Essentials for diagnosis
(1) The family members have congenital hereditary diseases.
(2) The early symptoms are various, the commonly-seen one being hypermyotonia. When replacing the diaper or bathing the infantile patient, the mother may feel stiffness of the body, or hypomyotonia, flaccidity of the body and spontaneous hypokinesis in the child. Symptoms may occur of primary hyporeflexia or hyperreflexia, weak cry, declined strength of sucking, onset of spasm in newborns, etc..
(3) Clinical manifestations
1. Retarded development of motor ability: Dyskinesia of various degrees exists in patients with cerebral palsy. In mild cases, development of grand motor ability may be normal so attention should be paid to the dysfunction in development of fine motor ability.
2. Abnormal postures: Experienced doctors can judge whether the child is normal or not only according to the infantile postures of being carried or lying in bed. Postures are divided into two types of static postures and dynamic postures. Abnormal static postures include posture of tonic neck reflex, rigidity of limbs, opisthotonus, and hemiplegia, etc.. Abnormal dynamic posture is the most important in hypomyotonia, ataxia and spasm such as choreic athetosis and torsion spasm, spastic hemiplegic gait, spastic paraparetic gait, cerebellar ataxic gait.
3. Abnormal reflex: Abnormal reflex and abnormal Vojta posture reflex during the infantile development are of great significance for the diagnosis of cerebral palsy.
Abnormal reflex includes two parts, one is the reflex which should have disappeared still exists, the other is abnormality of reflex type. The primary reflex such as tonic neck reflex, tonic labyrinthine reflex and grasp reflex still exists at the age of 3 to 6 months in infantile patients with severe cerebral palsy. In the case of cerebral palsy, abnormality of reflex type like reference reflex sees extreme dorsiflexion of the head and neck with the posture of opisthotonus, or straightening lower limbs with intorsion which should flex in infantile patients of 5 to 6 months old, crossed lower limbs or claviform orthostatisrn. In the case of athetosis type, the patient has dorsal digital dorsiflexion of foot and involuntary movement when the patient is pulled up. In the case of spasm type, trunk-elevating reflex sees camptocormia when muscles of back are in marked extension. After4 to 5 months, the patient still has extension pronation of upper limbs with clenched hands. Athetosis type sees drooping head and difficulty in being pulled up.
4. Abnormal muscular tone: The commonly-seen abnormal muscular tone in infantile patients with cerebral palsy includes hypomyotonia, hypermyotonia, paramyotonia and incoordination of muscular tone.