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Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
Published on: January 11, 2016
Establishing the diagnosis of cerebral palsy
1Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, Michigan 48823, USA. paneth@msu.edu
Insights
Diagnosing cerebral palsy (CP) requires careful consideration, avoiding early conclusions in infants and excluding other conditions. Confirmation by specialists and assessment of activity limitation are crucial for accurate CP diagnosis.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Background:
- Cerebral palsy (CP) presents diagnostic challenges for obstetricians.
- Early neuromotor abnormalities can resolve, particularly in premature infants.
- Differentiating CP from genetic/metabolic disorders with similar symptoms is essential.
Purpose of the Study:
- To highlight the complexities in diagnosing cerebral palsy.
- To emphasize the importance of experienced practitioners in confirming CP diagnosis.
- To guide the appropriate timing and criteria for diagnosing CP.
Main Methods:
- Clinical assessment by experienced practitioners (child neurologists/psychiatrists).
- Exclusionary diagnostic process for genetic and metabolic disorders.
- Characterization of activity limitation alongside examination findings.
- Utilization of brain imaging for identifying brain abnormalities.
Main Results:
- Diagnosis of CP can be challenging and may require expert confirmation.
- Premature infants may show resolution of early neuromotor abnormalities, necessitating caution in early diagnosis.
- Abnormal examination findings alone are insufficient for a CP diagnosis; activity limitation must be evident.
- Brain imaging aids in locating brain abnormalities and can offer etiological insights.
Conclusions:
- Accurate cerebral palsy diagnosis requires specialized expertise and should not be made prematurely.
- Excluding other conditions and confirming functional activity limitations are critical components of the diagnostic process.
- Brain imaging serves as a valuable tool in the etiological investigation of cerebral palsy.
Abstract:
Cerebral palsy (CP) is a diagnosis of considerable concern to obstetricians, but the diagnosis of CP can be challenging, and may need to be confirmed by an experienced practitioner, ideally a child neurologist or psychiatrist. It is important not to make the diagnosis too early in infancy, especially when the signs are not severe, as resolution of early neuromotor abnormalities does occur, particularly in premature infants. Exclusion of genetic/metabolic disorders presenting with CP-like findings is important. The degree of activity limitation should be characterized; labeling children as having CP on the basis of abnormal examination findings alone without evidence of activity limitation is not useful. Brain imaging can be helpful in pinpointing the location of the underlying brain abnormality and sometimes provides etiologically useful information.
