Diagnosing cerebral palsy

Signs of cerebral palsy (CP) may not be present or detected at birth. A doctor may closely monitor a newborn or child for signs of CP if he or she has known risk factors. These factors may be related to problems during pregnancy or birth, being born early (premature birth), or problems that occur within the first 2 or 3 years of life.

Health professionals use caution in diagnosing CP too early because some babies who have motor skill abnormalities soon after birth never develop CP.

Sometimes symptoms may not appear until the nervous system matures with the continual growth of the brain, nerves, and muscles. It can take up to a few years before doctors determine whether a baby with body movement and posture (motor) problems has CP.

Cerebral palsy is diagnosed based on observations of a baby's or young child's physical development delays or irregularities, medical history, a physical examination, screening tests, and other tests, such as MRI. Specifically, these tests include:

• Asking questions about the child's medical history, including details about the mother's pregnancy. Developmental delays are often reported by parents or observed by a health professional during routine well baby checks. These visits are also an opportunity for health professionals to watch your baby and ask details about his or her sensory and motor skills, especially those that are expected to occur during the first year or second year.
• A physical examination to look for signs of CP. During a physical exam, a health professional evaluates whether a child retains newborn reflexes longer than normal, which can be an indication of CP. Postures and basic muscle function, hearing, and vision are usually also assessed.
• Screening tests. Your health professional will recommend developmental questionnaires and other tests to help determine the extent of developmental delays and whether they should be further evaluated.
• Magnetic resonance imaging (MRI) of the head, which may be done to identify brain abnormalities.

Taken together, results of these tests can point toward a diagnosis of CP.⁷

If diagnosis is unclear, additional tests may be done to evaluate the brain and possibly rule out other conditions. Sometimes, results from these tests can also be useful in evaluating the severity of CP. Tests may include:

• Additional developmental questionnaires.
• Computed tomography (CT) scan of the head.
• Ultrasound of the brain.

Evaluating and monitoring cerebral palsy

After CP is diagnosed, a child will also be screened for other medical conditions that can occur with cerebral palsy, such as:

• Other developmental delays in addition to those that have already been identified. Developmental abilities will be assessed periodically to determine whether new symptoms, such as speech and language delay, appear as a child's nervous system matures.
• Intelligence testing, to identify below-normal intelligence (mental retardation).
• Seizures. An electroencephalography (EEG) is used to check for abnormal activity in the brain if a child has a history of seizures.
• Problems with feeding and swallowing.
• Vision or hearing problems.
• Psychological evaluation, for any behavioral problems.