An algorithm for identifying and classifying cerebral palsy in young children.
OBJECTIVE
To develop an algorithm on the basis of data obtained with a reliable, standardized neurological examination and report the prevalence of cerebral palsy (CP) subtypes (diparesis, hemiparesis, and quadriparesis) in a cohort of 2-year-old children born before 28 weeks gestation.


METHODS
We compared children with CP subtypes on extent of handicap and frequency of microcephaly, cognitive impairment, and screening positive for autism.


RESULTS
Of the 1056 children examined, 11.4% (120) were given an algorithm-based classification of CP. Of these children, 31% had diparesis, 17% had hemiparesis, and 52% had quadriparesis. Children with quadriparesis were 9 times more likely than children with diparesis (76% versus 8%) to be more highly impaired and 5 times more likely than children with diparesis to be microcephalic (43% versus 8%). They were more than twice as likely as children with diparesis to have a score <70 on the mental scale of the BSID-II (75% versus 34%) and had the highest rate of the Modified Checklist for Autism in Toddlers positivity (76%) compared with children with diparesis (30%) and children without CP (18%).


CONCLUSIONS
We developed an algorithm that classifies CP subtypes, which should permit comparison among studies. Extent of gross motor dysfunction and rates of co-morbidities are highest in children with quadriparesis and lowest in children with diparesis.
Kuban
Karl C K
KC
Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, Boston, MA, USA. karl.kuban@bmc.org
Allred
Elizabeth N
EN
O'Shea
Michael
M
Paneth
Nigel
N
Pagano
Marcello
M
Leviton
Alan
A
D000465:Algorithms; D016251:CD-ROM; D002547:Cerebral Palsy / Q000145:classification* / Q000453:epidemiology; D002675:Child, Preschool; D015897:Comorbidity; D006429:Hemiplegia / Q000453:epidemiology; D006801:Humans; D008831:Microcephaly / Q000453:epidemiology; D009460:Neurologic Examination; D015995:Prevalence; D011782:Quadriplegia / Q000453:epidemiology