How is cerebral palsy diagnosed?
Cerebral palsy is not usually diagnosed at birth. Babies with severe cerebral palsy may have signs at birth that are obvious, such as very abnormal muscle stiffness (tone). However, most children are diagnosed between the ages of 6 months and 2 years.
Possible early signs that a baby may have cerebral palsy include:
- Unusual fidgety movements.
- Other abnormal movements, including not moving very much, or mainly moving one side of the body.
- Abnormal muscle tone - for example, reduced tone or appearing floppy (hypotonia), increased tone or stiffness (spacticity) or changing tone between being floppy and stiffness (dystonia).
- Abnormal development - for example, late with head control, rolling and crawling
- Feeding difficulties.
The most common delayed motor milestones for children with cerebral palsy are:
- Not sitting by 8 months. For premature babies, this time should be corrected for the child's age at birth (gestational age) - for example, it would be 10 months for a baby born two months early.
- Not walking by 18 months (corrected for gestational age).
- Preferring to use one hand rather than the other hand (hand preference) before the age of 1 year (corrected for gestational age).
There are variations and some babies are normal but late developers. However, a child who is late in these developmental milestones should usually be assessed for cerebral palsy. The diagnosis can usually be made by a child specialist, from the symptoms, signs and delay in development.
The diagnosis is mainly by careful examination and assessment of development. However, additional tests such as blood tests or a brain scan may be done if the cause of cerebral palsy is not clear. Other tests may also be needed if it is thought that there may be a different diagnosis other than cerebral palsy.
Further reading and references
Cerebral palsy in under 25s: assessment and management; NICE Guidance (January 2017)
Spasticity in children and young people; NICE Clinical Guideline (July 2012, updated Nov 2016)
Hadders-Algra M; Early diagnosis and early intervention in cerebral palsy. Front Neurol. 2014 Sep 245:185. doi: 10.3389/fneur.2014.00185. eCollection 2014.
Fairhurst C; Cerebral palsy: the whys and hows. Arch Dis Child Educ Pract Ed. 2012 Aug97(4):122-31. doi: 10.1136/edpract-2011-300593.
Surman G, Hemming K, Platt MJ, et al; Children with cerebral palsy: severity and trends over time. Paediatr Perinat Epidemiol. 2009 Nov23(6):513-21. doi: 10.1111/j.1365-3016.2009.01060.x.
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