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Neurological Exams for Cerebral Palsy

Certain tests such as a neurological examination may be given in order to diagnose cerebral palsy.  A neurological exam will usually consist of various posture, reflex, and response tests.  There is no cerebral palsy specific examination available, so the diagnosis is usually made after an intensive and varied testing period.  A neurological test will help determine if the child’s brain is sending the correct signals to the body in order for the child’s natural motor skills and responses to develop.

A general neurological examination most often consists of seven steps, usually taken in this order:  1. General appearance, including posture and motor activities.  2. A speech and mini-mental status exam.  3.  Cranial Nerve testing.  4.  Motor System, including atrophy, tone, and strength.  5.  Sensory System, including vibration and pin-prick.  6.  Reflexes, including deep tendon and the plantar reflex.  7.  Coordination and gait tests.

There are certain specific but slight neurological examinations that a doctor will make on a child suspected of having cerebral palsy, but none are usually conclusive on their own, nor are these exams seen as sole determinants of diagnosing cerebral palsy.  These tests are usually done over a period of time and may last up to 18 months or so before a diagnosis is finally made.  The diagnosis of cerebral palsy is a specifically physically determined one, and as such, time is needed in order to ascertain whether or not the child is reaching certain natural milestones (such as walking).  Follow up with your medical practitioner on failures to detect cerebral palsy early, or at all, as early detection is vital in stemming symptoms of cerebral palsy.

Some of the specific motor functions involved in cerebral palsy that can be tested are reaching, sitting, and walking.  All three are very basic functions that neurological tests can determine deficiencies leading to cerebral palsy in.  Reaching for toys is a response that is usually tested in children 3 to 4 months old and involves the child’s natural response to items.  Sitting is tested when the child is aged 6 or 7 months and is a test of the child’s ability to remain upright in one place.  Walking usually takes place between 10 to 14 months after the child’s birth and any deficiencies in this area should be further investigated.  Most children are diagnosed by 18 months and through a combination of tests, which include these basic neurological exams.  Failure to detect cerebral palsy by a medical practitioner can result in future problems for the cerebral palsy sufferer.

There are also several upper body neurological examinations that can be made on a suspect child or infant.  These exams consist of various hand, wrist, and finger movements, which can determine brain function and growth.  These tests include range of motion, resting position, muscle testing, and several special wrist and hand tests that examine the person’s ability to stretch and manipulate their hands in certain ways.

The examination will also be made on the child’s sociability and response to social provocations such as cooing and smiling. 

Suspect test results will include lack of or diminished sociability, no or little response to sounds, jerky body movements or continual poor posture, hyper-reflexia, fisting of one or both hands (which may signal hypertonia) and retention of the thumb in the fist, which may signify cortical injury.

It should be noted that not all of these test results are conclusive and a diagnosis can and should only be made after a lengthy testing period containing multiple tests of various degrees.  Following up on a doctor’s prognosis is key in ironing out a well-considered diagnosis as well.  The failure in determining cerebral palsy early on can lead to detrimental results in the child at a later age.

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