Cerebral palsy (CP) refers to a group of neurological disorders caused by damage or abnormalities in the developing brain. CP appears in early childhood and affects body movement and muscle coordination, and causes delays in reaching developmental milestones.
Confirming a CP diagnosis often takes months following regular screening for mental and motor development. A diagnosis is usually confirmed within the first two years of life. However, milder forms can take up to five years to diagnose.
With no one definitive diagnostic test for CP available, doctors usually rely on several tests to rule out or confirm CP. The child may be referred to specialists such as a child neurologist, a developmental-behavioral pediatrician, an ophthalmologist, or an otologist for diagnostic tests.
Preliminary examination
During a preliminary examination, the doctor observes certain aspects of the child during scheduled well-baby visits before CP is even suspected. These include:
- Checking for CP symptoms
- Reviewing the medical history of the parents and the child
- Ascertaining incidents during pregnancy that are likely to cause CP
- Checking whether the child has reached appropriate growth and developmental milestones
- Examining the child’s muscle tone, posture, coordination, and balance
- Observing movement control
- Checking for hearing or vision problems
Developmental screening
Developmental screening usually consists of interviews or questionnaires to help the doctor understand the child’s progress in achieving developmental milestones. Parents are interviewed while children are given specific tasks to perform.
These screenings are recommended during well-baby visits at ages nine months, 18 months, and 24 or 30 months. By the end of 30 months, most motor delays can be identified.
Brain scans
Brain scans can reveal signs of brain injury or malformation. Commonly used scanning methods for CP diagnosis are summarized below.
Magnetic resonance imaging
Magnetic resonance imaging (MRI) is a non-invasive imaging technique that uses strong magnetic fields and radio waves to generate detailed images of the brain and other organs to identify lesions and other abnormalities. The child may be given a sedative or light general anesthesia before the procedure.
In some cases, a functional MRI (fMRI) is used to determine how each part of the brain handles activities such as speech and motor movements.
Cranial ultrasound
Cranial ultrasound is a method of using reflected sound waves to create an image of the brain and its internal fluid-filled chambers called ventricles. A cranial ultrasound does not produce as detailed an image as an MRI but is quick and relatively inexpensive.
Since ultrasounds cannot pass through bones, a cranial ultrasound has to be done before the bones of the cranium fuse together in early childhood or in premature babies. The procedure helps to look for premature birth defects in the brain, such as periventricular leukomalacia (damage to the tissue around the brain ventricles due to lack of blood supply or oxygen) and intraventricular hemorrhage (bleeding in the brain).
Computerized tomography
Computerized tomography (CT) is a non-invasive computerized X-ray imaging technique that is used to generate cross-sectional images or visual slices of organs such as the brain. These visual slices are stacked together to create a three-dimensional image that provides more information about brain malformations than a conventional X-ray.
The CT procedure is similar to an MRI in that the child may be mildly sedated so that he or she remains still during the scan, which usually lasts for 15 to 20 minutes.
Electroencephalogram
An electroencephalogram (EEG) detects the electrical activity in the brain, which is captured via small metal discs that are attached to the scalp. The pattern of electrical activity helps in diagnosing brain disorders and checks for signs of epilepsy.
Laboratory tests
Blood, urine, or skin samples may be taken to conduct routine laboratory tests to screen for genetic or metabolic problems and rule out other conditions that can cause similar symptoms to CP.
Last updated: Feb. 24, 2020
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