When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Cerebral palsy

Last reviewed: 18 Jun 2025
Last updated: 31 Aug 2023

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • early general movement abnormalities
  • abnormal HINE scores
  • 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
Detalhes completos

Outros fatores diagnósticos

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

Fatores de risco

  • prematurity
  • low birth weight
  • fetal birth asphyxia
  • multiple births
  • maternal illness
  • fetal brain malformation
  • major birth defects
  • familial metabolic/genetic disorder
  • neonatal complications
  • meningitis
  • maternal teratogen exposure
  • low socioeconomic status
  • nonvertex presentation
  • postmaturity
  • head injury
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • MRI brain
Detalhes completos

Investigações a serem consideradas

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

Algoritmo de tratamento

CONTÍNUA

spastic hemiplegia

spastic diplegia

spastic quadriplegia

dyskinetic

ataxic

Colaboradores

Autores

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy, null

Los Angeles

CA

Declarações

See individual author disclosures.

William L. Oppenheim, MD
William L. Oppenheim

Distinguished Professor Emeritus Pediatric Orthopedics

Margaret Jones Kanaar Chair, Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

WLO is an author of several references cited in this topic.

Loretta Staudt, MS, PT
Loretta Staudt

Research Physical Therapist

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

LS is a clinical evaluator for several sponsored clinical trials as part of her salaried employment at UCLA. She has received travel, meals, and accommodation to attend training meetings for some of these trials but does not receive any direct reimbursements or personal benefits from the companies, which include Pfizer, Sarepta, Audentes Therapeutics, Bristol-Meyers Squibb, Biogen, Santhera, Fibrogen, Cytokinetics, Italfarmaco, and AveXis. As part of her salaried employment at UCLA, LS is working on a project funded by the Cerebral Palsy Foundation. She is an author of several references cited in this topic.

Rachel Thompson, MD

Assistant Professor-in-Residence, Department of Orthopaedic Surgery

Associate Residency Program Director, Department of Orthopaedic Surgery

Director, UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

William and Patricia Oppenheim Presidential Chair in Pediatric Orthopaedics

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

RT declares that she has no competing interests.

Marcia Greenberg, MS, PT
Marcia Greenberg

Physical Therapist

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

MG is a consultant for the NGO, UCP Wheels for Humanity, teaching physical therapists in developing countries. She is an author of several references cited in this topic.

Eileen Fowler, PhD, PT
Eileen Fowler

Professor

Department of Orthopaedic Surgery

Director of Research and Education

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

Peter William Shapiro Chair

David Geffen School of Medicine at UCLA

Los Angeles

CA

Declarações

EF receives grant funding from the Cerebral Palsy Foundation. She is a member of the Scientific Advisory Committee of the Cerebral Palsy Foundation. She is an author of several references cited in this topic.

Agradecimentos

Dr William L. Oppenheim, Loretta Staudt, Dr Rachel Thompson, Marcia Greenberg, and Dr Eileen Fowler wish to gratefully acknowledge Dr Albert Stroberg, Dr Erika Hassan, Dr Rebecca Hanson, Dr Joan Earle Hahn, Dr Tien T. Nguyen, and Dr Sarah Copeland, previous contributors to this topic.

Declarações

AS, EH, RH, JEH, TTN, and SC declare that they have no competing interests.

Revisores

Hank Chambers, MD

Clinical Professor

Department of Orthopaedic Surgery

University of California at San Diego

Medical Affairs Officer

Rady Children's Hospital

San Diego

CA

Declarações

HC is an author of a number of references cited in this topic. HC has received research support from the National Institutes of Health greater than 6 figures USD.

Michael Sussman, MD

Orthopaedic Surgeon

Shriners Hospital for Children

Portland

OR

Declarações

MS declares that he has no competing interests.

Charles Fairhurst, MBBS MSc

Consultant in Paediatric Neurodisability

Evelina Children's Hospital

Guy's & St Thomas' NHS Foundation Trust

London

UK

Declarações

CF declares that he has no competing interests.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007 Feb;109:8-14. Resumo

Noritz G, Davidson L, Steingass K, et al. Providing a primary care medical home for children and youth with cerebral palsy. Pediatrics. 2022 Nov 21;e2022060055.Texto completo  Resumo

Shepherd E, Salam RA, Middleton P, et al. Antenatal and intrapartum interventions for preventing cerebral palsy: an overview of Cochrane systematic reviews. Cochrane Database Syst Rev. 2017 Aug 8;(8):CD012077.Texto completo  Resumo

Novak I, Morgan C, Fahey M, et al. State of the Evidence Traffic Lights 2019: systematic review of interventions for preventing and treating children with cerebral palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3.Texto completo  Resumo

Shepherd E, Salam RA, Middleton P, et al. Neonatal interventions for preventing cerebral palsy: an overview of Cochrane Systematic Reviews. Cochrane Database Syst Rev. 2018 Jun 20;(6):CD012409.Texto completo  Resumo

Novak I, Morgan C, Adde L, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017 Sep 1;171(9):897-907. Resumo

Delgado MR, Hirtz D, Aisen M, et al; Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review). Neurology. 2010 Jan 26;74(4):336-43.Texto completo  Resumo

Fehlings D, Brown L, Harvey A, et al. Pharmacological and neurosurgical interventions for managing dystonia in cerebral palsy: a systematic review. Dev Med Child Neurol. 2018 Apr;60(4):356-66.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Cerebral palsy images
  • Diagnósticos diferenciais

    • Spinal muscular atrophy
    • Muscular dystrophy/myopathy
    • Familial/primary dystonia
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Providing a primary care medical home for children and youth with cerebral palsy
    • Indications for gastrocsoleus lengthening in ambulatory children with cerebral palsy: a Delphi consensus study
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Cerebral palsy: what is it?

    Cerebral palsy: what treatments work?

    Mais Folhetos informativos para os pacientes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal