Neurology- CP

Ask a PT

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Posted - 09/07/2006 :  13:45:04  Show Profile  Reply with Quote
Our user asked: "What is the physical examination for a 1 yr old cerebral palsy child and how will you diagnose the type of cerebral palsy?Plz clarify this dout sir."

Ask a PT Response: "It is not in the realm of qualifications for physical therapists to diagnose cerebal palsy. A diagnosis is hard to come by and must come from a physician and other specialists after careful review and conduction of various tests. According to the National Institute of Neurological Disorders and Stroke "Cerebral palsy is an umbrella-like term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. The disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain's ability to control movement and posture. Symptoms of cerebral palsy include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance or walking, involuntary movements. The symptoms differ from person to person and may change over time. Some people with cerebral palsy are also affected by other medical disorders, including seizures or mental impairment, but cerebral palsy does not always cause profound handicap. Early signs of cerebral palsy usually appear before 3 years of age. Infants with cerebral palsy are frequently slow to reach developmental milestones such as learning to roll over, sit, crawl, smile, or walk. Cerebral palsy may be congenital or acquired after birth. Several of the causes of cerebral palsy that have been identified through research are preventable or treatable: head injury, jaundice, Rh incompatibility, and rubella (German measles). Doctors diagnose cerebral palsy by testing motor skills and reflexes, looking into medical history, and employing a variety of specialized tests. Although its symptoms may change over time, cerebral palsy by definition is not progressive, so if a patient shows increased impairment, the problem may be something other than cerebral palsy."

Cerebal palsy can be classified by area of the body with impairment and includes: 1) monoplegia (one limb) 2) diplegia (lower limbs) 3) hemiplegia (upper and lower limbs on one side of the body) & 4) quadriplegia (all limbs). It can also be classified by the most obvious impairment resulting from common brain damage: 1) spastic CP 2) dyskinesia or athetoid CP 3) ataxic CP & 4) hypotonic CP.

Developmentally in a typical "normal" 8-12 month year old, you can expect to see (just to name a few): creeping (quadruped), frequent transitions from 4 point to sit to pull to stand, beginning to cruise and walk with hands held, reaching way from body, lateral trunk flexion + trunk rotation. A child with CP most likely would not posess these skills. I hope this answers your question."