The Quality Standards Subcommittee ...

The Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society have released a modern guideline on neuroimaging tests for cerebral palsy and related disorders. "Practice Parameter: Diagnostic Assessment of the Child with Cerebral Palsy" appears in the March 2004 issue of Neurology and is available online at http://www.aan.com/professionals/practice/guideline/index.cfm.

According to the guideline, available evidence now supports the use of magnetic resonance imaging (MRI) rather than computerized tomography when cerebral palsy is suspected, although this is not in addition routine. Metabolic and genetic studies ne not be done routinely unles the cause of the brain's abnormality is not evident onward the MRI scan or at clinical history and examination.

Because the incidence of cerebral infarction is high in children with hemiplegic cerebral palsy, diagnostic testing for coagulation disorders should be considered. However, there is insufficient evidence at ready to be precise as to what studies should be ordered. Electro-encephalography is not commended unless there are characteristics suggestive of epilepsy or a specific epileptic syndrome

Evidence also hints that children who are diagnosed with cerebral palsy should be routinely examined for other related disorders, in the same state [i]or[/i] condition as mental retardation, vision and hearing impairments, articulate utterance and language disorders, and chewing and swallowing disorders.

An early diagnosis helps the child's parent or caregiver and the child's physician understand the cause of the disorder, as well as make informed decisions upon a treatment plan. Most children with cerebral palsy are diagnosed according to the time they are sum of two units years of age and their condition improves as they gain older.

COPYRIGHT 2004 American Academy of Family Physicians

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