How Cerebral Palsy Is Diagnosed

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The diagnosis of cerebral palsy requires a careful and methodical process that relies largely on observation and clinical examination. If you suspect a diagnosis, an understanding of the process can help alleviate concerns.

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Parent Observations

Children who have cerebral palsy may display a variety of symptoms that are central to the diagnosis of the condition. Symptoms include motor weakness of the face, arms, hands, legs or trunk, stiff and jerky movements or floppy muscles, speech that is spastic and difficult to understand, problems chewing and swallowing, and cognitive deficits.

As a parent or caregiver, noticing these symptoms may be stressful and concerning. To make sure they are addressed appropriately, it may be helpful to jot down specifics about them—timing, activities before/after, and more can be helpful to a healthcare provider during your communication.

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Labs and Tests

There are several tests that support and confirm the diagnosis of cerebral palsy, the most important of which is a clinical history and physical examination.

Clinical History and Physical Examination

Clinical history can identify events such as traumatic injuries, childhood infections and illnesses such as digestive, breathing and heart problems that can cause symptoms that appear similar to those of cerebral palsy, particularly in very young babies.

An evaluation of a child’s abilities using a detailed neurological exam can be 90% accurate in diagnosing cerebral palsy.

A few other methods of testing a child’s abilities include the Prechtl Qualitative Assessment of General Movements and the Hammersmith Infant Neurological Examination, both of which systematically assess and score a child’s physical and cognitive abilities on a scale.

Blood Tests 

Metabolic syndromes that are characterized by symptoms similar to those of cerebral palsy are expected to show blood test abnormalities, which can help in differentiating the conditions.

Blood tests are not expected to show abnormalities in cerebral palsy.

A blood test may also be considered if a child with symptoms of cerebral palsy has symptoms of an illness, organ failure or an infection.

Genetic Tests 

Genetic tests may help in identifying genetic abnormalities associated with cerebral palsy. Cerebral palsy is only rarely associated with verifiable genetic defects, and the greater value of genetic testing lies in the diagnosis of other conditions that are clinically similar to cerebral palsy and that have known genetic patterns.

Not everyone is open to having a genetic test. If you have concerns, talk to your healthcare provider. Also, discuss with your partner—planning for what to do when results are ready may help both of you cope and support each other better.

Electroencephalogram (EEG)

Some children with cerebral palsy have seizures. Some types of epilepsy that are not associated with cerebral palsy can have a profound impact on childhood development. In these types of seizure disorders, cognition may be impaired in a manner that is clinically similar to the cognitive deficits seen in cerebral palsy, and an EEG can help identify subclinical (not obvious) seizures. 

Nerve Conduction Studies (NCV) and Electromyography (EMG)

Some muscle and spine diseases may cause weakness that begins at a very early age. Nerve and muscle abnormalities are not characteristic of cerebral palsy, and therefore abnormal patterns on these tests can help rule in other conditions and rule out cerebral palsy.


Brain imaging generally does not confirm cerebral palsy itself, but it can identify one of the other conditions that may produce symptoms similar to those of cerebral palsy.

Brain CT

The brain CT scan of a child with cerebral palsy may be normal or may show evidence of a stroke, or anatomical abnormalities. Patterns suggesting that a child’s symptoms are not cerebral palsy include an infection, fractures, bleeding, a tumor or hydrocephalus.

Brain MRI

A brain MRI is a more detailed imaging study of the brain than a CT scan. The presence of some types of malformations, as well as abnormalities suggestive of prior ischemic injuries (lack of blood flow) to the white or gray matter of the brain, may support the diagnosis of cerebral palsy. There are certain MRI findings that may point to other conditions such as cerebral adrenoleukodystrophy.

In both of these imaging tests, a child (and caregiver) may feel fearful. Ask if there's anything that can be done to help ease the experience for the child—activities, having someone nearby, or using specific kid-friendly language may be something the healthcare provider can offer.

Differential Diagnosis

The treatment, management, and prognosis of cerebral palsy differ from that of other similar conditions, and this is one of the reasons that accurate diagnosis is so important. Some of these conditions are associated with a clear hereditary risk, and therefore identification of the condition in one child can help parents with early recognition and treatment of their other children, in addition to providing information to the whole family that can be useful in reproductive planning.

Shaken Baby Syndrome 

A condition caused by repeated trauma—shaken baby syndrome—can affect young children of all ages, and is more common in older infants than in newborns. Shaken baby syndrome is characterized by skull fractures, hemorrhage (bleeding) in the brain, and often trauma to other areas of the body.

Depending on when the trauma begins, shaken baby syndrome can result in a loss of cognitive skills that have already begun to emerge, while cerebral palsy is characterized by a lack of emerging skills.

