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Advice needed for a friend re:process to diagnose Cerebral Palsy

41 replies

TotalChaos · 22/01/2009 14:14

Hello ladies. Would appreciate advice on behalf of a friend.

Her eight month old baby is being referred to a paed, and CP has been mentioned. Her baby can if laid on front, lift their head but other than roll back to front the baby can't roll or sit up at all unaided. If propped on a cushion baby flops over. Also her
baby cannot weight bear on arms - ie pushing up, or legs at all. Arms, leg and trunk muscles are very, very weak.

Her baby did go through some birth trauma, and has been under physio six 6 weeks old.

My friend is naturally rather concerned, and wonders what is likely to happen next, and if they are likely to do an MRI scan to diagnose.

Many thanks

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sarah293 · 22/01/2009 14:16

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SparklyGothKat · 22/01/2009 14:17

My ds1 and Dd1 were both diagnosed after an MRI scan.

We went through a lot of different tests with Ds1 as he doesn't have typical CP, but was finally diagnosed at 2.5 years after an MRI scan.

TotalChaos · 22/01/2009 14:18

Thanks for the speedy responses Riven and Sparkly. Can I ask what tests the paed is likely to do? And whether the paed would diagnose straight away or they would do a wait and see?

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SparklyGothKat · 22/01/2009 14:20

Ds1 had blood tests to test for angelmans and an MRI, Dd1 had just an MRI, she was floppy and unable to support herself at 10 months old, so was referred to Ds1's consultant.

sarah293 · 22/01/2009 14:21

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SparklyGothKat · 22/01/2009 14:24

yes Riven is right, it took us 2 years to get a dx of CP for DS1, he has modarate CP and it was only when we went to GOSH it was finally dxd.

TotalChaos · 22/01/2009 14:27

so - consultant is likely to arrange for bloods and an MRI to rule out genetic conditions/muscular problems, and arrange OT and more physio??? do these hospital appointments tend to come through quickly (i.e. within a few months). My experience has been with community paeds that literally take years.... And is CP diagnosed more from problems with movements etc than from MRI results? Sorry for the noddy questions, I just want to be able to tell her something honest but in a non scary way iyswim.

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TotalChaos · 22/01/2009 14:28

can I ask why it took 2 years to get a DX? Is it because of the wait and see approach rather than because of delays in seeing consultants etc?

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SparklyGothKat · 22/01/2009 14:29

dd1 was referred at 10 months seen at 12 months, MRI done the following week, and dxd at 13 months. It can be fast but as I said it took 2 years with DS1

SparklyGothKat · 22/01/2009 14:31

It took 2 years because the consultant at the local hpsital had no idea..I asked if Ds1 had CP at 18 months old and was told NO! Within an hour of walking into GOSH the doctor knew what was wrong!

TotalChaos · 22/01/2009 14:37

oh gosh how very frustrating for you. was DS1 getting physio etc anyway at that point or did the delay cause problems?

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SparklyGothKat · 22/01/2009 14:48

He didn't have physio till he was seen at GOSH. As a result his left leg tighten a huge amount, he had to have surgery last year.

sarah293 · 22/01/2009 14:49

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sarah293 · 22/01/2009 14:50

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SparklyGothKat · 22/01/2009 14:50

There is pics on my profile of Ds1 after the op, and one of his feet after the plaster was removed. He used to walk on his toes and after he was able to put his foot flat

SparklyGothKat · 22/01/2009 14:52

Oh bugger, sorry forgot Riven lol.

Yes I have 2 with CP, DS1 has modarate CP and Dd1 has mild CP. DS1 is mobile but needs a wheelchair for distance, DD1 is able to walk but her balance is poor

sarah293 · 22/01/2009 14:53

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SparklyGothKat · 22/01/2009 14:56

sorry, will try and find your email. I will phone you in a bit (after school run) and will sort it out.

TotalChaos · 22/01/2009 14:56

oh how awful Sparkly.

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TotalChaos · 22/01/2009 14:57

thanks for the further info ladies.

