Understanding cerebral palsy: Diagnosis & treatment

How is cerebral palsy diagnosed?

There is no definitive test for cerebral palsy (CP) at the moment. The diagnosis is made by reviewing a child's medical history and performing a physical examination. A CP diagnosis can be difficult because babies may have more than one type of the disease and their symptoms may change in the early years making an exact diagnosis impossible. CP is easier to diagnose in more severely affected children. With these children, a diagnosis can often be made within the first months of life, but with more mildly affected children, doctors may not be able to confirm their diagnosis until the children are three or four years old.

Doctors diagnose CP by testing the baby’s motor skills, looking for characteristic symptoms and considering the child's medical history. They also may use computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to look for abnormalities in the baby’s brain. Certain laboratory tests may help rule out various progressive biochemical disorders that involve the motor system such as Tay-Sachs disease.

What treatment is there for cerebral palsy?

Cerebral palsy is a lifelong condition that cannot be cured. However, treatment can improve an affected person's capabilities, increasing motor function and independence. Many people who have CP enjoy near-normal lives. Depending on his or her symptoms, a person with CP may need the following:

• Surgery is used to correct muscle contractures, bending at a joint due to muscles that are too short or are spastic. With this surgery, muscle is lengthened. In another type of surgery, certain spinal nerves may be severed to help reduce spasticity in the legs.
• Medicines which treat muscle problems and other symptoms. Medicines such as diazepam, baclofen and dantrolene are sometimes used to control muscle spasticity. Anticholinergic medicines may be used to help control abnormal movements. Alcohol or Botox injections into muscle may be used to reduce spasticity for a short time so doctors can work to lengthen a muscle. Baclofen infused into the spinal canal under control of an electronic pump may be used to control spasticity for long periods of time. Other medicines may also be given to control seizures. 
• Physical therapy which consists of special exercises designed to increase and improve the child's movement and strength. In healthy children, normal daily activity stretches muscles, which helps the muscles to grow faster to keep up with the child's growing bones. However,  the muscles of children with CP do not stretch and grow normally. As the child ages, the difference between bone growth and muscle growth can interfere with motor abilities. Physical therapy helps combat this. 
• Mechanical aids which may help with a wide variety of functions. These aids can range from orthotic braces that help stretch muscles by holding bones in certain positions, to a computer equipped with special input devices and a speech synthesiser to help the person communicate. 
• Occupational therapy designed to help the child develop the fine motor skills needed to function day to day at home and school. 
• Speech therapy to help the child overcome communication problems. 
• Counselling to help the child and his or her family cope with the child's condition and access useful services. 
• Specially designed educational programmes for those who have learning disabilities or mental retardation.
• Reviews by an audiologist regarding hearing and an ophthalmologist regarding visual conditions may also be required.