Definition/Classification (Neurology 2004;62:851; Pediatr Rev 1995;16:411)
• Classified by syndrome of motor impairment, (including but not limited to): Spastic (hypertonic w/ inc DTRs), dystonic, athetoid, ataxic
• Nonprogressive d/o mvmt & posture 2/2 lesion/dysfxn in develop brain (often dxd <2 yo)
• Approx 70% have associated nonmotor impairments (commonly mental retardation)
• Not always permanent; many w/ mild motor dysfxn in infancy attain nml motor fxn later in childhood (but ¼ retain cognitive impairments)
Clinical Manifestations (Pediatr Rev 1995;16:411)
Epidemiology (Neurology 2004;62:851)
• Worldwide incidence 2/1,000 live births; 10,000/yr in US
Pathophysiology (Neurology 2004;62:851; Pediatr Rev 1995;16:411)
• Often multifactorial in etiology, which can occur in pre-, peri-, or post-natal periods
• Risk factors include (but are not limited to) prematurity, IUGR, cerebral infarction, hemorrhage, cystic encephalomalacia, brain malformations, genetic dzs, infxn, bilirubin encephalopathy, hypoxic ischemic injury, and trauma
• Preterm infant w/ periventricular leukomalacia is a common clinical scenario
Diagnostic Assessment (Neurology 2004;62:851)
• Confirm CP dx by H&P; assure no features of progressive/degenerative d/o, classify type of motor impairment
• Screen assoc conditions: Developmental delay, ophthalmologic/hearing impairments, speech/language disorders, feeding/swallowing difficulties
• EEG if H&P suggest seizures
• Neuroimaging if etiology is not established by perinatal imaging (MRI preferred to CT)
• Consider eval for coagulopathy if unexplained infarction in imaging
• Consider genetic/metabolic eval if malformation found on imaging
Treatment/Management (Pediatr Rev 1995;16:411)
