Diagnosing cerebral palsy
A doctor diagnoses CP based on:
- Questions about the child's medical history, including details about the mother's pregnancy.
- A physical exam to look for signs of CP. The doctor will look to see if the child retains newborn reflexes longer than normal. This can be a sign of CP. Postures and basic muscle function, hearing, and vision are usually checked.
- Screening tests. Developmental questionnaires and other tests may be done.
- MRI of the head. This test can find brain abnormalities.
If the diagnosis is unclear, more tests may be done. Sometimes these tests can help find out the severity of CP.
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.
Doctors are careful not to diagnose CP too early, because some babies who have motor skill problems soon after birth never get CP.
Sometimes symptoms may not appear until the nervous system matures. It can take up to a few years before doctors can tell if a baby with body movement and posture (motor) problems has CP.
Evaluating and monitoring cerebral palsy
- Other developmental delays in addition to ones already found. Developmental abilities will be checked to find out if new symptoms, such as speech and language delay, appear as a child's nervous system matures.
- Intellectual disability. This can be checked by intelligence testing.
- 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.
- Behavioral problems.
Most of the time, a doctor can predict many of the long-term physical effects of CP when a child is 1 to 3 years old. But sometimes such predictions aren't possible until a child reaches school age. That's when learning, communication skills, and other abilities can be checked.
Some children need repeated testing that may include:
- X-rays, to check for loose or dislocated hips. Children with CP are usually X-rayed several times during ages 2 to 5. Spinal X-rays also are done to look for curves in the child's spine (scoliosis).
- Gait analysis. This helps identify problems and guide treatment decisions.
Other tests may be needed, depending on a child's symptoms, other conditions, or medicines he or she takes.