Last reviewed: November 2017
Last updated: October  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • delay in motor development
  • delay in speech development
  • delay in cognitive/intellectual development
  • retention of primitive reflexes
  • lack of age-appropriate reflexes
  • spasticity/clonus
  • selective voluntary motor control impairment
  • toe walking/knee hyperextension
  • scissoring
  • crouched gait
  • contractures

Other diagnostic factors

  • muscle weakness
  • joint instability/dislocation
  • dystonia
  • chorea
  • athetosis
  • ataxia
  • neonatal hypotonia
  • scoliosis

Risk factors

  • prematurity
  • fetal birth asphyxia
  • multiple births
  • maternal illness
  • fetal brain malformation
  • major birth defects
  • familial metabolic/genetic disorder
  • neonatal complications
  • maternal teratogen exposure
  • low socioeconomic status
  • non-vertex presentation
  • postmaturity
  • head injury

Diagnostic investigations

Investigations to consider

  • ultrasound/CT brain
  • coagulation studies
  • genetic testing
  • metabolic screen
  • x-ray of affected joint
  • instrumented gait analysis
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Los Angeles

CA

Disclosures

See individual author disclosures.

William L. Oppenheim

Margaret Jones Kanaar Professor

Orthopaedic Surgery and Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

WLO declares that he has no competing interests.

Loretta Staudt

Research Physical Therapist

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

LS received travel and accommodation expenses for training as a clinical evaluator (of physical therapists), and received grants for clinical trials into Duchenne muscular dystrophy and spinal muscular atrophy from: Ionis; Bristol-Myers Squibb; Cytokinetics; Catabasis; Audentes Therapeutics; AveXis; and Summit.

Albert Stroberg

Assistant Professor

Department of Orthopaedic Surgery

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

AS declares that he has no competing interests.

Erika Hassan

Assistant Clinical Professor

Department of Orthopaedic Surgery

Physical Medicine and Rehabilitation

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

EH declares that she has no competing interests.

Marcia Greenberg

Clinical Coordinator

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

MG received travel and accommodation expenses from a non-profit organization, UCP Wheels for Humanity, while teaching in El Salvador and Ukraine through a grant from UCP Wheels for Humanity, and the USAID. MG was paid as a private consultant to undertake teaching in Colombia; UCP Wheels for Humanity paid for her travel and accommodation.

Rebecca Hanson

Clinical Professor

Pediatric Neurology and Orthopaedics (Cerebral Palsy)

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

RH declares that she has no competing interests.

Eileen Fowler

Associate Professor

Department of Orthopaedic Surgery

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

EF declares that she has no competing interests.

Joan Earle Hahn

Associate Professor

Department of Nursing

University of New Hampshire

Durham

NH

Disclosures

JEH declares that she has no competing interests.

Tien T. Nguyen

Orange County Brain and Spine Group

Fountain Valley

CA

Disclosures

TTN declares that he has no competing interests.

Sarah Copeland

Pediatric Neurologist

Santa Clara Valley Medical Center

Dept of Pediatrics

San Jose

CA

Disclosures

SC declares that she has no competing interests.

Peer reviewers VIEW ALL

Clinical Professor

Department of Orthopaedic Surgery

University of California at San Diego

Medical Affairs Officer

Rady Children's Hospital

San Diego

CA

Disclosures

HC is an author of a number of references cited in this monograph. HC has received research support from the NIH greater than 6 figures USD.

Orthopaedic Surgeon

Shriners Hospital for Children

Portland

OR

Disclosures

MS declares that he has no competing interests.

Consultant in Paediatric Neurodisability

Evelina Children's Hospital

Guy's & St Thomas' NHS Foundation Trust

London

UK

Disclosures

CF declares that he has no competing interests.

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