Diagnosis of Cerebral Palsy

 In Cerebral Palsy

Diagnosis of cerebral palsy is being made on the basis of symptoms and sign. Detail history from the parents is very important. In history we would like to know mother condition during pregnancy, ANC checkup, immunization of mother, any adverse event at time of birth, history of delayed cry, low birth weight, premature, infection, trauma, and aspiration in new born. We would also like to know about progress of child since birth, social response, development milestone, feeding, muscle tone, persistence of abnormal primitive reflexes etc. Most of the time diagnosis can be made very early between age of 6 months to 1 year. But some time in very mildly affected children it became very difficult to make correct diagnosis before 1 year of age.  

Test to Diagnosis Cerebral Palsy 

                  Detail history & examination is sufficient to make primary diagnosis. Most of time investigation is not required but still we need some pathological investigation few children. Few scoring and assessment system like GMFM scoring, house hand scoring, pediatric scoring are helpful in assessing the child clinically. Ultrasound brain is helping only in early infancy. MRI brain is required to see pathological changes in brain and structural abnormality. Metabolic blood investigation is required some time to rule out metabolic problem in child. Genetic evaluation is required to see genetic abnormality in child. X-ray of pelvis is required to see hip dislocation, subluxation and foot problem. Blood investigation is required to assess thyroid, vitamin D and general condition of child.     

Treatment for Children and Adults 

               Cerebral palsy children require early identification so that early intervention can start. It has been seen that when we provide early intervention by the good modality of rehab measure between 6months to 1 year then more than 80% children can have good recovery. These children require good therapy from their early age. But tradition therapy including stretching and joint mobilization do more harm than benefit so it should be utilised. Initially our focus should be on correction of primitive reflexes and abnormal tone in body by different measure and simultaneously they should be given training in normal milestone like creeping, crawling, knee walk, walking and hands activities. Very few children require botulinum toxin and surgery. Braces are required for few year. Treatment of adults with cerebral palsy is based their severity, achieved developmental milestone and fix deformity. If they have good development milestone but deformity is interfering then surgery can helps a lots but they need long term physical therapy, yoga and gym.

Can Medications help in Cerebral Palsy

       Medication is required to treat associated medical problem of child. Anti spastic medicine is required to treat spasticity but not so helpful. Still we are using it after surgery and painful spasm etc. Few medicines is also helpful in managing dyskinetic movement disorder. Dribbling of saliva can also be managed by medicine. Most of the medicine have side effect so not so commonly used. Calcium and vitamin D supplements are very necessary in these children. Anti epileptics drugs are required to control seizure and continued for long. These medicine not should be started on own and nor should be stopped without consultation with specialist.

Therapies can help Cerebral Palsy Patients

                  Therapies are the primary mode of treatment in cerebral palsy. It includes physical therapy, occupational therapy and speech therapy. Many advance therapeutic modality has develop in last two decade. It helps in improving physical condition of child, functional activities, activities of daily life, speech, deglutition, ambulation etc. Therapist should assess and examining the child in detail before starting the therapy. Every child need separate set of therapy and it should be focus to correct specific problem present in child. Parents should also learn all needed therapy methods. Therapy in these children is needed for whole life but with specific pattern of required at specific age. Training in activities of daily life should be part of therapy session. Sport activities for cp children are very important to boost-up their moral and increase their stamina and participation in society.

Surgical or other Procedure in CP

        Physical therapy is mainstay in treatment of cerebral palsy but if child have spasticity they need botulinum toxin and plaster. But repeated injection is avoided otherwise it cause muscle weakness. Surgery is needed once child develop fix deformity, muscle contracture, joint dislocation, bony torsion. These problem develop in spastic and mixed variety but not in dyskinetic. Usually we defer surgery before the age of 7 year except hip dislocation. Surgery is not needed in every children with cerebral palsy. Now days with the new concept usually we avoid doing muscle surgery and focus more on bony surgery so those children don’t get muscle weakness and faster recovery. Only placed we do muscle surgery with advance modification. Even in muscle surgery we don’t prefer tenotomy but fascial release and tendon transfer. Well perform surgery with good post op rehab give excellent outcome.

If your family doctor or pediatrician presumes your child has cerebral palsy, and the doctor will evaluate your child’s signs and symptoms, review your child’s medical history, and conduct a physical evaluation. Your doctor may refer you to a specialist trained neurologist in treating children with brain and nervous system conditions.
Your doctor will also prescribe a series of tests to make a Cerebral Palsy diagnosis and rule out other possible causes.

Cerebral Palsy Diagnosis

The procedure around a Cerebral Palsy Diagnosis

The whole procedure for Cerebral Palsy diagnosis includes monitoring the child’s development and watching possible signs. If your baby is born prematurely, or with low weight, he or she has monitored some neurological disability, so don’t waste time and visit the nearest hospital or pediatric neurologist.
In the event that the newborn child goes to standard well-infant visits, amid examination of the kid the pediatrician might be first to see indications of Cerebral Palsy. Sometimes, the guardians see manifestations they hand-off to the youngster’s specialist.
Guardians are regularly getting down to discover that there is no particular test that will completely determine a tyke to have Cerebral Palsy. Once a series of therapeutic thought is started so as to shape a diagnosis, guardians get ready for a long and at times disappointing procedure that will, in time, give answers about a youngster’s condition.
The diagnosis procedure can appear to be scaring. Understanding the diagnosis procedure can be a wellspring of solace for guardians on edge about the procedure.
Here, are some easy step for Cerebral Palsy diagnosis:
• Parent Observation
• Doctor Observations
• Motor Skill Development Analysis
• Medical History Review
• Documenting Associative Conditions, Co-Mitigating Factors, and Ruling-Out Other Conditions
• Obtaining Test Results
• Diagnosis
• Obtaining a Second Opinion
• Determining Cause
• Care Team Assembly
• Care Plan Creation

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