Strategies for the early diagnosis of cerebral palsy.
Abstract Strategies for the early detection and diagnosis of cerebral palsy include multiple measures of the underlying brain abnormalities and their neurodevelopmental consequences. These measures can be grouped into the categories of pathogenesis, impairment, and functional limitation. Neuroimaging techniques are the most predictive measures of pathogenesis of cerebral palsy in both the preterm and term infant. Measures of neurological impairment focusing on muscle tone, reflexes, and other features of the neurological examination are poorly predictive in the first months of life. Detection of functional limitations manifested by motor developmental delay is sensitive and specific for later cerebral palsy, but not until well into the second 6 months of life. Abnormal spontaneous general movements in the infant 16 to 20 weeks postterm and earlier reflect functional limitations in the first months of life and have been shown to predict later cerebral palsy. Recognition of abnormal spontaneous general movements may improve early detection and diagnosis of cerebral palsy if these techniques can be successfully incorporated into organized follow-up programs and developmental surveillance.
Palmer
Frederick B
FB
Boling Center for Developmental Disabilities, University of Tennessee Health Science Center, Memphis, Tennessee 38105, USA. fpalmer@utmem.edu
D000203:Activities of Daily Living; D000367:Age Factors; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D042241:Early Diagnosis; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D009048:Motor Skills; D015997:Neonatal Screening; D009460:Neurologic Examination; D009485:Neuroradiography; D011187:Posture; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D017585:Ultrasonography, Doppler, Transcranial; D014743:Videotape Recording