Advertisement

When and How to Evaluate the Child with Possible Cerebral Palsy

  • Sonika Agarwal
Living reference work entry

Abstract

Cerebral palsy is a neurodevelopmental disorder with lifelong consequences. It includes a group of disorders of movement and posture, attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often associated with disturbances of sensation, cognition, communication, perception, behavior, and by a seizure disorder. CP may be caused by several different etiologies causing insults to the developing brain at different stages of development. CP is a clinical diagnosis based on a thorough history (prenatal, perinatal, and postnatal), review of developmental milestones, and neurologic examination. The work-up may include neuroimaging, metabolic or genetic testing, and testing for specific disorders. Also, the work-up may include testing for the associated conditions and complications: intellectual disability (52%), epilepsy (45%), speech and language disorders (38%), vision defects (28%), and hearing impairments (12%). These children often need long-term multidisciplinary care and therapies and supports for educational and social functioning to optimize the outcome. The disorder may exhibit a wide spectrum of functioning. Although the approach to treatment and rehabilitation may be similar for most children with CP, a description of the condition based on neuroimaging, and metabolic or genetic testing, may help individualize treatment and also help better predict the associated morbidity and what to expect for a particular child.

Keywords

Cerebral palsy Neurodevelopment Developmental delay Neuroimaging Genetic Delayed milestones Perinatal brain injury 

