Most of the information leading to the diagnosis of cerebral palsy is generally obtained from a thorough medical history and examination. The most critical tasks of the health care professional are to identify potentially treatable causes of a child’s impairment. The health care professional evaluating the child with possible cerebral palsy should be experienced in neurological examination and assessment of impaired children and well-versed in the potential causes of cerebral palsy. Often, but not necessarily, this practitioner should be a pediatric neurologist. Once the examination is complete, depending on the findings, the practitioner may order laboratory tests to help in the assessment.
There is no single test to diagnose cerebral palsy. But since cerebral palsy is the result of multiple different causes, the tests performed are used to identify specific causes when possible. Other tests will be performed to assess the condition of the child (nutritional status for example) or to assess other concomitant conditions that the child might have.
Blood and urine tests may be used to identify some of the more common inborn errors of metabolism. Blood tests may also be used for chromosomal or other genetic studies. Brain imaging studies can also be used to detect structural changes in the brain. The most sensitive brain imaging study is the MRI examination. Nuclear medicine neuroimaging studies such as SPECT or PET have no place in the initial evaluation of a child with cerebral palsy, but may prove very useful in the assessment of selected candidates.
Despite all of these tests, it may not be possible to answer some of the burning questions in the mind of a parent of a neurologically impaired infant, such as “Why does my child have cerebral palsy?” or “Will my child be normal?” This is particularly true if a specific diagnosis is not reached and the child is under one year of age. Some severely impaired young infants can grow up to be independent, productive members of society, while other children, seemingly less impaired, may require care throughout their lives.
Once the diagnostic evaluation is complete, further testing may be needed in order to define the specific needs of any individual child. For example, if seizures are present or suspected, an EEG (electroencephalogram) is performed. However, this test is not needed if there are no signs of epilepsy.