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When To Call a Doctor

Call 911 or other emergency services if your child with cerebral palsy (CP):

* Is having problems breathing.
* Chokes during feeding and you are not able to dislodge the food.

Call a health professional immediately if:

* You are pregnant and develop or suspect you have German measles (rubella) or signs of other infection; have been exposed to harmful substances, such as strong chemicals or radiation; or you have consumed alcohol or used illegal drugs.
* Your child has a seizure for the first time.

If you have a child diagnosed with CP, call your doctor if he or she has:

* A seizure (if it is the first time, call your doctor or seek care immediately)
* Constipation that is not relieved by home treatment.
* Skin irritation that is not getting better, starts to bleed or weep fluid, or causes pain.
* Feeding problems that are not relieved by home treatment, such as:

o A pattern of coughing and choking during feeding. If food is inhaled into the lungs, it increases the risk of developing pneumonia.
o Chewing difficulty along with weight loss or complaints of being hungry.
* Frequent accidents that threaten your child's safety.
* Other signs of complications, such as bladder control problems, bleeding gums, or an increase in joint stiffness.

Watchful Waiting

Pay attention to whether your child is reaching early developmental milestones. Report your observations to your health professional at regularly scheduled well child visits or any time you have concerns.

Watchful waiting is not appropriate if your child has been diagnosed with cerebral palsy and develops complications. See your child's health professional.

If you have cerebral palsy and you are pregnant, talk with a health professional about how the disorder can affect your pregnancy and delivery.

Who To See

Health professionals who can diagnose and treat people with cerebral palsy (CP) include:

* Pediatricians (some pediatricians specialize in developmental disabilities).
* Family medicine doctors.
* Nurse practitioners.
* Physician assistants.
* Internal medicine doctors.
* Neurologists.
* Neurological surgeons.
* Physiatrists, physical medicine and rehabilitative physicians, and other doctors who specialize in therapeutic and long-term treatment issues.

Other specialists who may be involved in the care of people with CP include:

* Ophthalmologists.
* Orthopedic surgeons.
* Psychiatrists, psychologists, social workers, and psychiatric nurses.

Other health professionals who may be involved in the care of people with CP include:

* Occupational therapists.
* Physical therapists.
* Dentists or orthodontists.
* Hearing specialists (audiologists).
* Speech therapists (speech-language pathologists).
* Registered dietitians.

Some health care clinics specialize in treating children with CP. Call your local health department for the nearest clinic in your area.

Jerald Chan writes for http://www.cerebralpalsycure.info where you can find out more about cerebralpalsy cure and other topics.



To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

Diagnosing cerebral palsy

Signs of cerebral palsy (CP) may not be present or detected at birth. A doctor may closely monitor a newborn or child for signs of CP if he or she has known risk factors. These factors may be related to problems during pregnancy or birth, being born early (premature birth), or problems that occur within the first 2 or 3 years of life.

Health professionals use caution in diagnosing CP too early because some babies who have motor skill abnormalities soon after birth never develop CP.

Sometimes symptoms may not appear until the nervous system matures with the continual growth of the brain, nerves, and muscles. It can take up to a few years before doctors determine whether a baby with body movement and posture (motor) problems has CP.

Cerebral palsy is diagnosed based on observations of a baby's or young child's physical development delays or irregularities, medical history, a physical examination, screening tests, and other tests, such as MRI (usually done to rule out other conditions). Specifically, these tests include:

* Asking questions about the child's medical history, including details about the mother's pregnancy. Developmental delays are often reported by parents or observed by a health professional during routine well baby checks. These visits are also an opportunity for health professionals to watch your baby and ask details about his or her sensory and motor skills, especially those that are expected to occur during the first year or second year.
* A physical examination to look for signs of CP. During a physical exam, a health professional evaluates whether a child retains newborn reflexes longer than normal, which can be an indication of CP. Postures and basic muscle function, hearing, and vision are usually also assessed.
* Screening tests. Your health professional will recommend developmental questionnaires and other tests to help determine the extent of developmental delays and whether they should be further evaluated.
* Magnetic resonance image (MRI) of the head., which may be done to identify brain abnormalities and rule out other conditions.

Taken together, results of these tests can point toward a diagnosis of CP. 7

If diagnosis is unclear, additional tests may be done to evaluate the brain and possibly rule out other conditions. Sometimes, results from these tests can also be useful in evaluating the severity of CP. Tests may include:

* Additional developmental questionnaires.
* Computed tomography (CT) scan of the head.
* Ultrasound of the brain.

Evaluating and monitoring cerebral palsy

Once CP is diagnosed, a child will also be screened for other medical conditions that can occur with cerebral palsy, such as:

* Other developmental delays in addition to those that have already been identified. Developmental abilities will be assessed periodically to determine whether new symptoms, such as speech and language delay, appear as a child's nervous system matures.
* Intelligence testing, to identify below-normal intelligence (mental retardation).
* Seizures. An electroencephalography (EEG) is used to check for abnormal activity in the brain if a child has a history of seizures.
* Problems with feeding and swallowing.
* Vision or hearing problems.
* Psychological evaluation, for any behavioral problems.

Most of the time, a health professional can predict many of the long-term physical effects of CP when a child is between 1 and 3 years of age. Sometimes, however, such predictions are not possible until a child reaches school age when learning, communication skills, and other abilities can be measured. The amount of help and supervision needed depends on the number and severity of problems.

Some children need repeated testing that may include:

* X-rays, to check for loose or dislocated hips. Children with CP are usually X-rayed several times between ages 2 and 5. A child will also have an X-ray any time he or she complains of hip pain or has other signs of dislocated hips, such as unusual leg or knee movements. Spinal X-rays also are done to look for curves in the child's spine (scoliosis).
* Gait analysis, which helps identify problems and guide treatment decisions.

Additional tests may be needed, depending on the child's symptoms or other conditions that are present.