Morgan Catherine, Fahey Michael, Roy Bithi, Novak Iona
School of Medicine, Paediatrics and Child Health, Sydney, New South Wales, Australia.
Cerebral Palsy Alliance, School of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2018 Oct;54(10):1159-1164. doi: 10.1111/jpc.14177.
More than 50% of infants with cerebral palsy (CP) are born at or near term, with the vast majority having pre- or perinatally acquired CP. While some have a clinical history predictive of CP, such as neonatal encephalopathy or neonatal stroke, others have no readily identifiable risk factors. Paediatricians are often required to discriminate generalised motor delay from a variety of other diagnoses, including CP. This paper outlines known causal pathways to CP in term-born infants with a focus on differential diagnosis. Early and accurate diagnosis is important as it allows prompt access to early intervention during the critical periods of brain development. A combination of clinical history taking, standard clinical examination, neuroimaging and genetic testing should be started at the time of referral. Attention to the investigation of common comorbidities of CP, including feeding and sleep difficulties, and referral to early intervention are recommended.
超过50%的脑瘫（CP）患儿在足月或接近足月时出生，绝大多数患儿的脑瘫是在产前或围产期获得的。虽然有些患儿有预测脑瘫的临床病史，如新生儿脑病或新生儿中风，但其他患儿没有容易识别的危险因素。儿科医生经常需要区分一般性运动发育迟缓与包括脑瘫在内的各种其他诊断。本文概述了足月出生婴儿脑瘫的已知病因途径，重点是鉴别诊断。早期准确的诊断很重要，因为它能在大脑发育的关键时期及时获得早期干预。在转诊时应开始结合临床病史采集、标准临床检查、神经影像学检查和基因检测。建议关注脑瘫常见合并症的调查，包括喂养和睡眠困难，并转诊至早期干预机构。