References

  1. Arneson CL, Durkin MS, Benedict RE, Kirby RS, Yeargin-Allsopp M, Van Naarden Braun K, Doernberg NS (2009) Prevalence of cerebral palsy: autism and developmental disabilities monitoring network, three sites, United States, 2004. Disabil Health J 2(1):45–48CrossRefGoogle Scholar
  2. Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M, Stevenson R, Quality Standards Subcommittee of the American Academy of Neurology (2004) 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 62(6):851–863CrossRefGoogle Scholar
  3. Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N, Dan B, Jacobsson B, Damiano D (2005) Proposed definition and classification of cerebral palsy, April 2005. Executive Committee for the definition of cerebral palsy. Dev Med Child Neurol 47(8):571–576. ReviewCrossRefGoogle Scholar
  4. Bhasin TK, Brocksen S, Avchen RN, Van Naarden Braun K (2006) Prevalence of four developmental disabilities among children aged 8 years – Metropolitan Atlanta Developmental Disabilities Surveillance Program, 1996 and 2000. MMWR Surveill Summ 55(1): 1–9Google Scholar
  5. Croen LA, Grether JK, Curry CJ, Nelson KB (2001) Congenital abnormalities among children with cerebral palsy: more evidence for prenatal antecedents. J Pediatr 138:804CrossRefGoogle Scholar
  6. de Vries LS, Eken P, Groenendaal F, van Haastert IC, Meiners LC (1993) Correlation between the degree of periventricular leukomalacia diagnosed using cranial ultrasound and MRI later in infancy in children with cerebral palsy. Neuropediatrics 24:263–268CrossRefGoogle Scholar
  7. Ellenberg JH, Nelson KB (2013) The association of cerebral palsy with birth asphyxia: a definitional quagmire. Dev Med Child Neurol 55:210CrossRefGoogle Scholar
  8. Executive summary: neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists’ task force on neonatal encephalopathy. (2014) Obstet Gynecol 123:896Google Scholar
  9. Grether JK, Nelson KB (1997) Maternal infection and cerebral palsy in infants of normal birth weight. JAMA 278:207CrossRefGoogle Scholar
  10. Lee RW, Poretti A, Cohen JS, Levey E, Gwynn H, Johnston MV, Hoon AH (2014) Fatemi . A diagnostic approach for cerebral palsy in the genomic era. NeuroMolecular Med 16(4):821–844CrossRefGoogle Scholar
  11. McCormick A, Brien M, Plourde J, Wood E, Rosenbaum P, McLean J (2007) Stability of the gross motor function classification system in adults with cerebral palsy. Dev Med Child Neurol 49:265–269CrossRefGoogle Scholar
  12. McMichael G, Bainbridge MN, Haan E et al (2015) Whole-exome sequencing points to considerable genetic heterogeneity of cerebral palsy. Mol Psychiatry 20:176CrossRefGoogle Scholar
  13. Miller G, Clark GD (1998) The cerebral palsies: causes, consequences, and management. Butterworth-Heinemann, BostonGoogle Scholar
  14. Moreno-De-Luca A, Ledbetter DH, Martin CL (2012) Genetic insights into the causes and classification of cerebral palsies. Lancet Neurol 11:283CrossRefGoogle Scholar
  15. Morris C, Bartlett D (2004) Gross motor function classification system: impact and utility. Dev Med Child Neurol 46:60–65CrossRefGoogle Scholar
  16. Msall ME, Limperopoulos C, Park JJ (2009) Neuroimaging and cerebral palsy in children. Minerva Pediatr 61(4):415–424Google Scholar
  17. Nelson KB, Ellenberg JH (1978) Epidemiology of cerebral palsy. Adv Neurol 19:421–435Google Scholar
  18. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, Brunstrom-Hernandez J, Cioni G, Damiano D, Darrah J, Eliasson AC, de Vries LS, Einspieler C, Fahey M, Fehlings D, Ferriero DM, Fetters L, Fiori S, Forssberg H, Gordon AM, Greaves S, Guzzetta A, Hadders-Algra M, Harbourne R, Kakooza-Mwesige A, Karlsson P, Krumlinde-Sundholm L, Latal B, Loughran-Fowlds A, Maitre N, McIntyre S, Noritz G, Pennington L, Romeo DM, Shepherd R, Spittle AJ, Thornton M, Valentine J, Walker K, White R, Badawi N (2017) Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr 171:897CrossRefGoogle Scholar
  19. O’Shea TM (2002) Cerebral palsy in very preterm infants: new epidemiological insights. Ment Retard Dev Disabil Res Rev 8:135CrossRefGoogle Scholar
  20. Palisano RJ, Cameron D, Rosenbaum PL, Walter SD, Russell D (2006) Stability of the gross motor function classification system. Dev Med Child Neurol 48: 424–428CrossRefGoogle Scholar
  21. Paneth N, Hong T, Korzeniewski S (2006) The descriptive epidemiology of cerebral palsy. Clin Perinatol 33(2): 251–267CrossRefGoogle Scholar
  22. Prechtl HFR, Einspieler C, Cloni G, Bos AF, Ferrari F, Sontheimer D (1997) An early marker for neurological deficits after perinatal brain injury. Lancet 349: 1361–1363CrossRefGoogle Scholar
  23. Razek AAK, Kandell AY, Elsorogy LG, Elmongy A, Basett AA (2009) Disorders of cortical malformation: MR imaging features. Am J Neuroradiol 30(1):4–11CrossRefGoogle Scholar
  24. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B (2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 109:8–14Google Scholar
  25. Schaefer GB (2008) Genetics considerations in cerebral palsy. Semin Pediatr Neurol 15:21CrossRefGoogle Scholar
  26. Segel R, Ben-Pazi H, Zeligson S et al (2015) Copy number variations in cryptogenic cerebral palsy. Neurology 84:1660CrossRefGoogle Scholar
  27. Whitehouse WP (2011) Metabolic testing in children with cerebral palsy: yield could be up to 20%. Dev Med Child Neurol 53(12):1160CrossRefGoogle Scholar
  28. Wu YW, Escobar GJ, Grether JK et al (2003) Chorioamnionitis and cerebral palsy in term and near-term infants. JAMA 290:2677CrossRefGoogle Scholar
  29. Zhou J, Butler EE, Rose J (2017) Neurologic correlates of gait abnormalities in cerebral palsy: implications for treatment. Front Hum Neurosci 11:103CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of NeurologyPerelman School of Medicine at University of Pennsylvania/Children’s Hospital of PhiladelphiaPhiladelphiaUSA

Section editors and affiliations

  • Steven J. Bachrach
    • 1
    • 2
  1. 1.Department of Pediatrics (Emeritus)Nemours/Alfred I. duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Sidney Kimmel Medical College of Thomas Jefferson UniversityPhiladelphiaUSA

Personalised recommendations