Last reviewed:September 2019
Last updated:February  2019

Summary

Definition

History and exam

Key diagnostic 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
  • nonvertex 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

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 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.

Associate Director

UCLA/Orthopaedic Institute for Children Center for Cerebral Palsy

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

RH 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 a grant to UCLA from USAID for developing material and providing direct training to physical therapists in Ukraine. Dissemination of material developed is only to participants in Ukraine in Ukrainian.

Eileen Fowler

Associate Professor

Department of Orthopaedic Surgery

David Geffen School of Medicine at UCLA

Los Angeles

CA

Disclosures

EF is a board member of the American Academy of Cerebral Palsy and Developmental Medicine and a Scientific Advisory Committee member for the Cerebral Palsy Foundation. She has received honorarium for a lecture on cerebral palsy at the Burke Cornell Neurological Institute and payment as a consultant for Shriners Hospital for Children for a grant submission.

Dr William L. Oppenheim, Loretta Staudt, Dr Rachel Thomson, 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.

Peer reviewersVIEW 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 topic. HC has received research support from the National Institutes of Health 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.

Use of this content is subject to our disclaimer