Rett Syndrome 

A rare condition that generally affects girls, Rett syndrome may cause a lack of motor control and cognitive deficits. The biggest differences between the conditions are that children with Rett syndrome generally appear to develop normally for 6 to 12 months, and then show a decline in function, while children with cerebral palsy do not attain developmental milestones.

Autism Spectrum Disorder 

With symptoms that can manifest as cognitive and behavioral deficits, autism spectrum disorder can cause motor or speech deficits with characteristics that may be mistaken for cerebral palsy or the other way around. 

Metabolic Syndromes

Certain inherited metabolic disorders such as Tay Sacks disease, Noonan Syndrome, Lesch-Nyan syndrome, and Neimann-Pick disease can all have features of motor weakness and cognitive deficits that may be mistaken for cerebral palsy—and cerebral palsy can be mistaken for these conditions.

In addition to some trademark physical features, metabolic syndromes often show abnormalities on specialized blood tests, which can help in differentiating them from each other and from cerebral palsy.


Encephalitis, which is inflammation of the brain, can cause profound symptoms ranging from seizures to paralysis to unresponsiveness. There are two main categories of encephalitis, which are primary and secondary.

  • Primary Encephalitis: This is due to a virus or other infectious agent directly infecting the brain. It is characterized by rapid onset, and has evidence of infection and inflammation on blood tests, brain CT, brain MRI or in lumbar fluid. 
  • Secondary Encephalitis: This is due to the body's immune system "mistakenly" attacking the brain, sometimes after an infection somewhere else in the body. There may be associated fevers and usually blood tests, brain CT, brain MRI and lumbar fluid show evidence of inflammation. 

Spinal Muscular Atrophy 

A disorder that causes the loss of motor neurons in the spine, it can begin during infancy, childhood, or adulthood. The form of spinal muscular atrophy that begins during infancy can be devastating, causing varying impacts on motor function. The motor weakness of early onset spinal muscular atrophy, also often referred to as SMA type 1, is more debilitating than that of cerebral palsy.

Cerebral Adrenoleukodystrophy

A rare disorder characterized by visual deficits and cognitive decline, cerebral adrenoleukodystrophy predominantly affects boys. The key differences between adrenoleukodystrophy and cerebral palsy are that children with cerebral adrenoleukodystrophy have white matter abnormalities on their brain MRI and the condition causes a decline in cognitive and motor function, not a lack of development of skills as in cerebral palsy. 

Muscular Dystrophy 

There are several types of muscular dystrophy, all characterized by weakness and lack of muscle tone. The differences between cerebral palsy and muscular dystrophy are that muscular dystrophy is usually not associated with cognitive deficits, and the muscle weakness of muscular dystrophy can be diagnosed as being caused by muscle disease through a physical examination and by EMG/ NCV studies.

Frequently Asked Questions

  • How is cerebral palsy diagnosed?

    The diagnosis is based primarily on observable symptoms by caregivers in tandem with a physical exam and a review of the child's medical history. The healthcare provider will look for signs like abnormal muscle tone, motor development, and reflexes. Imaging tests like an MRI can aid in the diagnosis mainly by excluding other causes. Genetic tests may also help support the diagnosis.

  • What type of healthcare provider diagnoses cerebral palsy?

    Pediatric neurologists (a.k.a. child neurologists) are doctors specially trained in childhood diseases of the brain, spinal cord, and nerves. Because the diagnosis of cerebral palsy requires specialist insight and evaluation, these healthcare providers are generally best suited to determine if your child has the disorder.

  • What early signs or symptoms might lead you to suspect cerebral palsy?

    The first signs are often noticed when a baby’s body feels rigid or floppy when lifted. Their head may fall back when picked up, or their back and neck may overextend when cradled. Noticeable delays, such as the inability to roll over or coordinate hand movements, are also common signs. Older babies may crawl in a lopsided manner or will scoot on their bottoms or hop on their knees rather than crawl on all fours.

  • At what age is cerebral palsy typically diagnosed?

    Most children with cerebral palsy are diagnosed before age 2. Those with mild cerebral palsy may not be diagnosed until they are older and, in some cases, when they are adults.

  • Can cerebral palsy be diagnosed in babies?

    Yes. If the symptoms are pronounced or severe, a neurologist can diagnose cerebral palsy at a very early age. A medical evaluation, called the Prechtl General Movement Assessment (GMA), measures spontaneous movements in babies 3 to 5 months of age and is one of the most accurate tests in diagnosing cerebral palsy in babies.

  • How accurate is a cerebral palsy diagnosis?

    The combination of an MRI and GMA in babies under 5 months old has a sensitivity (true positive result) of around 98%. After 5 months, a physical, neurological, and developmental assessment with an MRI offers a sensitivity of around 90%. Still, because some cases are mild, it can take time before a definitive diagnosis is reached.

13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Heidi Moawad, MD
Heidi Moawad is a neurologist and expert in the field of brain health and neurological disorders. Dr. Moawad regularly writes and edits health and career content for medical books and publications.