Diagnosing Cerebral Palsy

Most cerebral palsy diagnoses happen within the first two years of a child’s life, but it is possible to positively diagnose it earlier if a doctor suspects a child has developed cerebral palsy from a labor or delivery complication or injury. Depending on the severity of a child’s symptoms, a diagnosis may take longer. In some cases, mild symptoms of cerebral palsy may prevent an attending physician from confirming a diagnosis until age four or five.

Monitoring Child Development

If the symptoms of cerebral palsy are not immediately obvious after birth, a child’s pediatrician can detect warning signs during standard well visits. Pediatricians check many aspects of a child’s growth during these visits including:

  • Posture and bone development
  • Muscle tone
  • Body mass index and weight gain
  • Motor control
  • Balance and coordination
  • Range of motion
  • Vision and hearing

During a typical well-visit screening, a pediatrician may refer the child’s parents to a specialist if the pediatrician notices any symptoms indicating cerebral palsy. Parents should remember that there is no firm set of symptoms that positively identifies cerebral palsy; every child will experience different symptoms with different levels of severity based on individual factors. Some children may have cerebral palsy and show no obvious symptoms for several years while others develop debilitating symptoms immediately after birth.

Imaging Tests to Detect Cerebral Palsy

When a pediatrician or other medical specialist notices signs of symptoms of cerebral palsy during a routine checkup, there are several imaging tests available that may help confirm a cerebral palsy diagnosis:

  • MRI's. Magnetic resonance imaging (MRI) scans use magnets and radio waves to create a three-dimensional image of the patient’s brain that provides cross-sectional views into the different parts of the brain. An MRI procedure requires the patient to remain as still as possible, involves noisy machinery, and can take up to an hour to complete, so a child who undergoes an MRI will likely receive a mild sedative before the procedure.
  • Ultrasound. Sonographic devices used during pregnancy to track fetal growth can also provide images of a child’s brain after birth. A doctor will typically recommend ultrasound for premature infants or other infants who cannot undergo MRI scans. An ultrasound does not provide as detailed an image as an MRI, but it can still provide a quick and valuable initial assessment of the extent of a child’s brain damage.
  • Computed tomography (CT) scans use x-rays to create images of the child’s brain so doctors can identify damaged brain matter.
  • Electroencephalograms (EEGs) measure brain wave activity and electrical activity in the brain. If a child has seizures, an EEG can help diagnose epileptic conditions. During an EEG, electrodes attached to the patient’s scalp measure types of brain activity that can help diagnose seizure disorders.
Developmental Screenings

During the course of pediatric treatment, a child’s doctor will perform periodic developmental screenings to ensure healthy development. These screenings typically take place at nine months, eighteen months, and two years following birth. Some developmental issues may not display noticeable symptoms during earlier screenings and some symptoms may worsen over time.

Developmental screenings are usually the times when a child’s pediatrician will identify symptoms of cerebral palsy and start developing a treatment plan for the child. Some children with cerebral palsy only experience mild symptoms and may appear no different than children without cerebral palsy, but they will still likely require specialist attention over time.

Confirmation From Specialists

If an obstetrician or pediatrician notices any signs of cerebral palsy in an infant, he or she will likely refer the child’s parents to a specialist for a confirming diagnosis. A pediatric neurologist can help identify issues with a child’s brain and nervous system and a developmental pediatrician can help the parents develop a comprehensive treatment plan that encourages healthy development throughout childhood.

Ophthalmologists who can track a child’s vision, otologists who can identify hearing problems, or orthopedic surgeons who can identify and treat musculoskeletal symptoms of cerebral palsy are other specialists who may play roles in a child’s care after a cerebral palsy diagnosis.

Supportive Treatments

Since cerebral palsy can cause delays in speech development, intellectual development, muscle growth, and a host of other possibilities, many specialists, therapists, and instructors may play roles in a child’s life following a cerebral palsy diagnosis. These individuals will typically help the child’s parents understand the severity of their child’s symptoms and develop individualized treatment plans for each child. While one child with cerebral palsy may develop speech abilities only slightly slower than usual, another child with cerebral palsy may be completely nonverbal for several years, or experience more significant language processing delays.

In diagnosing a child with cerebral palsy, it is necessary to not only fully assess the extent of the child’s brain damage but also fully diagnose the co-occurring medical conditions that can accompany cerebral palsy and the severity of the child’s symptoms. Parents should expect an extensive round of testing for a child with cerebral palsy and remember that treatment can continue for many years after birth depending on the severity of symptoms.