When an infant or toddler is seen with a movement disorder, clinicians start with a complete medical history and physical examination.
Some key factors to consider
If the health care provider
has reason to suspect that the child may have cerebral palsy or another neurological
disorder, he or she may order diagnostic tests to rule out other medical problems
that can mimic some of the symptoms associated with cerebral palsy. These include
laboratory tests to pinpoint inborn errors of metabolism, thyroid or liver function
tests, and chromosomal analyses to rule out various genetic syndromes.
A variety of imaging studies
can be performed to take a look at the child's brain. In neonates, a cranial
ultrasound may identify structural abnormalities and perhaps signs of hemorrhage
or hypoxic-ischemic injury. CT scans of the head are generally used to identify
congenital malformations within the brain, as well as intracranial bleeding
and periventricular leukomalacia (area of necrosis) in infants. Cranial MRI's
are the preferred diagnostic study in older children, because they can define
white matter and abnormalities within the brain, and can also measure myelination.
The health care provider
may also order an electroencephalogram (EEG) to diagnose seizure disorders,
an electromyelogram (EMG) to pinpoint motor neuropathy, and nerve conduction
studies (NCS) to identify sensory neuropathy. In older children, intelligence
tests may be used to estimate the degree of cognitive impairment.