Early accurate diagnosis and early intervention in cerebral palsy and high risk of cerebral palsy

Abstract

Cerebral palsy or high risk of cerebral palsy can be diagnosed accurately and early using the clinical signs and symptoms of cerebral palsy, involves neuroimaging, standardized neurological and standardized motor assessments before 6 months′ corrected age.When the clinical diagnosis is suspected but cannot be made with certainty, re-commend using the interim clinical diagnosis of high risk of cerebral palsy until a diagnosis is confirmed, because infant with cerebral palsy require and benefit from different early interventions.Before 5 months′ corrected age, the most predictive tools for detecting risk are term-age magnetic resonance imaging(MRI), the Prechtl Qualitative Assessment of General Movements(GMs), and the Hammersmith Infant Neurological Examination(HINE). After 5 months′ corrected age, the most predictive tools for detecting risk are MRI, HINE and the Developmental Assessment of Young Children.Early diagnosis and early intervention can optimize infant motor and cognitive plasticity, prevent secondary complications.Cerebral palsy-specific early intervention maximizes neuroplasticity and minimizes deleterious modifications to muscle and bone growth and development.Early interventions included Goals-Activity-Motor Enrichment, neurodevelopmental treatment(Bobath, Vojta), Conductive Education and Environmental enrichment.Infants with of cerebral palsy who receive early CIMT have better hand function, and infants with any type and topography of cerebral palsy who receive GAME have better motor and cognitive skills than those who receive usual care. Key words: Cerebral palsy; Early diagnosis; Infants at high risk of cerebral palsy; Diagnostic criteria; Early intervention