child is having difficulty in these areas of development. If the child is showing delay in reaching normal milestones, his or her physician may order other tests to aid in the diagnosis.
An electroencephalogram (EEG) is an easy way to measure brain function. Electrodes are attached to the scalp and record the continuous electrical function of the brain. This test is often used to determine if epilepsy is present in the child, specifically if the child has had seizures in the past. Epilepsy is a common condition in patients with cerebral palsy.
A quick, inexpensive test that may be used during cerebral palsy diagnosis is cranial ultrasound. The device is placed over the soft spot in the child’s skull (fontanel), and high frequency sound waves form a basic picture on a computer screen. This is often just a preliminary diagnostic tool.
A tool using X-rays and computers, computed tomography (CT) scans provide cross-sectional “slices” of both hard and soft tissues. These detailed images are painless, take about 20 minutes to develop and require that the patient lie completely still. Children are often given a mild sedative during this procedure.
Magnetic Resonance Imaging
The preferred test, when available, magnetic resonance imaging (MRI) provides clear, detailed cross-sectional pictures of the patient’s brain, using a magnetic field and radio waves. This test is painless, but since it requires the patient to lie still, children may be given a mild sedative.
Several other tests may be required, in order to make sure that a child’s symptoms are not caused by something else. These can include blood tests, metabolic tests and genetic tests.
Also, depending upon a child’s specific symptoms, patients may be referred to other specialists, due to concern over other conditions than can affect cerebral palsy patients, such as hearing, vision, speech and intellectual function disorders.
The University of Chicago Pritzker School of Medicine, https://pedclerk.bsd.uchicago.edu/cerebalPalsy.html
Children’s Hospital of Pittsburgh, https://www.chp.edu/CHP/P02594
A.I. DuPont Gait Laboratory, https://gait.aidi.udel.edu/gaitlab/cpGuide.html#RTFToC8