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. 2008 Oct;153(4):466-72.
doi: 10.1016/j.jpeds.2008.04.013. Epub 2008 Jun 2.

An algorithm for identifying and classifying cerebral palsy in young children

Karl C K Kuban  1 , Elizabeth N Allred, Michael O'Shea, Nigel Paneth, Marcello Pagano, Alan Leviton; ELGAN Study Cerebral Palsy-Algorithm Group
Collaborators, Affiliations

An algorithm for identifying and classifying cerebral palsy in young children

Karl C K Kuban et al. J Pediatr. 2008 Oct.

Abstract

Objective: To develop an algorithm on the basis of data obtained with a reliable, standardized neurological examination and report the prevalence of cerebral palsy (CP) subtypes (diparesis, hemiparesis, and quadriparesis) in a cohort of 2-year-old children born before 28 weeks gestation.

Study design: We compared children with CP subtypes on extent of handicap and frequency of microcephaly, cognitive impairment, and screening positive for autism.

Results: Of the 1056 children examined, 11.4% (120) were given an algorithm-based classification of CP. Of these children, 31% had diparesis, 17% had hemiparesis, and 52% had quadriparesis. Children with quadriparesis were 9 times more likely than children with diparesis (76% versus 8%) to be more highly impaired and 5 times more likely than children with diparesis to be microcephalic (43% versus 8%). They were more than twice as likely as children with diparesis to have a score <70 on the mental scale of the BSID-II (75% versus 34%) and had the highest rate of the Modified Checklist for Autism in Toddlers positivity (76%) compared with children with diparesis (30%) and children without CP (18%).

Conclusion: We developed an algorithm that classifies CP subtypes, which should permit comparison among studies. Extent of gross motor dysfunction and rates of co-morbidities are highest in children with quadriparesis and lowest in children with diparesis.

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Conflict of interest statement

The authors declared no potential conflicts of interest

Figures

Figure
Figure
CP classification flow sheet. The algorithm begins by identifying laterality and number of features seen in the lower extremities (column 1). Then based on laterality and extent of findings in the upper extremities (column 2), a CP diagnosis is rendered (column 3).
See this image and copyright information in PMC

Comment in

References

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