Early diagnosis in cerebral palsy Neurology, Psychiatry, Physical medicine

Cerebral palsy (CP) is the most common lifelong physical disability, affecting millions globally. Early detection and intervention are critical for optimizing developmental consequences and quality of life for children and their families, yet many children are diagnosed late. CP describes a group of disorders of the development of movement and posture, causing activity restriction that is attributed to disorders that occurred in the fetal or infant brain. The prevalence rate is ۱-۴ per ۱۰۰۰ live births globally, with higher rates in low- and middle-income countries. Most lesions original CP occur in the second half of gestation, when developmental activity in the brain reaches its high level. Differences in timing of the damage not only result in different lesions but also in different neuroplastic responses and different related neuropathologies. This turns CP into a heterogeneous object. This may mean that the best early diagnostics and the best intervention methods may differ for various subcategories of children with CP. Thus, in early diagnosis, predictive value of neuromotor and neurological tests, neuroimaging techniques, and neurophysiological assessments may be different. International clinical guidelines recommend diagnosis as early as possible using accurate assessment tools in the first months of life. However, many children worldwide lack access to valid early screening methods, thus delaying intervention. Prediction is best when complementary techniques are used in longitudinal series. Possibilities for early prediction of CP differ for infants admitted to neonatal intensive care and other infants. In the former group, best prediction is accomplished with the combination of neuroimaging and the assessment of general movements (GMA), in the latter group, best prediction is based on carefully documented milestones and neurological evaluation. GM Assessment is a highly accurate clinical tool for detecting infants at high probability of CP.