Cerebral Palsy Diagnosis

Parents are often the first to notice that their child has a developmental problem. A parent may be concerned if his or her child is slow to roll over, sit up, handle a fork, or learn other early skills. Parents may also be worried about their child’s muscle tone, level of irritability, posture, or ability to swallow. For some children, these problems are symptoms of cerebral palsy. Although developmental problems may be observed early in a child’s life, a physician will often hold off on making a formal diagnosis of cerebral palsy until the child’s development has stabilized. This normally occurs before a child reaches the age of three.

When diagnosing a child’s condition, a doctor will perform physical tests, investigate whether or not the child has any associated conditions (like seizures or mental impairment), review the child’s medical history, and arrange for the child to undergo MRI, CT, or ultrasonography testing.

Physical Tests

When determining whether or not a child has cerebral palsy, a doctor will check the child’s physical health and development, paying careful attention to the following:

• The child’s muscle tone – Children with cerebral palsy may have decreased muscle tone (hypotonia), or increased muscle tone (hypertonia). Some children may experience a shift from hypotonia to hypertonia early in their development.
• Tendency of the child to favor one side of the body – Children with spastic hemiplegia and other forms of cerebral palsy may prefer to use one side of their body over the other. During testing a doctor will observe the child’s posture and test to see if he or she prefers one hand to the other. Children with cerebral palsy tend to exhibit hand preference earlier than other children.
• The child’s Moro reflex – The Moro reflex causes infants to raise their arms when laid with their feet above their heads. Normally infants will lose this reflex after six months, but an infant with cerebral palsy will exhibit the reflex for an extended period of time.
• Worsening of developmental problems – Cerebral palsy is not a progressive condition, and thus worsening symptoms are an indication that a child does not have cerebral palsy.

Associated Conditions

A doctor will check for signs of mental impairment, vision problems, hearing problems, dysphagia, and seizures when diagnosing cerebral palsy.

Medical History

A doctor will review an infant’s medical history when determining the root of his or her developmental problems. Special attention is paid to:

• The infant’s APGAR score – Immediately after a child’s birth, and again five minutes later, his or her activity or muscle tone, pulse, grimace or reflex irritability, appearance, and respiration are scored. The score measures the child’s health. A child with CP will often receive a low APGAR score.
• Irregular problems related to pregnancy, labor, or delivery – Problems during pregnancy, labor, or delivery can cause brain damage to infants. Oxygen deprivation is a major cause of brain damage, but Rh incompatibility, jaundice, and bacterial infections may also cause problems.
• Any injuries sustained during or shortly after birth – Brain injuries occurring after birth may permanently impede an infant’s development.

Brain Tests

To determine the extent of brain damage a child has suffered, a doctor will normally advise that he or she receive a CT scan, MRI scan, or ultrasonography test. CT scans identify cysts and areas of abnormal growth in the brain through X-ray imaging. MRI (magnetic resonance imaging) scans produce a better image of abnormal brain growth close to bone tissue. Ultrasonography tests form sonograms by measuring the time sound waves take to bounce off of structures and growths in the brain.

Doctors and parents may identify developmental delay in an infant early on, but a formal diagnosis of cerebral palsy will usually not be made until the child’s development has stabilized. Find more information here about how cerebral palsy is diagnosed.