Special Needs

early signs of CP?

My 4 month old son has tortocollis and we have been in PT for 3 weeks now, he has a hard time looking left but its getting better. I still notice that he doesn't use his left arm/hand as much. Occasionally he will but not nearly as much as the right hand. Could this be from the tortocollis? He is getting better at tummy time, still not a huge fan but holding his head up and has rolled a few times. When I hold him up to stand he will put weight on his legs but he doesn't jump or anything. His movements seem jerky to me, not controlled. Are these early signs of CP? I had a normal pregnancy, he was a VBAC and came pretty fast. No issues at birth. 

Do these seem like early signs? 

Re: early signs of CP?

  • They could be but they may not be either.  4mos is still pretty early to tell.  Is your son in EI for the torticollis?  If you are worried about his development at all and is not currently in EI (early intervention) then I would give them a call.  I wasn't sure if the PT he was already in was private or EI therapy.

    I have a son with CP. He had undiagnosed torticollis (the pedi would not diagnose him with it but EI took one look at him and started working with him right away....then apparently they noticed other issues and kept working with him).  For me, the biggest sign came at 6mos old which was my mother stating that he was right hand dominant.  I already knew babies do not choose their dominant hand at that point so I watched more closely and realized she was right.  My son was late to roll, had ankle clonus, his eyes crossed intermittently, and the tone in his muscles varied.  I consider my son, now 5.5yr, to have moderate CP.

    CP has such a wide variety in the depth of disability.  As in, some people diagnosed with CP can walk, run, etc. while others are completely wheelchair bound, cannot speak, etc.  There is no "test" that says 100% for certain that a child has CP.  It is diagnosed more out of case history and physical exam.  My son had a MRI which showed PVL (periventricular leukomalacia - could be spelled wrong!).  MRIs simply help to support a diagnosis but do not give a diagnosis of CP.
  • Something else I noticed was that I typically had to bend his legs during diaper changes.  That little nugget is more to show you the amount of tone he had in his legs.  :-)
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  • My 14 yr old has quad cp and hypertonia as well as distonia, I agree 100% with the above! Contact EI, , it would be a good idea to have an eval done as well. What are pt's thoughts?
  • Signs of cerebral palsy.
    • Hypotonia – decreased muscle tone or tension (flaccid, relaxed, or floppy limbs)
    • Hypertonia – increased muscle tone or tension (stiff or rigid limbs)
    • Dystonia – fluctuating muscle tone or tension (too loose at times and too tight at others)
    • Mixed – the trunk of the body may be hypotonic while the arms and legs are hypertonic
    • Muscle spasms – sometimes painful, involuntary muscular contraction
    • Fixed joints – joints that are effectively fused together preventing proper motion
    • Abnormal neck or truncal tone – decreased hypotonic or increased hypertonic, depending on age and cerebral palsy type
    • Clonus – muscular spasms with regular contractions
      • Ankle/foot clonus – spasmodic abnormal movement of the foot
      • Wrist clonus – spasmodic movement of the hand

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