Cerebral Palsy: Misdiagnosis of Movement Disorders

Author: Thomas C. Weiss
Published: 2015/04/30 - Updated: 2021/08/18
Peer-Reviewed: N/A
Contents: Summary - Main - Related Publications

Synopsis: Due to a number of factors, movement disorders such as Cerebral Palsy are often times misdiagnosed. It is a common misconception and stereotype that prompts people who have no knowledge of cerebral palsy or movement disorders to associate movement disorders with learning disabilities or cognitive impairment. To gain some insight into what it is to experience a movement disorder, consider something everyone has experienced while in the twilight stages of sleep as we are falling asleep, our body twitches. Another analogy would involve spasms or muscle cramps.

Main Digest

The majority of parents of children who develop cerebral palsy leave the hospital with an initial diagnosis of some form of brain injury, although the extent of the damage is not known. Other parents might be sent home with a vague concern about low Apgar scores and little else. Symptoms such as lack of suck and lethargy may send these parents; frustrated and worried, back to a pediatrician repeatedly. Over time, failure to meet developmental milestones leads to a diagnosis of cerebral palsy.

Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. Signs and symptoms vary between people. Often problems include: poor coordination, stiff muscles, weak muscles, trouble swallowing or speaking, and tremors among others. There may also be problems with sensation, vision, and hearing. Often babies with CP do not roll over, sit, crawl, or walk as early as other children their age. Difficulty with the ability to think or reason and seizures each occurs in about one third of cases. While the symptoms may get more noticeable over the first few years of life, the underlying problems do not worsen over time.

Most children with cerebral palsy are diagnosed by the age of three. A diagnosis of a movement disorder within cerebral palsy can follow the same path of frustration. Due to a number of factors, movement disorders are often times misdiagnosed.

Seizures; for example, occur in 30-50% of children with cerebral palsy. In some instances, severe movement disorders may mimic the same exaggerated muscular involvement as a seizure with similar posturing, spasticity and uncontrollable movements. An infant or a non-verbal child do not have the ability to communicate what they are experiencing or feeling during these episodes - something that makes it very hard for a health care provider to diagnose the condition.

The same spastic or uncontrollable movements may also be triggered by things such as acid reflux, ear aches, or certain medications, all of which will need to be treated and ruled out. Even an attempt by a person with cerebral palsy to control a movement may trigger the types of spasms seen in a movement disorder.

Because of these reasons, a non-verbal child with a movement disorder may go for years without a diagnosis. It is not uncommon for doctors with no experience with the needs of this population or movement disorders to misdiagnose a movement disorder as a seizure one. In severe movement disorders such as dystonia, it usually takes a neurologist or developmental pediatrician who specializes in children with cerebral palsy to achieve a diagnosis. An EEG or extended EEG with video would be helpful in reaching a movement disorder diagnosis. It might confirm or rule out seizure activity.

A Parent's To Do List for Children with Cerebral Palsy

Some different actions on the part of parents of children with cerebral palsy can help to achieve a diagnosis from a pediatrician. These actions include the following:

Some movement disorders, if left untreated, may seriously compromise a child's quality of life and have a negative impact on the child's development. Make note of as many details of the behavior as you can, such as what limbs were involved and the severity of the movements. Ask yourself if the movements were mild, extreme, or violent. Were your child's movements jerky, or did they resemble tremors? Did your child appear to experience pain with the movements? Write down anything and everything that will give as much information as possible to your child's doctor. Try to paint a picture for the doctor using words and be as descriptive as you can.

Symptoms and Signs of Movement Disorders

To gain some insight into what it is to experience a movement disorder, consider something everyone has experienced at some point, while in the twilight stages of sleep as we are falling asleep - our body twitches. Another analogy would involve spasms or muscle cramps. A number of movement disorders involve excessive muscle tone, also referred to as, 'hypertonia,' or, 'spasticity,' which may lead to spasms. Imagine your entire body or some extremity experiencing similar episodes of muscle spasms, spasticity, or involuntary movement for an extended period of time and there is nothing you can do to stop it. Symptoms and signs of movement disorders can include:

It is a common misconception and stereotype that prompts people who have no knowledge of cerebral palsy or movement disorders to associate movement disorders with learning disabilities or cognitive impairment. Depending upon the severity and nature of the cerebral injury, not all of those with movement disorders are developmentally delayed.

Forms of Movement Disorders

Movement disorders often times involve either excessive or reduced levels of muscle tone and may include a number of involuntary gross motor movements. These movements may be described by the following:

Medications and Treatment of Movement Disorders

Bensodiazepines are a class of medications that act upon a person's central nervous system to reduce communication between certain neurons, lowering the level of activity in the person's brain. Benzodiazepines are muscle relaxants such as baclofen, diazepam and dantrolene. They are often times the first line of treatment in managing movement disorders.

Developed in the 1980's to treat spinal cord injury and other neurological conditions involving motor neurons, spinal cord stimulation is a procedure involving the implantation of an electrode that selectively stimulates nerves at the base of the person's spinal cord to inhibit and decrease nerve activity. The effectiveness of spinal cord stimulation for the treatment of cerebral palsy has not been proven in clinical studies. It is considered only when other conservative or surgical treatments have been unsuccessful at relaxing the person's muscles, or relieving their pain.

Selective Dorsal Rhizotomy or, 'SDR,' is a surgical procedure recommended only for people with severe spasticity when all of the more conservative treatments have proven to be ineffective. In this procedure, surgeons locate and selectively sever over-activated nerves at the base of the person's spinal cord.

Intrahecal Baclofen was approved by the FDA in 1996 for treatment of cerebral palsy. The therapy is becoming the common choice of treatment in movement disorders that do not respond well to other types of treatments. This type of therapy uses an implanted pump device to deliver baclofen, a muscle relaxant, into the intrathecal space of the person's spinal cord. This type of therapy is most appropriate for children who experience chronic, severe hypertonia and uncontrolled movement disorders throughout their bodies.

Aggressive research is being conducted around the word involving the treatment and prevention of movement disorders. A lot of progress has been made and children who experience muscle spasms and dystonic posturing due to severe cerebral injury and subsequent neuromuscular involvement; for example, are benefiting.

Quick CP Facts and Statistics

Author Credentials:

Thomas C. Weiss is a researcher and editor for Disabled World. Thomas attended college and university courses earning a Masters, Bachelors and two Associate degrees, as well as pursing Disability Studies. As a Nursing Assistant Thomas has assisted people from a variety of racial, religious, gender, class, and age groups by providing care for people with all forms of disabilities from Multiple Sclerosis to Parkinson's; para and quadriplegia to Spina Bifida. Explore Thomas' complete biography for comprehensive insights into his background, expertise, and accomplishments.

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Cite This Page (APA): Thomas C. Weiss. (2015, April 30). Cerebral Palsy: Misdiagnosis of Movement Disorders. Disabled World. Retrieved February 22, 2024 from www.disabled-world.com/health/neurology/cerebral-palsy/misdiagnosis.php

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