- It is a motor disorder (mainly, although there may be associated deficits). <\/li>
- It is a disorder originating in the central nervous system (and neuromuscular diseases are excluded), which is inferred by the presence of clinical signs:
- Pyramidal. <\/li>
- Extrapyramidal. <\/li><\/ul><\/li><\/ul><\/li>
- The clinical history may be sufficient<\/a> to establish a cause, although it is almost always necessary to use complementary tests, mainly neuroimaging, although genetic testing has gained special importance in cases without an established diagnosis. <\/li><\/ul>\n\n\n\n
The term cerebral palsy is therefore a descriptive term; it is not a single disorder but a set of different disorders with different etiologies, which nevertheless present in a stereotyped manner and share a series of characteristic complications. <\/p>\n\n\n\n
\n\n\n\nClinical presentations:<\/h2>\n\n\n\n
In outpatient clinics and primary care: <\/p>\n\n\n\n
- In the follow-up of children \"with risk factors\", such as preterm infants. <\/li>
- In children with motor development delay, particularly gross motor (sitting, standing, and walking).<\/li>
- In children with asymmetric movement patterns, such as early hand preference. <\/li>
- In children with muscle tone abnormalities, both hypotonia (early) and spasticity (late). <\/li>
- In children with feeding problems, for example swallowing difficulties not explained by other medical causes. <\/li><\/ul>\n\n\n\n
In emergencies:<\/p>\n\n\n\n
- Respiratory problems, particularly aspiration pneumonia. <\/li>
- Poor control of epileptic seizures, including status epilepticus. <\/li>
- Unexplained irritability: to consider acute infections, esophagitis, dental problems, hip subluxation, pathological fractures, constipation, adverse effects of pharmacological treatment, etc. <\/li><\/ul>\n\n\n\n
\n\n\n\nStratification according to severity:<\/h2>\n\n\n\n
For severity stratification, the GMFCS (Gross Motor Function Classification System) is used. <\/p>\n\n\n\n
![\"\"](\"https:\/\/neuropediatoolkit.org\/wp-content\/uploads\/2022\/07\/imagen-26.png?w=776\")
<\/figure>\n\n\n\n
\n\n\n\nAssociated disorders: <\/h2>\n\n\n\n
Neurological comorbidity: <\/p>\n\n\n\n
- Visual problems (up to 40%), such as strabismus, refraction problems, visual field defects, and cortical visual impairment. <\/li>
- Hearing impairment (3-10%). <\/li>
- Language and speech disorders. <\/li>
- Epilepsy (50%). <\/li>
- Cognitive difficulties, ranging from specific learning difficulties to intellectual disability.<\/li>
- Spasticity.<\/li>
- Sialorrhea.<\/li>
- Urinary and\/or fecal incontinence. <\/li><\/ul>\n\n\n\n
Other health problems: <\/p>\n\n\n\n
- The growth and nutrition<\/a> is a common problem in all cases; there are specific curves for this population group, based on their GMFCS and whether they are fed via gastrostomy or not.
- Motor disability leads to skeletal deformations secondary to immobility, spasticity, and the effect of gravity. <\/li><\/ul>
- The growth and nutrition<\/a> is a common problem in all cases; there are specific curves for this population group, based on their GMFCS and whether they are fed via gastrostomy or not.