Cerebral Palsy Diagnosis - Medical Negligence Solicitor - Compensation Lawyers

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The process of cerebral palsy diagnosis takes time. It is common for a doctor to take several months to make a clear diagnosis and even instruct parents to wait for up to three years before making a final decision. Even when a diagnosis is reached, doctors will often not issue a definitive prognosis immediately. This is due mainly in part to recovery of the child’s central nervous system, either partially or completely, following an injury.

Recovery?

The brains of young children are much more capable of repairing themselves than brains of adults. Should a brain injury happen early in life, the undamaged area of the brain might repair the damage by, in some cases, taking over some of the compromised functions. Even though there may be residual motor impairment, the child is often able to make great strides in developing basic motor skills.

Re-organisation

Another reason doctors may delay concluding a cerebral palsy diagnosis is because the nervous system of children tends to “organize” with time. This means brain damage can affect motor abilities quite differently. For example, involuntary movements can become more obvious, or tone can change from low to high, or vice versa. In most cases, a child’s motor skills stabilize by the age of two to three years. After age three, tone will more than likely remain constant.

Early Diagnosis?

This may leave you wondering, what exactly does all of this mean? It merely indicates it is nearly impossible to make an early diagnosis. The extent of your child’s disability will more than likely not become clear for a long period of time, and his or her symptoms need to monitored by parents and health care professionals. Usually a group of health care professionals that specialize in different areas of cerebral palsy will be in charge of evaluation. These professionals will collect information based upon the child’s age and accomplishments, and then compare these findings over the course of months and years.

Assessment & Evaluation

This information is complied into a report to track the needs and physical condition of the child. The report will also include completed medical tests, as well as documentation of any other possible medical explanations for the symptoms. When making a diagnosis of cerebral palsy, this team of medical professionals will first conduct a basic assessment to evaluate the child’s precise needs and strengths in all areas of development. As the child continues to age, further assessments are made.

Definitive Diagnosis

Diagnosis may take time following a thorough examination of the child’s overall health condition. Doctors will regularly test the development of your child’s motor skills and carefully study the medical history. They will be on the lookout for unusual posture, slow development and abnormal muscle tone. When making a definitive diagnosis, doctors have to rule out any other possible medical condition that may cause abnormal muscle movement. Since cerebral palsy is non-progressive, meaning it does not become worse with time; doctors have to verify your child’s issues are not worsening.

Specialist Testing

The process of diagnosing cerebral palsy will involve specialized tests. The doctor may order a CT (computed tomography) scan, which provides an image of the brain that can identify undeveloped or poorly developed brain tissue areas. The doctor may also order an MRI (magnetic resonance imaging) test, which also provides an image of the brain that can be used to view damaged areas. Along with imaging tests, intelligence tests may also be conducted. These tests help to determine how the child compares mentally to other children of a similar age. A complete review of the mother’s health during pregnancy, along with the labour and delivery process, may also be carried out.

Cerebral Palsy Overview

What is cerebral palsy?

Cerebral palsy is a movement disorder that can affect the muscle tone or posture of an infant and child secondary to brain damage that happens to an immature brain before birth, at the time of birth or shortly after birth.

The symptoms don�t usually show up right away but can take several months or even a couple of years to manifest themselves after the insult. In cerebral palsy, the individual often manifests themselves as having hyperactive reflexes, rigidity or floppiness of the trunk and limbs, deformed posture, unsteady gate, and/or involuntary movements.

A child with cerebral palsy can have swallowing difficulties and imbalances of the eyes that affect vision. The total effect on the body varies significantly from kid to kid. Some children learn to walk while others do not. Some have normal intellect, while others have diminished intellect. Still others suffer from blindness, deafness or epilepsy. Brain abnormalities are almost always present.

