Cerebral Palsy Diagnosis In India

Cerebral Palsy Diagnosis

Cerebral palsy is a group of neuro-motor disorder, which comprise of difficulty in sitting, crawling, standing & walking along with other associated problem in speech, hearing, vision, recurrent chest infection, epilepsy etc. Cerebral palsy occurs because of some insult to an immature brain of fetus in-utero, during delivery and infant upto 2 years of life. Most of the time aetiology of brain insult is unknown.
Cerebral palsy can be predicted at the time of birth with the history of high risk like very premature birth, very low birth weight & history of some insult to the brain like the history of hypoxia, delayed cry, sever jaundice, intrauterine infection. A definite cerebral palsy diagnosis can be made at 3-6 months of age with the history of abnormal social response, delayed in developmental milestone like the inability to take side turn & absent neck holding, abnormal / fluctuating tone of muscle like hyotonia / hypertonia, sucking problem, epilepsy etc.
As the child matures other problems including achieving the milestone for a particular age like the inability to sit, crawl, walk, the problem in speech, vision, hearing and persistence of infantile reflexes along with other medical problem can support the cerebral palsy diagnosis. MRI, CT scan of the head is required only to look for any pathology in the brain and in doubtful cases. Genetic analysis is required if suspected for some genetic cause. Metabolic assessment by blood investigation is required for evaluation of metabolic cause of brain insult. Usually neck holding is matured at the age 3 months, sitting at 6 months, standing at 1 year and walking capability at 13-14 months. If there is a gross delay in getting this milestone along with the history of some insult to brain & high-risk history then cerebral palsy diagnosis is confirmed. It is very important to differentiate non progressive cerebral palsy from a progressive neurodegenerative disorder. In neurodegenerative disorders, the child will loss acquired milestone with passage of time and disability will increase. In muscular dystrophy child will also deteriorate with aging. Muscular atrophy & fatty replacement of muscles will be marked in this problem.

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