How Does a Doctor Diagnose Cerebral Palsy?

doctor with patientCerebral palsy symptoms are often present at birth, and a child usually receives a diagnosis before his or her second birthday. On the other hand, if a child only presents mild symptoms, a doctor may not be able to make the diagnosis until he or she is 4 or 5 years old.

Based on clinical observations during well-child visits and parental reports, a doctor will likely schedule an appointment to observe the child and make a diagnosis, or refer the parents to a specialist who can complete a comprehensive evaluation of the child.

Evaluating a Child for Cerebral Palsy

A diagnosis of cerebral palsy involves observation and questions about a child's behavioral and physical development. A healthcare provider will look for common characteristics of cerebral palsy, including hypotonia or hypertonia, unusual posture, and motor developmental delays. In the course of evaluating a child, a doctor will also have to determine if another disorder could be causing the symptoms.

For example, though the symptoms of cerebral palsy may change over time, the disease is not progressive. In other words, the symptoms should not get worse. If a parent reports that a child's symptoms worsen over time, it's likely that another issue exists.

An evaluation generally starts with a series of questions. Parents may receive questions about the child's developmental history and an inventory of milestones.

Developmental evaluations generally involve a primary care provider such as a pediatrician; the following specialists may also be involved in the process:

  • A developmental or neurodevelopmental pediatrician, who has special training in evaluating children with delays or other problems
  • A pediatric neurologist, trained in evaluating in treating children with diseases involving the nerves, brain, or spinal cord
  • A pediatric physiatrist, who has specialized training in physical medicine and rehabilitation

In addition to a full developmental inventory, a pediatrician or specialist may order additional tests that confirm or determine the cause of the cerebral palsy. Such tests may include:

  • A CT scan of the head, which shows the structures of the brain and any damage.
  • An MRI, which uses magnetic fields and radio waves to show detailed images of the brain. A practitioner may prefer this kind of testing because it not only allows for more
  • detailed images; it does not expose the child to any potentially harmful levels of radiation.
  • Cranial ultrasounds, which are the least intrusive and come with the lowest level of risk. Since it does not provide detailed images of the brain, doctors only use this on high-risk infants, such as those that are premature.

In many cases, these tests serve to rule out other movement disorders and determine if the cause of a child's symptoms is treatable. They can also confirm CP and show the location of damage within the brain responsible for a child's symptoms.

Many children with cerebral palsy have related developmental disorders resulting from brain damage. These can range from intellectual disabilities and seizure disorders to speech and hearing issues. Doctors will provide a full examination of the child to identify the presence of cerebral palsy and any comorbid conditions.

Sometimes, imaging may not reveal CP but other medical conditions that can mimic its symptoms. Examples may include evidence of strokes at birth, clotting disorders, and other coagulation problems.

After a Diagnosis of CP

After reviewing a patient's developmental history and scans, a doctor may be confident in diagnosing or confirming cerebral palsy, particularly if he or she is a specialist. Once a doctor confirms CP, he or she can work with parents to begin a treatment plan. Treatment for CP may include management of symptoms and occupational, speech, or physical therapy to achieve the optimum quality of life. Though a diagnosis of cerebral palsy may be difficult for parents to hear, timely intervention is essential to achieve the best outcomes for the child.