Abnormal gait in 2 year old.

[WorzselMummage]

My Ds George 2.5 and an ex 27 weaker, since he started walking I've noticed his physical development isn't coming on as it should, his fine motor skills are as I would expect but his gait is very odd, he kind of twists to propel himself and seems to be very unbalanced with little stamina. He can't run, he just walks faster and he can't jump. ( he can, however, climb anything! ). It's becoming more obvious as he gets older and people are starting to ask questions. I'm not worried about getting a diagnoses, George is George but DH thinks we should be doing something.

I know he may have mild cerebral palsy. He had some periventricular flare on his early NICU scans but I thought we had dodged that particular bullet. He hasn't had a neuro assessment since babyhood and unless we need to put him though a load of tests I'm inclined to just wait and see how things pan out.

Do we need to do anything ?

I hope you don't mind me posting here. I thought about posting in children's health but my DS is perfectly healthy!

[TotalChaos]

Hi Worzel. My experience is of language delay rather than CP, but I think it would be worthwhile going to GP (are you still under a paed?) over this, as it maybe that something like a course of physio and/or supportive footwear/splints could help his physical development.

[Galena]

Hi Worzsel - I think we've 'met' on the Bliss forum... Firstly, don't panic! However, let me tell you about us...

Skye has just been diagnosed with mild CP having been born at 27 weeks 2.3 years ago. When you say he 'twists' to propel himself, do you mean that when his right foot goes forward his right shoulder goes forward too, etc? The physio has just picked up that that's what she does. However, she's not yet walking much - a few unsteady steps and not much else. She pulls up and cruises like a maniac though and crawls too.

One thing I would say is that I have been told that with CP, leaving it uncorrected can cause more problems as the muscles which have tightened can then become shortened and as the child grows they can cause more problems. She has had no tests as such - we've been seeing a physio for the past 6 months and she became aware of increased tone in her legs particularly. She referred us to the paed who listened to the physio, had a feel of her legs and said that yes, it was CP! I know some areas insist on an MRI though...

DD now has insoles in her shoes to relax her toes, she will be having little flexible ankle splint things to make sure her feet return to the correct position rather than turning in (which is her favoured position at the moment). If left uncorrected, it can cause issues with her bones becoming twisted, etc.

I am not trying to worry you, I guess I'm just saying that, despite wanting everything to be ok and seeing that he's coping fine thus far, it's probably worth getting it checked out. It could be hypermobile joints, it could be CP or it could just be George.

If you want to ask me anything more, feel free to PM me...

[sneezecakesmum]

Agree with everything galena says. It is worth pushing for a diagnosis to prevent problems in the future. It sounds like mild spastic diplegia (assocaited with PVL most usually) with only the legs mildly affected. The swinging motion you mention could be because of tight hips. It is so important to do stretches and certain exercises to minimise any problems in the future, as when SD children have growth spurts they tend to tighten further. Dont worry though I am sure DS is minimally affected and its about prevention of problems rather than a major problem.

[WorzselMummage]

Yes Galena, we have met before :) Thank you so much for your reply. Skye and George are a similar age, for some reason I thought George was much older

When I say twisting I mean it seems as if he has to use his arms to gain momentum and cant persuade his gets to go what he wants them too. he tries to run but seems massively uncoordinated. I cant work out if one side is weaker then the other and sneezecakesmum i'm not sure that there is any tightness, he certainly has no trouble waving his legs in all directions when im changing his nappy and what ever the problem is it doesn't stop him from doing what he wants

I had a look at the Spastic Diplegia Wiki page and some of the traits look similar but when I looked on youtube the gait didn't look like the way George moves.

We have a Paed appointment in Nov but i think I might ring Georges Consultant and see if I can bring it forward. He had a lot of Physio untill he started walking at about 19 months and was then discharged.

[Galena]

I was surprised too - I thought he was older!

Skye is very determined to do exactly what she wants to as well - this afternoon she was climbing up the toddler group climbing frame and going down the slide without any assistance (although I do stand nearby ready to leap is she falls!). She doesn't have a weaker side really either as diplegia basically means both sides are affected pretty much equally. Having had a quick look at the videos of spastic diplegia gait on YouTube, none of them look like Skye either! The thing to remember is that a lot of those are much more severe cases than she has. I'm uploading a video of her walking onto photobucket and will pm you the link once it's done.

It won't hurt to bring the appointment forward - if it's nothing at least you're reassured. Skye had physio till she was 8 months then not again till Nov last year. It still took the physio 6 months to discover there was a problem! The problem with Skye is that she likes to complicate matters, so she has hypermobile (loose) hips and ankles as well as cerebral palsy causing muscle stiffness in other places! Bless her, it's no wonder she has trouble balancing!

[sneezecakesmum]

muscle weakness and muscle tightness do seem to go together. DGS has hypertonic movements on initiating a movement but hyper mobile wrists and ankles. His hands bend almost onto his arm. yuk!