A Comprehensive Cerebral Palsy Resource

Diagnosing

How do Doctors Diagnose Cerebral Palsy?

If you have a fractured bone, you go into the doctor’s office, and then he or she performs an x-ray and confirms whether or not you have a fractured or broken bone. There is no single test specifically dedicated to confirming or denying the presence of cerebral palsy.

You will have a meeting with a doctor where you can express your concerns. Before a diagnosis of cerebral palsy can be made, however, your doctor will perform many tests and evaluations in order to rule out possible causes of cerebral palsy. These are ruled out one by one until a diagnosis of cerebral palsy is successfully made.

The process takes months at a minimum and very often requires a couple years or more. The condition sometimes goes unnoticed for several years by parents and doctors.
However, in most cases, your doctors diagnose your child before he or she is two years old.

If your child has severe symptoms, it is possible to receive a diagnosis shortly after birth.

Observation of motor abnormalities in a child, either by the parents or doctor, is typically the first step in the diagnostic process. While parents are often the first to notice something is “a little off” with their child, they most often dismiss the motor impairment as a normal part of their child’s development.

If you have any concerns regarding your child’s growth or muscular coordination, be sure to bring them to the attention of your child’s pediatrician.

In general, doctors will check to see if your child:

  • Has difficulty maintaining correct posture
  • Has developed a hand preference prior to the age of 6 months
  • Has missed any significant physical growth milestones
  • Has unusually tight or floppy muscles on one side of his or her body
  • Has difficulty focusing on his or her caregivers
  • Is not reaching developmental milestones such as rolling over or sitting up

Unfortunately, one of the most difficult struggles you will face as a parent is the length of the diagnostic process. The process requires a large amount of your patience, and at times, is extremely frustrating.

Doctors would love to provide a conclusive diagnosis after one visit. However, diagnosing cerebral palsy is not that simple.

Some of other types of tests doctors may perform include:

  • Reflex testing, which checks for excessive muscle tone and incorrect posture
  • A hand preference check
  • Cranial ultrasounds, which are used for high-risk premature infants
  • Computed tomography (CT) scans, which show brain structure and areas of damage
  • EEGs, which detect the brain’s electricity and help determine whether epilepsy is present
  • MRIs, which offer finer levels of detail of brain damage
  • EMGs and Nerve Conduction Studies (NCS), which distinguish cerebral palsy from muscular or nervous disorders
  • Lab tests, which rule out blood-clotting disorders causing strokes mimicing symptoms of cerebral palsy
  • Genetic studies, which examine conditions running in families known to cause cerebral palsy
  • Metabolic tests, which evaluate levels of enzymes such as amino acids and carbohydrates necessary to the normal functioning of your child’s body
  • Feeding studies
  • Cranial ultrasonography, which can detect hemorrhages or other structural abnormalities
  • Gait analysis, which tests the functioning of your child’s lower body
  • Karyotype analysis, which examines red and white blood cells and other bodily fluids for chromosomal abnormalities
  • The 6-minute walk test (6MWT), which is a performance-based measure of functional exercise capacity for children with cerebral palsy

Cerebral palsy, by definition, is not progressive. Symptoms may change over time, but they will not worsen. If symptoms are worsening, the problem more likely results from a different cause.

Strokes resulting from blood clotting disorders, which cause brain damage and symptoms similar to those of cerebral palsy, are most commonly mistaken for cerebral palsy. On rare occasions, metabolic disorders cause symptoms very similar to those of cerebral palsy.

In most cases, doctors will diagnose children suspected to have cerebral palsy with a broader term first. He or she may classify your child as having:

  • Developmental delay, which simply means he or she meets developmental milestones slower than the average child
  • Neuromotor dysfunction, which is a delay in the nervous system’s maturation
  • Motor disability, which involves long term movement challenges
  • Central nervous system dysfunction, which very generally indicates the brain isn’t functioning properly
  • Static encephalopathy, which means the brain is functioning abnormally, but that functioning is not getting worse

Doctors will delay in diagnosing children with cerebral palsy because of plasticity. Plasticity refers to the fact that a child’s central nervous system possesses a stronger ability to recover from injury than an adult’s.

Although a child may have noticeable impairment in one area of motor functioning or another, the brain may compensate and help the child make strong progress in other motor skills.

Another reason diagnosis is delayed is because a child’s nervous system becomes more organized over time. Muscle tone, for example, can swing from low to high and high to low. But, generally, by two to three, motor symptoms stabilize and experience only small changes.

If you are concerned about some of the symptoms your child is displaying, contact your doctor immediately.