Algorithm for the evaluation of the child with cerebral palsy

CP: cerebral palsy; EEG: electroencephalogram; MRI: magnetic resonance imaging; CT: computed tomography, TORCH: toxoplasmosis, other, rubella, cytomegalovirus, herpes simplex virus.
* CP is generally classified into one of several subtypes based upon the type and distribution of motor abnormalities, which often correlate to location of injury. However, it is important to recognize that there is substantial overlap in these classifications and clinical features often change over time. For further details, refer to separate UpToDate topics on clinical features of CP.
¶ Thrombophilia testing is not necessary for most patients with known or presumed perinatal stroke. However, testing may be warranted if there is a strong family history of thrombosis or if the stroke occurred outside of the perinatal period. For details of laboratory evaluation for thrombophilia, refer to separate UpToDate content on thrombophilia testing in children.
Δ Metabolic and genetic testing are generally warranted if there are atypical symptoms or atypical MRI findings, or if no etiology is identified by clinical history and neuroimaging. Findings that might suggest a metabolic or genetic etiology include deterioration or episodes of metabolic decompensation, dysmorphic features, and/or a family history or childhood neurologic disorder associated with CP. For additional details, refer to UpToDate topic on evaluation and diagnosis of CP and separate topics on inborn errors of metabolism.
◊ For details of evaluation for suspected congenital infection, refer to separate UpToDate content on TORCH infections and individual topics on each infection.