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Topics: Spastic diplegia, Cerebral palsy, Reflex Pages: 3 (758 words) Published: April 16, 2014
History & examination
Key diagnostic factorsshow all
presence of risk factors (common)
Strong risk factors include prematurity, multiple births, maternal illnesses (e.g., chorioamnionitis, TORCH infections, thyroid disease, iodine deficiency, thromobotic disorders), birth asphyxia (due to placental abruption, rupture of the uterus, prolonged/obstructed labour, instrumental delivery), brain malformation, metabolic/genetic disorders, severe hyperbilirubinaemia, periventricular haemorrhage, neonatal sepsis, respiratory distress, early meningitis, neonatal seizures, teratogen exposure, low socioeconomic status. delay in motor development (common)

A full history of developmental milestones must be obtained. Delayed motor milestones are often the key diagnostic factor. Typically, children sit by 6 months, crawl with reciprocal locomotion by 9 months, walk between 12 and 18 months, and climb stairs in an adult fashion (step over step) by the age of 3 years. Gross Motor Function Classification System (GMFCS) levels I-V range from mild impairment of advanced motor skills to total dependence on assistance for all mobility and daily living skills. The upper extremity in CP requires classification schemes of its own. One review supports the use of the Manual Ability Classification System (MACS) and House methods. [73] delay in speech development (common)

Typically, children talk in short sentences by 2 years. A delay in speech development may reflect motor delay or an intellectual disability. Speech delay is more prevalent in children with total body involvement. delay in cognitive/intellectual development (common)

Cognitive impairment is observed in 40% of patients with CP. Intellectual disability is more common in individuals with more severe motor involvement (GMFCS levels IV and V). retention of primitive reflexes (common)

Reflexes and reactions that are poor prognostic factors for development of independent walking include retention of asymmetric and...
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