observations of movement and imaging tests used in diagnosis of
complications of cerebral palsy.
six ways in which cerebral palsy can be prevented.
describe the six types of treatment that may be used.
Click here to revisit the
web site on cerebral palsy: . Note that
all quotations in the following sections are from this site.
become concerned about their baby’s or toddler’s development if the
child is having problems learning to roll over, sit, crawl or walk.
Parents always should discuss these concerns with their baby’s
is diagnosed mainly by evaluating
how a baby or young child
moves. The doctor will evaluate the child’s
muscle tone, which can make them appear floppy. Others have increased
muscle tone, which makes them appear stiff, or variable muscle tone
(increased at times and low at other times). The doctor will check the
child’s reflexes and look to see if the baby has developed a preference
for using his right or left hand. While most babies do not develop a
hand preference (become right- or left-handed) until at least 12 months
of age, some babies with cerebral palsy do so before six months of age.
Another important sign of cerebral palsy is the persistence of certain
reflexes, called primitive reflexes, that are normal in younger
infants, but generally disappear by 6 to 12 months of age. The doctor
also will take a careful medical history, and attempt to rule out any
other disorders that could be causing the symptoms.
also may suggest brain imaging tests such as magnetic resonance imaging
computed tomography (CT
or ultrasound. These tests sometimes can help
identify the cause of cerebral palsy. Ultrasound often is recommended
in preterm babies who are considered at risk of cerebral palsy to help
diagnose brain abnormalities that are frequently associated with
cerebral palsy (allowing therapy to begin early). In some children with
cerebral palsy, especially those who are mildly affected, brain imaging
tests show no abnormalities, suggesting that microscopically small
areas of brain damage can cause symptoms. About half of babies who are
diagnosed with mild cerebral palsy appear to outgrow their
The health care team. A team
of professionals works with the child and family to develop a
needs-based individualized treatment plan. “The team is generally
coordinated by one health care professional and may include
pediatricians, physical medicine and rehabilitation physicians,
orthopedic surgeons, physical and occupational therapists,
ophthalmologists, speech/language pathologists, social workers and
psychologists.” Dentists also play an important role.
Physical therapy. Physical therapy is usually begun
immediately after diagnosis. Physical therapy “enhances motor skills
(such as sitting and walking), improves muscle strength and helps
prevent contractures (shortening of muscles that limits joint
movement).” Braces, splints or casts may also be used “to help prevent
contractures and to improve function of the hands or legs. If
contractures are severe, surgery may be recommended to lengthen
Drugs. They are sometimes used to dampen
spasticity and decrease abnormal movement. While oral drug treatment is
often “not very helpful,” intramuscular injection with Botox (botulinum
toxin) may prove helpful for a period of several months, making
physical therapy more effective. Finally, “a new type of drug treatment
is showing promise in children with moderate to severe spasticity.
During a surgical procedure, a pump is implanted under the skin that
continuously delivers the anti-spasmodic drug baclofen.”
dorsal rhizotomy is a surgical technique used with some children with severe spasticity
that affects both legs and has not responded to alternative treatments.
This technique “may permanently reduce spasticity and improve the
ability to sit, stand and walk. In this procedure, doctors identify and
cut some of the nerve fibers that are contributing most to spasticity.
This procedure usually is done when a child is between 2 and 7 years of
Occupational therapists assist the
child to learn basic skills such as feeding, dressing, hygiene, etc.
Speech therapists assist children with speech problems. Increasingly,
in severe cases, children may be taught to use a computerized voice
synthesizer to generate speech.
Mechanical aids. These
include “walkers, positioning devices (to allow a child with abnormal
posture to stand correctly), customized wheelchairs, specially adapted
scooters and tricycles.”
Click here to visit the
National Institute of Neurological Disorders
and Stroke web site, which
provides more information on cerebral