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anonandlikeit · 22/01/2009 16:45

ds2 has never had an MRI. He has CP, asd etc.
He was born at 28 wks & always very delayed so monitored form birth.
The physio first treated him for low muscle tone & developmental delay.
His dx changed at about 2.5 when he was dx'd with CP.
Over the 1st couple of yrs they discussed quad CP, hemiplegia (as he does have one side stronger than the other) but finaly ettled on a dx of spastic diplega which means mainly his legs are effected.
We were offered an MRI but TBH at the time his lungs were still recovering & we just did not want to put him through a GA as he was gettign teh physio, OT etc anyway so the dx was for our benefit not his.
The paed gave the dx based on history & clinical presentation rather than MRI.

I must admit to being a bit curious now as to what an MRI would show especially given his ASD & learning difficulties as well.

I think it may be up to your friend along wiht the dr's to decide if she would like an MRI or to take the wait & see approach. As long as her baby is getting the support he needs & as the others have said if they rule out other causes.

TotalChaos · 22/01/2009 16:59

thanks, will let her know the MRI isn't inevitable.

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laumiere · 22/01/2009 23:29

Another for non MRI. DS1 was born at 31 weeks, was hypotonic (floppy) at four days, but was only diagnosed at 19mo when he couldn't walk or talk.

We've had blood tests for Downs, Fragile X and anaemia. DS1 has had orthotics since 9 months, physio since 19mo and is currently 28mo. He's linked to a local children's centre where all of his interventions happen and has a MAPP as well.

I don't know if this will help your friend, but this is what we posted on our blogs when DS1 was diagnosed:
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As you may know, we took Michael to be assessed on 19th February.

Michael has diplegic cerebral palsy. We are telling you this because Michael is and always will be a beautiful, intelligent and happy boy, and we want everyone to treat him normally and not ask why he isn?t doing this or that by such and such an age.

What cerebral palsy is:

CP is a non-progressive collection of symptoms caused by an injury to a developing brain. It varies in severity and in which limbs it affects and two children with the same diagnosis may have completely different experiences. CP affects the way muscles work because the nerves in the muscles fire incorrectly, causing muscles to get too tight (spastic) or too loose (hypotonic). It isn?t genetic and it won?t get worse. Michael?s is likely to have been caused by his early arrival at 31 weeks.

What it means:

Diplegic cerebral palsy is an official medical tag for Michael having some muscle weakness in his pelvis (which is what makes him wobble) and some tightness in his ankles and hamstrings (which is what makes him unwilling to walk). Diplegic means that his legs are affected more severely than his arms. Michael also has hypotonia, which means that his speech may be a little slow to develop, but that it will happen. He will walk, but it will take some time and he may need some extra support outdoors for the time being. He also has hypermobile joints, which means he is very flexible.

What this does NOT mean:

that Michael will not walk, run or play football (he just may take a year or two longer to get there), that his lifespan will be shortened, that his quality of life will be affected or made less in any way, or that he can?t do what other children can do. He is our Michael and he is no different to how he has ever been.

What this DOES mean is that we have a programme of exercises to do with him, that he will need to start swimming classes and that we will be able to get all of our appointments at Kaleidoscope Children?s Centre in Lewisham. We will have a physiotherapist, a speech and language therapist, and will be put in contact with the Lewisham Education team to make sure when he starts school and nursery that any support he may need will be there. The team will also have a walker like his one at home made for him but at the right height so that he will have support to walk outdoors more.

On the plus side, even though Michael?s version of cerebral palsy is on the mild to moderate part of the scale, we still may qualify for ?portage? which is pre-school education that comes to your home. In the longer term we hope to help Michael to minimise any problems he may have so that by the time he?s 14 or 15 he?ll just need to swim and to do some exercises.

In the short term you?re unlikely to notice anything much different, and we?re very keen that Michael should be treated the same as he?s always been. All that?s changed is now we can get help and support to make sure Michael has support for any challenges that come his way instead of struggling to be listened to. We are a strong family and we will be fine.

We?re posting this to give you a chance to ask us any questions you want to. We don?t want or need any replies saying ?hugs? or ?I?m so sorry?, as there is nothing to be sorry about, but we?re happy to answer anything you want to ask.

A diagnosis is not the end of the world, and often it can be the start of a really positive way to move forward and support your baby.

sarah293 · 23/01/2009 08:16

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laumiere · 23/01/2009 12:24

Hi Riven, I'd quite like an MRI, as it would be useful to see if DS's speech centre is affected by the CP, or if he's just a late talker. DH is not sure though as DS would have to be under a general anaesthetic and he's worried about risks.