How Cerebral Palsy in Premature Babies Is Diagnosed

Updated on May 04, 2023

Medically reviewed by Nicholas R. Metrus, MD

Cerebral palsy (CP) is a brain disorder that causes impaired movement. Cognitive and sensory problems, as well as epilepsy, also may be present.

Cerebral palsy can occur when part of the fetal brain fails to develop properly. An injury to the brain before, during, or after birth can also cause CP. Cerebral palsy is permanent: treatment may help someone with cerebral palsy to move better, but the underlying injury to the brain can’t be repaired. Cerebral palsy is also non-progressive. Although time might cause the symptoms to worsen, the injury to the brain won’t get any worse.

mother holding premature baby — Jill Lehmann Photography / Getty Images

Who Is at Risk?

The risk of cerebral palsy goes up dramatically for very premature babies. About 1 to 2 out of 1,000 babies born at full term will have CP. For babies born at less than 28 weeks gestation, though, the risk is 100 out of 1,000 surviving infants.

How to Tell If a Baby Has Cerebral Palsy

Most cases of cerebral palsy are diagnosed by the age of 2, unless the symptoms are quite mild in which case the diagnosis may be delayed. Many babies, especially those who were born premature, may show signs of an abnormality in the brain that disappear as they get older. If your baby is not meeting his or her milestones on time, even after adjusting for gestational age, then share your concerns with your pediatrician.

Diagnosis

Because there is no definitive test for cerebral palsy, healthcare providers will look at several things before making the diagnosis.First, they will talk to the parents and observe the child. The parents will be questioned about when the child learned to sit, stand, and walk, and the provider will evaluate the child’s posture, reflexes, and muscle tone.

The provider also may use an assessment scale to help decide if a child has CP or not, and an MRI may be ordered to look for abnormalities in the brain. Depending on a child's symptoms, they may order an EEG if there is suspicion for seizure activity, as well as an ophthalmologic and hearing screening, and speech and swallow evaluation.

Cerebral Palsy Doctor Discussion Guide

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Treatment

Although cerebral palsy cannot be cured, treatment can help symptoms to be less severe. Physical and occupational therapy can help people walk better, stretch their muscles, and learn to overcome physical challenges to care for themselves and participate in day-to-day life. Speech therapy can help treat swallowing and communication problems, and counseling can help families cope with the diagnosis.

Braces can help people walk better and have better balance, and wheelchairs can be used for those who aren’t able to walk. Surgery also can correct some problems in the muscles. If there is high suspicion for seizure activity, a workup is completed and epilepsy treatment initiated.

Prevention

Preventing preterm birth is the best way to prevent cerebral palsy. If you are pregnant and have risk factors for premature birth, then try to reduce your risk however you can. Magnesium sulfate may help reduce the risk of cerebral palsy among parents who expect to deliver early, although more research is needed. The risk factor assessment should be done in partnership with a physician. Magnesium sulfate should not be used without supervision.

It is important to note that events right around the time of birth only rarely cause cerebral palsy. Although it was once thought that lack of oxygen during birth was a major cause of CP among otherwise healthy newborns, less than 10% of cases of CP occur during birth.

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