The signs and symptoms of cerebral palsy are different depending on the insult and when the damage took place. Symptoms include the following:

• Spasticity of the muscles
• Stiff or floppy muscles
• Rigidity of the muscles with normal reflexes
• Inability to coordinate the muscles
• Involuntary movements
• Tremors that can�t be controlled
• Being delayed in reaching milestones
• Having athetosis, which are slow writhing movements of the body
• Difficulty walking or having an unusual gate
• Favoring one side of the body over the other
• Drooling caused by swallowing problems
• Problems with sucking behavior or eating
• Speech problems, including a speech delay
• Difficulty with fine motor action skills

Cerebral palsy can involve just arm or just one leg, three extremities, half of the body or the entire body. Because cerebral palsy isn�t progressive, once the disease manifests itself it doesn�t get either worse or better with age.

Neurological Problems

Because cerebral palsy is caused by a brain injury, other neurological conditions can take place alongside the cerebral palsy. These include vision and hearing deficits, seizures, cognitive disorders, mouth problems, Pain or touch disabilities, mental health problems and incontinence of urine.

Causes of Cerebral Palsy

There are a number of causes of cerebral palsy, many that happen before a baby is born. Some can occur due to damage at the time of birth from oxygen deprivation in a difficult birth or delivery. Other causes of cerebral palsy include the following:

• A genetic defect such as a random gene mutation that affects the development of the brain.
• Infections in the mother that travel to the developing foetus.
• A stroke in the foetal brain.
• Asphyxia or lack of oxygen during labour and delivery.
• Infant infections after birth that affect the brain or the lining around the brain (meningitis)
• A head injury in an infant due to child abuse, a fall, or a motor vehicle accident.

A mother�s health in pregnancy can affect her ability to pass on the propensity to get cerebral palsy in her infant. This can include getting German measles or rubella in pregnancy. This can strongly lead to birth defects in the infant and is why it is recommended that all children get immunized against German measles. The chicken pox virus can also lead to pregnancy risks of birth defects in a fetus but it is less risky than German measles. Cytomegalovirus is a virus that can lead to birth defects if the mother has the infection in her first trimester or has never had the infection before. Toxoplasmosis and syphilis can cause problems in pregnancy and exposure to toxins like mercury and lead can possibly cause cerebral palsy. Thyroid problems in pregnancy can lead to cerebral palsy in infancy.

Illness in Infancy

There are certain illnesses in infancy that can contribute to getting cerebral palsy. These include bacterial meningitis or an infection that affects the lining of the brain, viral encephalitis, which is a viral infection of the brain and spinal cord, and jaundice or yellowing of the skin that can cause cerebral palsy in conditions that are not adequately treated.

There are other factors that can lead to cerebral palsy if present in a pregnancy or birth. These include having a premature baby earlier than 37 weeks gestation or three weeks premature. There can also be a risk of cerebral palsy if the baby is born weighing less than five and a half pounds or 2.5 kilos. The smaller the baby, the greater is the risk of cerebral palsy. Babies have an increased risk of preterm birth if the foetus is in the breech presentation for the birth. This is the feet first position. If there are more babies than one in the pregnancy, each has an increased risk of cerebral palsy. If one of the babies dies, the risk is higher that the surviving babies will have cerebral palsy.

As the Child Grows Up

The child growing up with cerebral palsy can have some of the following complications when in childhood or adulthood:

• Malnutrition can happen in a child who has had swallowing or eating problems during life. This is especially a problem in infancy, when the suck reflex can be diminished but these children can have lifelong feeding difficulties leading to growth impairment or osteoporosis.
• Contractures involve shortening of a part of a limb so that the arm or leg is permanently bent and unable to get out of that position. It can result in dislocation or deformity of a joint, bending of bones and inhibition of bone growth.
• Lung problems can stem from cerebral palsy. These people can develop inability to breathe properly and need to wear oxygen at night or throughout the day.
• Mental health problems. People with cerebral palsy are prone to depression and loneliness due to social isolation. They have challenging physical conditions that can lead to mental conditions.
• Neurological disorders can develop and can get worse over time. These can include nerve-related movement disorders.
• Arthritis. Because there is a lot of pressure on the joints, the joints can become arthritic, even at an early age. This develops out of the muscle spasticity that so many with cerebral palsy have.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here